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Journal Issue: Children with Disabilities Volume 22 Number 1 Spring 2012

Childhood Health: Trends and Consequences over the Life Course
Liam Delaney James P. Smith


Evidence indicates that childhood health has persistent effects through adulthood on health and socioeconomic status.1 This paper examines the changing prevalence of childhood physical and mental health conditions, particularly in the United States; considers the estimated lifetime economic costs of childhood health problems; and reviews the literature on costs and consequences of childhood interventions.

Recent work has documented the shift in developed countries from focusing on early life health crises that often result in death to identifying and treating specific chronic childhood illnesses and providing a foundation for good child mental health. At a societal level, the growing importance of childhood mental health is emphasized in several recent papers.2 We argue that poor treatment of childhood mental health problems carries significant long-term costs not only to individuals but to large populations.

How the approximately 75 million U.S. children through age 18 are provided with the best possible conditions for good mental and physical health will affect their well-being now and have implications for America's transition to an increasingly graying society. Americans spend proportionately more of their income on health care than residents of any other country in the world, and federal, state, and local health care agencies spend more than $1 trillion each year. It is possible that the promotion of childhood health might reduce these costs in the long run.

We present evidence on the changing prevalence of physical and mental health problems for American children and raise issues about the reliability of this evidence. Then we examine the lifetime economic consequences of poor health in childhood, with an emphasis on distinguishing between childhood physical and mental health. Finally, we discuss potential routes to improve outcomes for children with mental health disorders and offer suggestions for research and policy.