Promoting the health of young children, before 5 years
of age, could save society up to $65
billion in future health care costs, according to an
examination of childhood health conducted by
researchers at the Johns
Hopkins Bloomberg School of Public Health. The results
are published in the
May 15 issue of Academic Pediatrics.
"Our review found convincing evidence that the four
health problems we studied — early-life
tobacco exposure, unintentional injury, obesity and mental
health — constitute significant burdens on
the health of preschool-age children and are antecedents of
health problems across the life span,"
said Bernard Guyer, lead author of the study and the Zanvyl
Krieger Professor of Children's Health in
the Bloomberg School's Department of
Population, Family and Reproductive Health.
"These health problems affect approximately one-third
to one-half of children born in the U.S.,
and we estimated that total lifetime societal cost could be
about $50,000 per child, which translates
to $65 billion to $100 billion for the entire birth cohort
of children. The currently available research
justifies targeted investments in early childhood health
promotion as a means to averting future
health costs and improving overall health during their life
span."
Researchers conducted a systematic review of early
childhood interventions using multiple
health databases: PubMEd, PsycINFO, National Health Service
Economic Evaluation Database,
National Bureau of Economic Research working paper database
and EconLit. Guyer and his colleagues
examined the magnitude of the future effects of tobacco
exposure, unintentional injury, obesity and
mental health. They looked at prevalence of these issues
during the target age period, their cost
implications across the life span, the availability of
preventive interventions in this period of life and
evidence indicating that prevention of these problems early
in life would pay off or save costs in the
future.
Researchers found that the available evidence for the
effectiveness of intervention in this age
group was strongest in the case of preventing tobacco
exposure and controlling unintentional injuries.
Smoking impacts young children through prenatal
exposure and environmental tobacco smoke. In
the United States, an estimated 25 percent of children are
exposed to environmental tobacco smoke
by household members, and 500,000 babies are born annually
to mothers who smoke during pregnancy,
according to tobacco prevention studies. Environmental
tobacco smoke programs specifically aimed at
reducing exposure to children within the first five years
of life would produce an estimated cost
savings of $500 million.
Injuries are the leading cause of death, disabilities
and health care utilization for U.S. children
and teenagers between the ages of 1 and 19. Recent studies
have concluded that both fatal and
nonfatal injuries among children from infancy to 4 years
resulted in $4.7 billion for lifelong medical
costs and $14 billion for present and future productivity
losses.
While obesity among preschoolers has recently been
recognized as a major health problem, age-
appropriate prevention and intervention strategies are
still lacking. Researchers say they believe that
there is a need for carefully targeted research to examine
the relationship between early childhood
preventive interventions and health outcomes across the
life course.
"The four children's health topics selected
demonstrate that the policy solutions needed to
address them go well beyond the medical model of a doctor
treating a sick child," said Sai Ma,
corresponding author of the study and an assistant
scientist in the Bloomberg School's Department of
Population, Family and Reproductive Health. "Meeting the
underlying health needs of American
children will require decision makers and practitioners to
understand complex multiple determinants of
health and disease, as well as public health approaches
that involve family, community and national
interventions."
The study was written by Guyer, Ma, Holly Grason,
Kevin Frick, Deborah Perry, Alyssa Sharkey
and Jennifer McIntosh.
The research was supported by the Partnership for
America's Economic Success and the Zanvyl
and Isabelle Krieger Fund.