Do investments in children’s health programs reap benefits beyond the costs?
In this paper, Dr. Bernard Guyer and his colleagues at Johns Hopkins University examine the costs
of four specific types of young children’s health problems—exposure to tobacco smoke,
unintentional injury, mental health problems, and obesity—and review over 300 studies of a
range of interventions to address them. While results vary for each health issue, the bottom line is
that investing in early childhood health makes economic sense.
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According to the authors, our society has failed to take an investment
approach to the health of young children, despite the logic of doing so
and despite the evidence available that these investments are beneficial.
Exposure to tobacco smoke, unintentional injury, mental health problems,
and obesity represent serious threats to young children’s health.
Additionally, all of them—if not prevented or addressed early in children’s
lives—can have lifelong consequences.
Based on an extensive review of studies on these four health issues, this
report lays out the costs to society of not treating these conditions and
assesses the economic benefit to society of doing so. While the precise net
benefits of treatments are often uncertain, many are clearly cost-effective.
Treatable Health Problems
Affect Many U.S. Children*
● One in seven preschool children
is obese—nearly triple the rate
of just three decades ago
● As many as one in five has
mental health problems that
cause at least mild functional
impairment
● Nearly half a million children are
born each year to a mother who
smoked during pregnancy, and up
to 50% of children are exposed to
tobacco smoke in the home
● Each year, one child in six suffers
a serious unintentional injury
* Data are from the most recent year available.
Early Childhood Health Problems and
Prevention Strategies: Costs and Benefits
Studies Show Lasting Societal Benefits from Investments in the Health of Young Children
Early Childhood Health Problems and
Prevention Strategies: Costs and Benefits
Studies Show Lasting Societal Benefits from Investments in the Health of Young Children
Issue Brief #3Page 2 | Partnership for America’s Economic Success | www.PartnershipforSuccess.org
Exposure to Tobacco Smoke:
“There is considerable evidence that many
anti-tobacco interventions are effective, can improve
child health, and save health care dollars.”
Despite the substantial evidence of the harm it causes,
nearly half a million U.S. children are born each year to
mothers who smoked while pregnant, and 25-50% of all
children are exposed by household members to
environmental tobacco smoke (ETS). Prenatal exposure
is associated with increased odds of a variety of ills—
premature delivery, low birth-weight, and sudden infant
death syndrome (SIDS) among them—as well as
attention deficit hyperactivity disorder in childhood.
Low birth-weight, in particular, has been linked to
delays in children’s later development and progress in
school. Further, exposure to ETS is linked to various
respiratory ailments, including asthma, allergies, and
acute lung and ear infections.
These are expensive problems. The extra costs for
prenatal care and complicated births among women who
smoke during pregnancy are more than $4 billion a
year.
1 Care for childhood illnesses resulting from
exposure to tobacco smoke costs nearly $8 billion a year.
As a result, reducing parental smoking can produce
substantial economic benefits for society. One study
estimates that if smoking prevalence dropped among
pregnant women by just 1%, the nation would save $21
million in direct medical costs the first year alone. If it
continued to drop by 1% each year, we would save $572
million in these direct costs over seven years. Another
report estimates that, given the high costs associated with
childhood ETS exposure, reducing parental smoking by
15% could save $1 billion in direct medical costs at the
prenatal and neonatal levels and into childhood.
The authors’ survey of interventions and their
effectiveness in this area is encouraging. Over the last
decade, smoking prevention and cessation programs
have become more sophisticated. A wide variety of
proven interventions is now available, which are
especially effective when used in combination.
Among the findings on these programs:2
● Even short counseling sessions by trained providers
can reduce risks to the fetus and, thus, the need for
neonatal intensive care. A study by the CDC
estimates that one intense smoking cessation
counseling session of at least 10 minutes, which
costs $30 and can reasonably be expected to result
in an 18% quit rate, would produce a benefit-cost
ratio of 3.5:1.
● One meta-analysis of the effectiveness of
disseminating smoking cessation materials to
pregnant women suggests a benefit-cost ratio of
12:1. The analysis estimates that if all pregnant
smokers received these materials and i