Intervene on poverty, maltreatment, low IQ, or self-control to improve outcomes.

Policymakers hope that early childhood interventions and support can help children achieve their full potential. Some small-scale studies have shown that these interventions are effective, but it would be good to be able to identify who needs these sorts of programs the most, so that limited resources are used optimally. If childhood interventions are effective, then they could alleviate costs in adulthood that are associated with these high-risk childhood behaviors.

A recent study published in Nature Human Behavior shows that a small proportion of the adult population is responsible for a large portion of the economic burden triggered by poor health and criminal behavior, and that this population can be predicted using early childhood risks and exposures. Therefore, interventions that address these risks could improve outcomes in future generations.

The study used the Dunedin Longitudinal Study, which is a population-representative birth cohort of 1,037 people in New Zealand. All participants in this study were born between 1972 and 1973, and this study assessed participants a dozen times between ages three and 38.

During the participants’ childhoods, researchers measured a number of childhood risk factors: growing up poor, exposure to maltreatment, low IQ, and poor self-control. These four risk factors are proven predictors of adult health and social outcomes and are therefore important targets in many early intervention programs.

Using the most recent data on participants, collected when they were 38 years old, the researchers looked at issues that increased participants' economic burden on society, such as welfare dependence. They found that these four childhood issues were shared by adults who placed the highest economic burden on society.

The association held even when the participants were separated out into eight groups of high-cost adult outcomes: low social welfare, fatherless children, smoking, excess weight, excessive hospital stays, high numbers of prescription refills, high numbers of injury claims, and crime. The four childhood issues—being poor, experiencing maltreatment, low IQ, and poor self-control—were associated with each of these eight economically burdensome adult outcomes. This finding held true for both men and women. At the population level, each of the four childhood exposures was a significant predictor of risk for more high-cost adult outcomes.

The researchers found that when these factors were considered together, their effectiveness as predictors was amplified. Additionally, adults who belonged to one high-cost category were more likely to belong to other high-cost categories based on how many of the childhood issues they had faced.

These findings have important implications for early childhood interventions. The researchers state that their data shows that the importance of early childhood risks in terms of possible adult outcomes has been underestimated. Though the researchers acknowledge the risk that this finding could be used to stigmatize children who suffer from these four issues, they hope that their findings can be used in a preventive way. Limiting the effects of these childhood disadvantages could help many people achieve better outcomes in adulthood, thereby alleviating our societal burden.