{
  "abstract": "Background Early childhood disadvantages (up to age 5) can have life-long effects on health and wellbeing. Methods of birth cohort microsimulation can capture these long-term effects and the associated public cost savings, which are hard to estimate using conventional methods (e.g. trials) because the effects may take decades to manifest. We aimed to quantify the long-term effects and public costs of six different early years disadvantages up to age 17 in the UK and Bradford, a multi-ethnic deprived local authority, using a microsimulation model based on the UK Millennium Cohort Study.Methods Using a cohort of 15,380 children from the Millenium Cohort Study (MCS) we model early years risk factors (conception to age 5) and subsequent outcomes up to age 17. We choose six risk factors: having a teenage mother, preterm birth, low birthweight (for gestational age), low height (age 5); disability (age 5), and school readiness (age 5). The causal effect parameters used in our microsimulation model are estimated using regressions based on Directed Acyclic Graphs (DAGs) which clearly set out our causal inference assumptions. We quantify a set of policy-relevant outcomes and their annual public costs for the UK and calibrate to Bradford based on local prevalence and population data. We assess the robustness of our findings to alternative assumptions and measures.Results The public cost up to age 17 ranged between £86,058 [44,114–128,002] per 1,000 children for having a teenage mother, or £58,544 for each annual Bradford cohort to £432,920 [263,733–600,108] for school readiness or £1,872,265 for each Bradford cohort. The wellbeing impact ranged from 21 [-37–78] WELLBYs per 1,000 children for low birth weight or 20 per Bradford cohort, to 268 [245–290] for school readiness or 1,160 per Bradford cohort. Each WELLBY is valued by the UK Treasury at £13,000.Conclusion Improving school readiness yielded a larger wellbeing gain and public cost savings per child beneficiary than eliminating any of the other disadvantages we examined, but less than reducing early childhood poverty by moving families from the bottom income quintile to the next. When combined with evidence on short term effects of interventions, comparative long-term estimates of this kind may help policymakers prioritise and justify early years investments.We will report full results for the Uk and Bradford at the meeting, including a ready reckoner table of the long-term benefits and costs of reducing each childhood disadvantage.",
  "authors": [
    {
      "affiliations": [
        "Centre for Health Economics, University of York, York, UK"
      ],
      "name": "Shrathinth Venkatesh"
    },
    {
      "affiliations": [
        "Centre for Health Economics, University of York, York, UK"
      ],
      "name": "Ieva Skarda"
    },
    {
      "affiliations": [
        "Centre for Longitudinal Studies, University College London, London, UK"
      ],
      "name": "Aase Villadsen"
    },
    {
      "affiliations": [
        "Institute of Psychological Sciences, University of Leeds, Leeds, UK"
      ],
      "name": "Matthew Warburton"
    },
    {
      "affiliations": [
        "Health Sciences, University of York, York, UK"
      ],
      "name": "Liina Mansukoski"
    },
    {
      "affiliations": [
        "Department of Health Policy, London School of Economics and Political Science, London, UK"
      ],
      "name": "Miqdad Asaria"
    },
    {
      "affiliations": [
        "School of Psychology, University of Leeds, Leeds, UK"
      ],
      "name": "Mark Mon Williams"
    },
    {
      "affiliations": [
        "Centre for Health Economics, University of York, York, UK"
      ],
      "name": "Richard Cookson"
    }
  ],
  "title": "OP73 Human and financial costs of six early years disadvantages in the UK and Bradford: a birth cohort microsimulation study",
  "uid": "b61bea75-1879-5892-abea-c8d4d8de7f41"
}