Comparative social costs of six early years disadvantages:A Birth cohort microsimulation study

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 with high deprivation). Methods Using a microsimulation model, we compared harms to wellbeing (proxied by parent-reported emotional problems), health and educational attainment, and public finances up to age 17 of: teenage mother, preterm birth, low birthweight-for-gestational-age, low height-for-age-and-sex (age 5); disability (age 5), and learning difficulties (age 5). We modelled a UK birth cohort born in 2000 and a Bradford cohort born in 2019 based on local prevalence and population data, uprated to 2023 prices and discounted at 3.5%. Results Disability imposed the highest per-child burden, with a wellbeing loss of 7.2 WELLBYs (CI: 6.1-8.2; monetised value £89k) and public cost £64k (CI: £37k–£91k) per child by age 17. Learning difficulties had a smaller per-child burden of 3.8 WELLBYs (3.2-4.5) but the largest population-level burden in both the UK and Bradford at 728K WELLBYs (600K-856K; monetised value £9,044m) and £5,588m (£1,872-£9,303) public cost per cohort of 679,000 children born in the UK. Monetised wellbeing burden almost always higher than public cost and sometimes more than twice as high. Conclusions Learning difficulties at 5 years of age imposed larger total social costs than the other early disadvantages. For an individual child, however, wellbeing loss was most affected by disability or having a teenage mother.