We must be aware that a segment of the adult population in modern countries is not able to meet their own needs, they become high-rate users of multiple public services: social welfare, hospitals, prescription medication, injury claims, and the courts, accounting for over 20% of government expenditure. The key point was that this population segment began life with very high rates of mental health problems, and most had left school without qualifications. Compassion has got to compel prevention.Professor Terrie Moffitt, co-author and Chair in Social Behaviour & Development, IoPPN, King's College London
21 January 2020
Use of health and social services concentrated in small segment of society
Researchers have applied big data techniques to investigate the segment of society that rely heavily on health and social services.
Published in Nature Human Behaviour the study analysed records from 1.7 million citizens from New Zealand and identified the 10% of the study population that used a disproportionate share of health and social services. The study showed that this high need group:
- used 73.4% of the welfare benefits,
- occupied 85.6% of all hospital bed nights;
- filled 62.1% of all prescriptions;
- made 36.0% of all injury claims
- and were convicted of 100% of crimes.
Researchers also analysed the economic impact of this group’s service use and showed that, although these individuals are few in number, they account for a disproportionate share of economic costs related to service use.
The study also examined the pattern of use of health and social services in a population of 2.3 million citizens from Denmark, considering social welfare use, nights spent in hospital and crime level. Researchers showed there was a comparable clustering in the population and 10% of citizens showed a similarly disproportionate level of service use.
In order to investigate what might predispose individuals to this high level of service use, the researchers examined clinical data from a subsample of about 1000 New Zealand citizens that was collected as part of the Dunedin study. This showed that poor childhood brain health (based on cognitive assessments and neurological examinations), poor adolescent mental health, and leaving school without qualifications, and were all associated with whether an individual was a heavy user of health and social services later in life.
The results of the study suggest that a portion of the population is likely to be left behind without adequate support to meet the demands of the changing employment landscape. The researchers suggest there is a need for targeted interventions that, if possible, can take affect early in life to prevent this heavy use of health and social services. The study suggested three possible areas for intervention: education, mental health and neurological health.
For more insight into the study read the blog by lead author Leah Richmond-Rakerd featured on Nature Research’s Behind the Paper.