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Thursday, February 6, 2020

"Lifetime Social Cost"

Janet Cakira and colleagues have an article in  Research in Autism Spectrum Disorders titled "The lifetime social cost of autism: 1990–2029."

  • This study applies existing data on population, prevalence, and the cost of meeting the needs of individuals with ASD to estimate the lifetime social cost for the United States and each of the 50 states 1990–2029.
  • ASD is associated with approximately $3.6 million in lifetime social cost.
  • The lifetime social costs to date are more than $7 trillion, the equivalent of about two years of total federal revenue for the United States.
  • By 2029, If prevalence remains the same, the cost will grow to $11.5 trillion, and if prevalence continues to increase at the past rate, the cost will grow to nearly $15 trillion.
  • A variety of approaches in the field of vulnerability assessment and risk management could be used to identify known modifiable risk factors that could potentially reduce rates, thereby reducing costs.
This cost of illness analysis computes a baseline and future estimate of lifetime social costs associated with autism spectrum disorder (ASD) for the 50 states in the United States (US). The number of cases of ASD are estimated, then multiplied by annual direct and indirect medical and non-medical costs identified in the peer-reviewed literature. This amount is then extrapolated across the number of years each cost type is expected to be incurred to calculate a total lifetime cost for each state in the US from 1990–2019, and to project future cost for 2020–2029. From 1990–2019, there have been an estimated 2 million new cases of (ASD), with social costs of more than $7 trillion. If the future prevalence of ASD remains unchanged over the next decade, there will be an estimated additional 1 million new cases, resulting in an additional $4 trillion to the United States in social costs, however if the rate of increase in prevalence continues, costs could reach nearly $15 trillion by 2029. The financial burden of ASD is significant and identifying the modifiable causes of ASD has the potential to provide tangible benefits.
 The framing of "social cost of autism" is controversial.  An alternative frame is "social cost of failing to accommodate people on the spectrum"  As Ari Ne'eman once said:
And let's say that person does not get what they need in order to work. Would your model attribute those lost earnings, the cost of those lost earnings, to autism, to that individual's being on the autism spectrum, or would your model attribute the costs to lack of support or lack of accommodations or to discrimination?