Article Abstract

Article Abstract

Online ISSN: 1099-176X Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 14, Issue 3, 2011. Pages: 137-147
Published Online: 30 September 2011

Economic Outcomes in Adulthood and their Associations with Antisocial Conduct, Attention Deficit and Anxiety Problems in Childhood

Martin Knapp,^1,2* Derek King,¹ Andrew Healey,³ Cicely Thomas⁴

¹London School of Economics and Political Science, Personal Social Services Research Unit, Houghton Street, London, UK
²King's College London, Institute of Psychiatry, Centre for the Economics of Mental Health, Health Service and Population Research Department, De Crespigny Park, London, UK
³Visiting Senior Research Fellow, Personal Social Services Research Unit, Houghton Street, London, UK
⁴Mathematic Inc., Boston Mass., USA; formerly London School of Economics

* Correspondence to: Professor Martin Knapp, Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
Tel.: +44-20-7955 6225
Fax: +44-20-7955 6803
E-mail: m.knapp@lse.ac.uk.

Source of Funding: This paper presents independent research commissioned by the Department of Health's Policy Research Programme (grant 035/0045). The views expressed are those of the authors and not necessarily those of the Department of Health. The authors have no affiliations to or financial support from any organisation with direct financial interest in the subject matter of the paper.

Abstract

Mental health problems in childhood have negative effects on individuals and families for potentially many years. Using data from a British birth cohort study, we tested for links between behavioural and emotional problems in childhood, and occupational status and earnings in adulthood, adjusting for individual and family covariates. Among males, antisocial conduct at age 10 was associated with a higher probability unemployment at age 30, but higher earnings if employed, and higher expected earnings. Childhood attention deficit problems were associated with lower employment rates, worse jobs, lower earnings if employed, and lower expected earnings overall for both males and females. Childhood anxiety problems were associated with lower earnings in adulthood. Prevention, early detection and treatment of these mental health problems might head off many of these long-term negative consequences for children, their families and wider society.

Background: Conduct disorder (antisocial conduct), attention deficit problems and anxiety in childhood have negative effects on individuals during their childhood, on their families, and often into adulthood.

Aims of the Study: To quantify the connections between childhood antisocial conduct, attention deficit and anxiety, and some adulthood economic consequences.

Methods: Data from a British birth cohort study were examined for links between behavioural and emotional problems in childhood, and occupational status and earnings in adulthood, after adjusting for individual and family covariates.

Results: The effects of antisocial conduct on adult labour market outcomes were complex. Results for males with antisocial conduct at age 10 showed a higher probability of being unemployed at age 30 (after adjustment for other factors). However, males with antisocial conduct at age 10 had higher earnings than those without such behaviour, again after adjusting for other factors. There were no such differences for females with antisocial conduct. Attention deficit problems at age 10 were associated with lower employment rates, worse jobs, lower earnings if employed, and lower expected earnings overall - for both males and females. Anxiety problems were associated with lower earnings. Other childhood factors associated with worse adulthood economic outcomes included cognitive attainment, living in a disadvantaged neighbourhood, mother's educational qualifications, family income and being looked after by a local authority.

Discussion: Links between antisocial conduct and attention deficit in childhood and high adulthood personal and societal costs support arguments for effective interventions to prevent and treat behavioural problems in childhood. However, the cost-effectiveness of such interventions still needs to be considered carefully.

Implications for Policy: Childhood mental health problems are strongly linked to adverse adulthood experiences across a number of domains. Early detection and intervention might head off many of these negative outcomes for children, their families and wider society. The positive impact of antisocial conduct on earnings needs further examination: it is not necessarily counter-intuitive, but it raises interesting policy questions.

Implications for Further Research: The long-term outcomes of childhood problems and interventions need further study, as do the pathways connecting childhood morbidity, adulthood outcomes and other potential intervening factors.

Received 18 March 2010; accepted 23 August 2011