Marlon P Mundt1, Larissa I Zakletskaia. 1. Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Ct., Madison, WI, 53715, USA, marlon.mundt@fammed.wisc.edu.
Abstract
BACKGROUND: Social connections at all stages of life are essential for physical and mental well-being. Of particular importance are social relationships during adolescence that shape adult health behaviors and health outcomes. OBJECTIVE: The aim of this study was to estimate the association between adolescent peer status in school and later-life quality-adjusted life-years (QALYs) and healthcare costs. METHODS: This study used social network and health outcomes data from Wave I (ages 12-18 years) and Wave III (ages 18-24 years) of the US National Longitudinal Study of Adolescent Health (n = 10,578) to compare QALYs and healthcare costs (in 2012 US$) by adolescent peer status in US schools. Generalized linear models controlled for school fixed effects, individual and family characteristics, and US census block neighborhood effects. Non-parametric bootstrapping accounted for residual skewness in QALYs and healthcare costs. Net monetary benefit (NMB) was calculated by converting adjusted 5-year QALYs into US$ values and subtracting 5-year healthcare costs. NMB was then compared across quintiles of adolescent peer status in school at Wave I. RESULTS: Results obtained from non-parametric bootstrapping indicate that adolescents with higher peer status in school experience significantly better health and lower healthcare costs over the next 5 years. At US$50,000 per QALY, adolescents with 8 or more friends achieved NMB of US$214,300 (95 % CI 212,800-215,800) over a 5-year span, in comparison to adolescents with 0-1 friends, who attained US$209,900 (95 % CI 207,900-211,700) NMB. This difference translates into approximately US$4,440 (95 % CI 2,036-6,825) per socially disengaged adolescent in additional health costs and/or reduced QALYs over 5 years. CONCLUSION: The study calls for randomized controlled trials targeting adolescent peer group structures in schools as a means to promote better health and lower healthcare costs in adulthood.
RCT Entities:
BACKGROUND: Social connections at all stages of life are essential for physical and mental well-being. Of particular importance are social relationships during adolescence that shape adult health behaviors and health outcomes. OBJECTIVE: The aim of this study was to estimate the association between adolescent peer status in school and later-life quality-adjusted life-years (QALYs) and healthcare costs. METHODS: This study used social network and health outcomes data from Wave I (ages 12-18 years) and Wave III (ages 18-24 years) of the US National Longitudinal Study of Adolescent Health (n = 10,578) to compare QALYs and healthcare costs (in 2012 US$) by adolescent peer status in US schools. Generalized linear models controlled for school fixed effects, individual and family characteristics, and US census block neighborhood effects. Non-parametric bootstrapping accounted for residual skewness in QALYs and healthcare costs. Net monetary benefit (NMB) was calculated by converting adjusted 5-year QALYs into US$ values and subtracting 5-year healthcare costs. NMB was then compared across quintiles of adolescent peer status in school at Wave I. RESULTS: Results obtained from non-parametric bootstrapping indicate that adolescents with higher peer status in school experience significantly better health and lower healthcare costs over the next 5 years. At US$50,000 per QALY, adolescents with 8 or more friends achieved NMB of US$214,300 (95 % CI 212,800-215,800) over a 5-year span, in comparison to adolescents with 0-1 friends, who attained US$209,900 (95 % CI 207,900-211,700) NMB. This difference translates into approximately US$4,440 (95 % CI 2,036-6,825) per socially disengaged adolescent in additional health costs and/or reduced QALYs over 5 years. CONCLUSION: The study calls for randomized controlled trials targeting adolescent peer group structures in schools as a means to promote better health and lower healthcare costs in adulthood.
Authors: Katharina Ackermann; Anne Martinelli; Anka Bernhard; Christine M Freitag; Gerhard Büttner; Christina Schwenck Journal: Child Psychiatry Hum Dev Date: 2019-10
Authors: Arthur Gus Manfro; Pedro M Pan; Ary Gadelha; Marcelo Fleck; Maria C do Rosário; Hugo Cogo-Moreira; Rodrigo Affonseca-Bressan; Jair Mari; Euripedes C Miguel; Luis A Rohde; Giovanni A Salum Journal: Eur Child Adolesc Psychiatry Date: 2017-05-02 Impact factor: 4.785