سرمایه گذاری در توسعه اولیه بشر: زمان بندی و بهره وری اقتصادی

Policy discussions to ameliorate socioeconomic (SES) inequalities are increasingly focused on investments in early childhood. Yet such interventions are costly to implement, and clear evidence on the optimal time to intervene to yield a high economic and social return in the future is meagre. The majority of successful early childhood interventions start in the preschool years. However socioeconomic gradients in cognitive skills, socio-emotional functioning and health can be observed by age three, suggesting that preventative programmes starting earlier in childhood may be even more effective. We discuss the optimal timing of early childhood intervention with reference to recent research in developmental neuroscience. We motivate the need for early intervention by providing an overview of the impact of adverse risk factors during the antenatal and early childhood periods on outcomes later in life. We provide a brief review of the economic rationale for investing early in life and propose the “antenatal investment hypothesis”. We conclude by discussing a suite of new European interventions that will inform this optimal timing debate.

Inequalities in health, cognitive development, and socio-emotional functioning emerge early in life. Many subsequent social issues, such as crime, teenage pregnancy, low education and unemployment can be traced to an adverse early years’ environment. Limited evidence suggests that targeted, early intervention programmes aimed at disadvantaged children and their families are an effective means of reducing these inequalities. Such early childhood interventions can partially compensate for risk factors that compromise children's most critical stages of early development. Pioneering experimental studies, such as the Carolina Abecedarian programme (Ramey et al., 2000), High/Scope Perry Preschool programme (Schweinhart et al., 2005), Chicago Parent–Child Programme (Reynolds et al., 2002), and the Nurse–Family Partnership (Olds et al., 1997), have long been used to justify investing in early childhood in policy discussions worldwide. These longitudinal studies find that the personal benefits (cognitive development, behaviour and social competence, educational attainment, and earnings), social benefits (reduced delinquency and crime) and government savings (higher tax revenues, reduced social welfare spending), associated with intervening early in a child's life clearly outweigh the costs (Karoly et al., 2005). Investment in the early years is subsequently increasing, yet the question of the optimal age to intervene remains. This article describes the risk factors that motivate early intervention and reviews both the economic rationale for investing in early childhood and the evidence on the optimal timing of intervention to reduce inequalities. Based on the economic and biological arguments for early intervention we propose the “antenatal investment hypothesis” which suggests that investments made during the pregnancy period may yield the highest return. The article concludes by discussing a suite of new European interventions that will inform this optimal timing debate.

Interventions are costly to implement, therefore in order to derive the greatest benefits for children, while simultaneously having a high rate of return for investors, further research on the optimal time to intervene is needed. New policy initiatives recently launched in Europe represent a significant move towards investment in the antenatal and early years period. The UK Government has launched a large-scale pilot study of the Nurse–Family Partnership which will recruit 1000 families in 10 areas across England (UK Cabinet Office Social Exclusion Task Force, 2007). In addition, similar experimental antenatal interventions are taking place in France, Germany and Italy, enabling an important cross-national comparison. Finally, the first large-scale European childhood intervention programme has been initiated in Ireland. The Irish Government is co-funding, with Atlantic Philanthropies, a series of childhood interventions, many of which will be evaluated by randomised control trial. The programme is characterised by a large number of interventions which vary in terms of treatments, duration, and intensity. However, unlike the US studies there is some comparability across sites as the interventions are taking place simultaneously, and with elements of a common measurement framework. This enables a systematic comparison of the relative merits of one form of intervention over another. Importantly, as some of the interventions start in the antenatal period and others at later stages of childhood, this programme may shed light on the optimal timing debate.