{
  "abstract": "Background Policymakers lack comparative information about the social costs of specific early disadvantages. We compared six policy-relevant childhood (0–5 years) disadvantages and their diverse social costs over 17 years for the UK and Bradford (a multi-ethnic district of about 550 000 in the northeast of England with high levels of deprivation).Methods Using a microsimulation model, we compared the harms to well-being (proxied by parent-reported emotional problems), health and educational attainment and government spending (such as inpatient NHS costs) up to age 17 of the following: having a teenage mother, preterm birth, low birthweight-for-gestational-age, low height-for-age-and-sex (age 5), disability (age 5) and cognitive delay (age 5). We modelled a UK birth cohort born in 2000 and a Bradford cohort born in 2019 based on local prevalence data, uprated to 2023 prices and discounted at 3.5%.Results Disability imposed the highest per-child cost, with a well-being loss of 7.2 WELLBYs (CI 6.1 to 8.2; monetised value £89 k) and public cost £64 k (CI £37 k–£91 k) per child by age 17. Cognitive delay had a smaller per-child loss of 3.8 WELLBYs (3.2–4.5), but the largest population-level loss was in both the UK and Bradford at 728K WELLBYs (600 K–856K; monetised value £9,044 m) and £5,588 m (£1,872-£9,303) public cost per cohort of 679 000 children born in the UK. Monetised well-being loss is almost always higher than public cost and sometimes more than twice as high.Conclusions Cognitive delay at 5 years of age imposed larger total social costs than the other early disadvantages. For an individual child, however, well-being loss was most affected by disability or having a teenage mother.",
  "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, UCL Social Research Institute, London, UK"
      ],
      "name": "Aase Villadsen"
    },
    {
      "affiliations": [
        "School of Psychology, University of Leeds, Leeds, UK"
      ],
      "name": "Matthew Warburton"
    },
    {
      "affiliations": [
        "Hull York Medical School, University of York, York, UK"
      ],
      "name": "Liina Mansukoski"
    },
    {
      "affiliations": [
        "School of Psychology, University of Leeds, Leeds, UK",
        "Bradford Institue of Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"
      ],
      "name": "Mark Mon-Williams"
    },
    {
      "affiliations": [
        "Centre for Health Economics, University of York, York, UK",
        "Saw Swee Hock School of Public Health, National University of Singapore, Singapore"
      ],
      "name": "Richard Cookson"
    }
  ],
  "title": "Comparative social costs of six early years disadvantages: a birth cohort microsimulation study",
  "uid": "2b427ae6-5e49-5fba-9d1e-13474744ccf5"
}