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Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities
(2005) found that the program cost about $7,000 per child and produced total benefits of about $41,000 per child for the higher risk sample and about $9,000 per child for the lower risk sample.13 In general, some of the main benefits of home visitation programs, converted into dollar estimates of their value, have been reduced child abuse, improved achievement test scores, and decreased likelihood of arrest later in life. The benefits from reduced child abuse are generally estimated on the basis of reductions in medical, child welfare, and other public service costs and crime costs, based on epidemiological evidence showing correlations between child abuse and these costs later in life. Improved achievement test scores are usually valued on the basis of how earnings relate to education. Finally, arrests are valued in terms of both the costs to the criminal justice systems and victims (particularly health costs for crimes involving injuries) and lost productivity while incarcerated (see also the technical appendix to Aos, Lieb, et al., 2004).
Several different center-based early interventions also appear to have benefits that exceed their costs (see Targeting Early Childhood Development in Preschool in Chapter 6 for further discussion of these programs). In a meta-analysis of over 50 studies of early childhood education programs for low-income 3- and 4-year-olds, Aos, Lieb, and colleagues (2004) found that, on average, benefits per child were $17,000 and costs were $7,000. In an economic analysis of the Abecedarian Early Childhood project, an intensive, multiyear intervention for children from birth to age 5, Barnett and Masse (2006) found that per-child benefits were $158,000 and costs were $63,000; the primary benefits were related to cognitive abilities and education, which were valued in terms of estimated impact on future earnings. The intervention was also associated with a reduction in smoking, which was valued in terms of estimated reduction in premature mortality (with a year of life then valued at $150,000, based on willingness-to-pay estimates in the literature). The Perry Preschool project, which included 1-2 years of intensive preschool, home visiting, and group meetings of parents, had estimated per-child benefits of $240,000 and costs of $15,000 (Belfield, Nores, et al., 2006); the primary benefits, some of which were observed well into adulthood, were reduced crime, positive academic outcomes, and reduced smoking. The Chicago Child-Parent Centers, a center-based preschool education for disadvantaged children, had estimated benefits per child of $75,000 and costs of $7,400 (Temple and Reynolds, 2007); the primary benefits were improved academic outcomes and reduced crime.
Temple and Reynolds (2007) compared the benefit-to-cost ratios of
Although the estimates provided by Aos, Lieb, and colleagues (2004) and Karoly, Kilburn, and Cannon (2005) differ, the difference between benefits and costs is substantial for both.