Childhood forecasting of a small segment of the population with large economic burden
Childhood forecasting of a small segment of the population with large economic burden
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DOI：
10.1038/s41562-016-0005
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发表时间：
2017-01-01
影响因子：
29.9
通讯作者：
Moffitt, Terrie E.
中科院分区：
文献类型：
--
作者：
Caspi, Avshalom;Houts, Renate M.;Moffitt, Terrie E.
政策制定者对早年干预措施感兴趣，以减轻儿童风险。他们希望从长远来看，成年人的成绩会有所改善，从而带来投资回报。可以预期的回报规模在一定程度上取决于童年风险对成人结果的预测能力，但对于童年是否决定成年，人们存在分歧。我们将多个全国性的行政数据库和电子医疗记录与长达40年的达尼丁出生队列研究相结合，使用人口分割方法，以不同的方式测试儿童到成人的预测。由22%的队列组成的部分占该队列的伤害保险索赔的36%，超重肥胖公斤的40%，吸烟的54%，住院夜间的57%，福利福利的66%，无父抚育的77%，处方填写的78%，以及刑事定罪的81%。儿童时期的风险，包括三岁时大脑健康状况不佳，预测这一部分会产生很大的影响。对这一群体有效的早期干预措施可能会产生非常大的投资回报。
Policymakers are interested in early-years interventions to ameliorate childhood risks. They hope for improved adult outcomes in the long run that bring a return on investment. The size of the return that can be expected partly depends on how strongly childhood risks forecast adult outcomes, but there is disagreement about whether childhood determines adulthood. We integrated multiple nationwide administrative databases and electronic medical records with the four-decade-long Dunedin birth cohort study to test child-to-adult prediction in a different way, using a population-segmentation approach. A segment comprising 22% of the cohort accounted for 36% of the cohort's injury insurance claims; 40% of excess obese kilograms; 54% of cigarettes smoked; 57% of hospital nights; 66% of welfare benefits; 77% of fatherless child-rearing; 78% of prescription fills; and 81% of criminal convictions. Childhood risks, including poor brain health at three years of age, predicted this segment with large effect sizes. Early-years interventions that are effective for this population segment could yield very large returns on investment.