There is no higher return on investment that that which protects the happiness and wellbeing of future generations
We now know that Adverse Childhood Experiences (ACES) are the single biggest predictor for later problems in adult health and wellbeing.[i] In 2013 the UK government posed the question ‘How advisable is it for national or local policy-making bodies in the UK, with responsibility for child health or welfare, and control over spending, to switch investment more heavily to the early years?’[ii] It concluded:
“The short answer is there is general expert consensus that it is somewhere between economically worthwhile and imperative to invest more heavily, as a proportion of both local and national spend, in the very earliest months and years of life.”
Nine approaches to evaluating the outcomes of early years’ investment were reviewed in the associated report, with the following findings:
Every approach – even the most cautious and circumspect in its recommendations – found that returns on investment on well-designed early years’ interventions significantly exceeded their costs.
The benefits ranged from 75% to over 1,000% higher than costs, with rates of return on investment significantly and repeatedly shown to be higher than those obtained from most public and private investments.
Where a whole country has adopted a policy of investment in early years’ prevention, the returns are not merely financial but in strikingly better health for the whole population. The benefits span lower infant mortality at birth through to reduced heart, liver and lung disease in middle-age.
The logical links between the investments and the health benefits are described in the ‘Adverse Childhood Experiences’ (ACE) studies which reveal that for every 100 cases of child abuse society can expect to pay in middle or old age for (amongst a wide range of physical and mental health consequences): one additional case of liver disease, two additional cases of lung disease, six additional cases of serious heart disease and 16% higher rate of anti-depressant prescriptions
None of these estimates fully took account of the additional economic value of the knock-on effect that child abuse averted in one generation will itself result in a cumulative reduction in this dysfunction during future generations.
In 2017 the NSPCC calculated that the estimated average lifetime cost of non-fatal child maltreatment by a primary care-giver was £89,390 (with a 95% certainty that the costs fall between £44,896 and £145, 508).[iii]
And in the USA two influential reports [iv][v]concluded that:
The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion.`
[i] Heckman, James https://heckmanequation.org
[ii] Wave Trust (2013) Conception to age 2 – the age of opportunity, Appendix 4
[iii] Conti G, Morris S, Melnychuk M, Pizzo E (2017) The economic cost of child maltreatment in the UK, NSPCC
[iv] Xiangming Fang, Derek S. Brown Curtis Florence and James A. Mercy - The Economic Burden of Child Maltreatment in the United States And Implications for Prevention, published in Child Abuse and Neglect 2012 Feb; 36(2): 156–165.
[v] Haggerty RJ. Child health 2000: new pediatrics in the changing environment of children’s needs in the 21st century. Pediatrics. 1995;96:804–812.
UNICEF (2017) State of the World’s Children Report
Stiglitz, J.E. (2012) The Price of Inequality: How Today’s Divided Society Endangers our Future. W. W. Norton: London.
Wilkinson, R. and Pickett, K. (2009) The Spirit Level: Why More Equal Societies Almost Always Do Better. Allen Lane: London.