'High social cost' adults can be predicted from as young as three, says study

A small fraction of the population is likely to account for the majority of societal costs, according to new research into the impact of childhood disadvantage on later life.

The research – based on New Zealand data but involving an international team – also revealed that such “high cost” adults can be predicted when as young as three years old from an assessment of their brain health.

The study, which followed around 1,000 children from birth, found that at 38 years of age just 22% of the group accounted for 81% of its criminal convictions, 78% of pharmaceutical prescriptions, and 66% of welfare benefits.



“About 20% of the population is using the lion’s share of a wide array of public services and we found that the same people use most of the national health service, the criminal courts, insurance claims for disabling injury, pharmaceutical prescriptions and social welfare benefits,” said Terrie Moffitt, co-author of the research from Duke University, North Carolina.

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But she cautioned that the results should elicit compassion rather than being used to stigmatise individuals.



“Very often when we think of the people who are the greatest burden on society we can jump to the conclusion these are lazy layabouts who are happy to live off the public purse,” she said. “But in fact what this research suggests is, yes, there is a very high cost fragment of society, but these are people who weren’t very well prepared as pre-schoolers for making their way into the really modern, fast-paced, higher technical, education-dependant job markets.”

Josh Hillman, director of education at the Nuffield Foundation, who was not involved in the research, agreed, adding that while the study was based on children in New Zealand, the findings are likely to apply in other developed countries, including the UK.

“The implications are that we have really underestimated the long-term benefits of investment in early years education for disadvantaged children, both in terms of the benefits for the children themselves but also in terms of the payback for the public purse,” he said.



Writing in the journal Nature Human Behaviour, the team from the US, UK and New Zealand, described how they analysed data collected from 1,037 children born in Dunedin, New Zealand, who took part in what is known as the Dunedin Longitudinal Study.

Around 95% of the children were followed up until the age of 38, when data was collected from personal interviews and a host of national administrative databases, allowing the team the rare chance to explore connections between factors in childhood and a host of outcomes in adulthood.

The results reveal that 20% of the group accounted for the majority share for each of the different resources or services considered, ranging from criminal convictions to welfare benefits and cigarettes smoked.

But they also found that many individuals cropped up as heavy users of multiple services. “They did tend to be the same individuals who were showing up again and again and again in each of the different government databases,” said Moffitt.

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Indeed, analysis of heavy users of three of more services revealed that the same 22% of the cohort accounted for 81% of the group’s criminal convictions, 77% of fatherless children, 36% of injury insurance claims, 78% of prescriptions, 66% of welfare benefits and 40% of excess obese kilograms, as well as more than half of cigarettes smoked and nights spent in hospital.

It was possible to predict which of the children were most likely to grow up to become part of this high cost segment of society from measures of their socioeconomic background, experience of maltreatment, IQ and self-control, which were taken repeatedly from birth to age 11.



But the team also discovered that a rating of “brain health”, based on the combined results from a 45 minute-long assessment of motor skills, understanding of language, social behaviour and IQ at three years of age, was almost as accurate a predictive tool.

“Given two pre-schoolers about 80% of the time we can accurately predict which group they will end up in,” said Avshalom Caspi, another author of the research, also from Duke University.

Geoff Lindsay, director of the Centre for Educational Development, Appraisal and Research at the University of Warwick said the study adds powerful evidence in support of the need for research into early interventions.

Frances Gardner, professor of child and family psychology at the University of Oxford, described the new research as both novel and impressive in looking at the use of a wide range of services in adulthood. But, like Lindsay, she believes further work is needed to determine how to best ensure every child has a good start in life.

“On its own this study doesn’t tell us all that much about how to intervene or when, but it reassuring that the problems that we are trying to tackle in these childhood interventions have even stronger evidence of their long-term implications that we thought before,” she said.