Financial cost of social exclusion: follow-up study of antisocial children into adulthood

Stephen Scott, Martin Knapp, Juliet Henderson, Barbara Maughan (2001)

Please note: this is a legacy publication from CPEC (formely PSSRU at LSE).

British Medical Journal 323 191-194

https://doi.org/10.1136/bmj.323.7306.191

Available online: 28 July 2001

Abstract
Objectives: To compare the cumulative costs of public services used through to adulthood by individuals with three levels of antisocial behaviour in childhood. Design: Costs applied to data of 10 year old children from the inner London longitudinal study selectively followed up to adulthood. Setting: Inner London borough. Participants: 142 individuals divided into three groups in childhood: no problems, conduct problems, and conduct disorder. Main outcome measures: Costs in 1998 prices for public services (excluding private, voluntary agency, indirect, and personal costs) used over and above basic universal provision. Results: By age 28, costs for individuals with conduct disorder were 10.0 times higher than for those with no problems (95% confidence interval of bootstrap ratio 3.6 to 20.9) and 3.5 times higher than for those with conduct problems (1.7 to 6.2). Mean individual total costs were £70 019 for the conduct disorder group (bootstrap mean difference from no problem group £62 898; £22 692 to £117 896) and £24 324 (£16 707; £6594 to £28 149) for the conduct problem group, compared with £7423 for the no problem group. In all groups crime incurred the greatest cost, followed by extra educational provision, foster and residential care, and state benefits; health costs were smaller. Parental social class had a relatively small effect on antisocial behaviour, and although substantial independent contributions came from being male, having a low reading age, and attending more than two primary schools, conduct disorder still predicted the greatest cost. Conclusions: Antisocial behaviour in childhood is a major predictor of how much an individual will cost society. The cost is large and falls on many agencies, yet few agencies contribute to prevention, which could be cost effective.