Abstract
Cognitive ability in childhood is positively associated with economic productivity in adulthood. Expected gains in economic output from interventions that protect cognitive function can be incorporated in benefit–cost and cost-effectiveness analyses conducted from a societal perspective. This review summarizes estimates from high-income countries of the association of general cognitive ability, standardized as intelligence quotient (IQ), with annual and lifetime earnings among adults. Estimates of the association of adult earnings with cognitive ability assessed in childhood or adolescence vary from 0.5% to 2.5% per IQ point. That range reflects differences in data sources and analytic methods. We take a conservative published estimate of a 1.4% difference in market productivity per IQ point in the United States from a recent study that controlled for confounding by family background and behavioral attributes. Using that estimate and the present value of lifetime earnings calculated using a 3% discount rate, the implied lifetime monetary valuation of an IQ point in the United States is USD 10,600–13,100. Despite uncertainty and the exclusion of non-market productivity, incorporation of such estimates could lead to a fuller assessment of the benefits of public health and clinical interventions that protect the developing brains of fetuses, infants, and young children.
Highlights
Experts increasingly recommend that economic evaluations of prevention strategies be conducted from either a societal perspective, which includes impacts on other sectors of the economy, or a limited societal perspective that encompasses impacts on time costs and economic productivity [1]
Intellectual disability (ID) is a chronic condition defined as significant limitations in both cognitive ability and adaptive behavior that are recognized before the age of 22
Armed Forces Qualifying Test (AFQT) scores are correlated with intelligence quotient (IQ) scores, AFQT scores can be strongly influenced by inter-individual differences in personality traits, such as anxiety and inattention, and are an imperfect proxy for general intelligence [38,42]
Summary
Experts increasingly recommend that economic evaluations of prevention strategies be conducted from either a societal perspective, which includes impacts on other sectors of the economy, or a limited societal perspective that encompasses impacts on time costs and economic productivity [1]. Long-term outcome studies have demonstrated that disadvantaged children who receive intensive early interventions can experience lasting gains in educational attainment and occupational success as well as other benefits, the monetary valuation of which can greatly exceed the costs of the interventions [2,3]. Adverse impacts on children’s neurodevelopment can be mitigated through prevention or the early detection and treatment of exposures that cause cognitive impairment. Cognitive impairment is defined as limitations in cognitive ability. Intellectual disability (ID) is a chronic condition defined as significant limitations in both cognitive ability and adaptive behavior that are recognized before the age of 22. Some of the most common causes of ID in the general population are genetic syndromes (e.g., Down syndrome and fragile X syndrome), fetal alcohol spectrum disorder, and adverse birth outcomes (e.g., premature birth) [5]. Sociodemographic variables, e.g., low maternal education and poverty, are associated with mild ID in the general population [6,7]
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