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一项明智的投资:敏感型育儿在儿童期的长期成本节约。

A good investment: longer-term cost savings of sensitive parenting in childhood.

机构信息

Department of Child and Adolescent Psychiatry, University of Ulm, Ulm, Germany.

London School of Economics and Personal Social Services Research Unit, Cornwallis Central, University of Kent, Canterbury, Kent, UK.

出版信息

J Child Psychol Psychiatry. 2022 Jan;63(1):78-87. doi: 10.1111/jcpp.13461. Epub 2021 Jun 29.

Abstract

BACKGROUND

Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan. The hypothesis that early parenting quality has significant long-term financial benefits has not been previously tested.

METHODS

Design: Longitudinal study with follow-up from 2012 to 2016.

SETTING

UK multicentre study cohort (London, South-East England).

PARTICIPANTS

174 young people drawn from 2 samples, one at moderate risk of poor outcomes and one at high risk, assessed aged 4-6 years then followed up in early adolescence (mean age 12.1 years).

MEASURES

The primary outcome was total costs: health, social care, extra school support, out-of-home placements and family-born expenditure, determined through semistructured economic interviews. Early parenting quality was independently assessed through direct observation of parent-child interaction.

RESULTS

Costs were lower for youths exposed to more sensitive parenting (most sensitive quartile mean £1,619, least sensitive quartile mean £21,763; p < .001). Costs were spread across personal family expenditure and education, health, social and justice services. The cost difference remained significant after controlling for several potential confounders. These included demographic variables (family poverty, parental education); exposure to child abuse; and child/young person variables including level of antisocial behaviour in both childhood and adolescence, IQ and attachment security.

CONCLUSIONS

This study is the first showing that more sensitive early parental care predicts lower costs to society many years later, independent of poverty, child and youth antisocial behaviour levels and IQ. Savings are likely to increase as individuals grow older since early parenting quality predicts health, behavioural and occupational outcomes in adulthood. The findings provide novel evidence for the public health impact of early caregiving quality and likely financial benefits of improving it.

摘要

背景

良好的儿童早期养育质量与终生积极的身心健康密切相关。此前尚未检验过早期养育质量具有显著长期经济效益的假设。

方法

设计:2012 年至 2016 年进行的纵向研究,随访。

地点

英国多中心研究队列(伦敦、英格兰东南部)。

参与者

从两个样本中抽取了 174 名年轻人,一个处于不良结局的中度风险,一个处于高风险,评估年龄为 4-6 岁,然后在青少年早期(平均年龄 12.1 岁)进行随访。

措施

主要结果是总成本:健康、社会护理、额外学校支持、校外安置和家庭出生支出,通过半结构化经济访谈确定。早期养育质量通过对亲子互动的直接观察进行独立评估。

结果

接触到更敏感养育方式的年轻人成本较低(最敏感四分位数的平均值为 1619 英镑,最不敏感四分位数的平均值为 21763 英镑;p<0.001)。成本分布在个人家庭支出以及教育、健康、社会和司法服务上。在控制了几个潜在混杂因素后,成本差异仍然显著。这些因素包括人口统计学变量(家庭贫困、父母教育);儿童虐待暴露;以及儿童/年轻人变量,包括童年和青春期的反社会行为水平、智商和依恋安全性。

结论

这项研究首次表明,更敏感的早期父母关怀可预测多年后社会成本降低,独立于贫困、儿童和青年反社会行为水平以及智商。由于早期养育质量预测成年期的健康、行为和职业结果,因此随着个人年龄的增长,储蓄可能会增加。研究结果为早期照护质量对公共卫生的影响以及改善其质量的可能经济效益提供了新的证据。

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