Gifted Issues Discussion homepage Forums Age or Ability Specific Forums Adult Richie Poulton, NZ (Dunedin Longitudinal Study)

FINDINGS:

(1) Using nationwide government administrative data bases and electronic medical records, we found that a small number of individuals accounted for a disproportionate amount of costly services in different health-care, criminal-justice and social-welfare systems. These findings about the concentration of social costs resemble the Pareto principle (named after the Italian economist, Vilfredo Pareto), which maintains that 80 percent of the ‘resources’ in a given system are attributable to 20 percent of the ‘users’.

(2) Across multiple different service sectors, we identified a high-need/high-cost group in the cohort of 1000 individuals we studied. This group made up only 22% of their age cohort, but they left a big footprint on costs of service delivery. By midlife, this small group was convicted for 81% of the crimes charged to the cohort; had filled 78% of all prescriptions for pharmaceutical drugs; accounted for 77% of the years in which their children were growing up fatherless; had received 66% of the cohort’s welfare benefit payments; occupied 57% of their cohort’s nights spent in a hospital bed; smoked 54% of the cohort’s tobacco cigarettes; carried 40% of the cohort’s kilograms of obese weight; and made 36% of injury insurance claims.

(3) The high-need/high-cost group of adults could be identified as young as age 3 years on the basis of their ‘brain health,’ a summary index derived from a brief pediatric examination that included a neurological evaluation and assessments of verbal comprehension, language development, motor skills, and social behaviour.

WHY ARE THESE FINDINGS IMPORTANT?

(1) The new findings suggest that the importance of childhood risks for poor adult outcomes has generally been underestimated. It is not news to service-delivery professionals that some individuals use more than their share of services. What is news is that the same group of individuals features in multiple service sectors and that these high-need/high-cost individuals can be identified as young children, with reasonable accuracy.

(2) To know whether early-years intervention can lift health and social wellbeing and reduce taxpayer costs we need to know how strongly early-years risk factors are tied to adult outcomes in the population. The strong connections uncovered in this study between brain health and economically burdensome outcomes encourage nations to invest in their so-called grey-matter infrastructure.

LIMITATIONS:

(1) We are aware of the potential for misusing these findings, for stigmatising and stereotyping. But there is no merit in blaming a person for economic burden following from childhood disadvantage. Instead, ameliorating the effects of childhood disadvantage through early-years support for families and children could benefit all members of a society by reducing costs.

(2) Our research is based on only one cohort in one part of the world, and needs to be replicated.