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

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 (1.7 to 6.2) times higher than for those with conduct problems. Mean individual total costs were pound 70 019 for the conduct disorder group (bootstrap mean difference from no problem group pound 62 898; pound 22 692 to pound 117 896) and pound 24 324 (pound 16 707; pound 6594 to pound 28 149) for the conduct problem group, compared with pound 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 high and falls on many agencies, yet few agencies contribute to prevention, which could be cost effective.