Childhood forecasting of a small segment of the population with large economic burden

Abstract

Policy-makers are interested in early-years interventions to ameliorate childhood risks. They hope for improved adult outcomes in the long run, bringing return on investment. How much return can be expected depends, partly, on how strongly childhood risks forecast adult outcomes. But there is disagreement about whether childhood determines adulthood. We integrated multiple nationwide administrative databases and electronic medical records with the four-decade Dunedin birth-cohort study to test child-to-adult prediction in a different way, by using a population-segmentation approach. A segment comprising one-fifth of the cohort accounted for 36% of the cohort’s injury insurance-claims; 40% of excess obese-kilograms; 54% of cigarettes smoked; 57% of hospital nights; 66% of welfare benefits; 77% of fatherless childrearing; 78% of prescription fills; and 81% of criminal convictions. Childhood risks, including poor age-three brain health, predicted this segment with large effect sizes. Early-years interventions effective with this population segment could yield very large returns on investment.

Social Policy: Targeting programmes effectively

“…A new study by Caspi et al 3 contributes substantially to the body of evidence supporting targeted early childhood programs by analyzing rich longitudinal data from a large and representative sample of New Zealand children. The authors follow subjects over their lives from birth through age 38 4 and enrich their primary sample with matched individual records from a variety of administrative data sources.…”

Widespread covariation of early environmental exposures and trait-associated polygenic variation

“…For instance, maternal smoking during pregnancy, socioeconomic deprivation, and time spent watching television and playing video games are associated with lower academic achievement (1)(2)(3)(4)(5)(6)(7)(8)(9). Harsh parental physical discipline such as hitting has been linked to increased emotional and behavioral problems including aggression in adolescence (10)(11)(12)(13)(14).…”

Preventive healthcare strategies are a matter of social justice

“…The Dunedin Multidisciplinary Health and Development Study followed a large cohort of New Zealanders from early childhood to age 38 2. A subgroup analysis of the cohort identified a group at higher risk as early as age 3 years, and these people were assessed to contribute to the highest economic and social burdens.…”