Cost-Benefit Analysis of Communities That Care Outcomes at Eighth Grade
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This paper presents a cost-benefit analysis of the Communities That Care (CTC) prevention system, a public health approach to reducing risk, enhancing protection, and reducing the prevalence of adolescent health and behavior problems community wide. The analysis is based on outcomes from a panel of students followed from Grade 5 through Grade 8 in a randomized controlled trial involving 24 communities in 7 states. Previous analyses have shown that CTC prevented the initiation of cigarette smoking, alcohol use, and delinquency by the end of 8th grade in CTC communities compared to controls. This paper estimates long-term monetary benefits associated with significant intervention effects on cigarette smoking and delinquency as compared to the cost of conducting the intervention. Under conservative cost assumptions, the net present benefit is $5,250 per youth, including $812 from the prevention of cigarette smoking and $4,438 from the prevention of delinquency. The benefit-cost ratio indicates a return of $5.30 per $1.00 invested. Under less conservative but still viable cost assumptions, the benefit-cost ratio due to prevention of cigarette smoking and delinquency increases to $10.23 per $1.00 invested. Benefits from CTC’s reduction in alcohol initiation as well as broader inclusion of quality-of-life gains would further increase CTC’s benefit-cost ratio. Results provide evidence that CTC is a cost-beneficial preventive intervention and a good investment of public dollars, even under very conservative cost and benefit assumptions.
KeywordsCost-benefit analysis Community-based intervention Prevention
This study was supported by research grant R01 DA015183-03 from the National Institute on Drug Abuse, with co-funding from the National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, the Center for Substance Abuse Prevention, and the National Institute on Alcohol Abuse and Alcoholism. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
- Aos, S., Lieb, R., Mayfield, J., Miller, M., & Pennucci, A. (2004). Benefits and costs of prevention and early intervention programs for youth (Publication No. 04-07-3901). Olympia: Washington State Institute for Public Policy.Google Scholar
- Belfield, C. R., Nores, M., Barnett, S., & Schweinhart, L. (2006). The High/Scope Perry Preschool Program: Cost–benefit analysis using data from the age-40 followup. The Journal of Human Resources, 41, 162–190.Google Scholar
- Bureau of Labor Statistics. (2009). Occupational employment and wage estimates. Retrieved April 26, 2011 from http://bls.gov/oes/oes_data.htm.
- Bureau of Labor Statistics. (2011). National compensation survey. Employer costs for employee compensation. Historical listing, March 2004–December 2010. Retrieved April 26, 2011 from ftp://ftp.bls.gov/pub/special.requests/ocwc/ect/ececqrtn.txt
- Caulkins, J. P., Rydell, C. P., Everingham, S. S., Chiesa, J., & Bushway, S. (1999). An ounce of prevention, a pound of uncertainty: The cost-effectiveness of school-based drug prevention programs. Santa Monica, CA: RAND.Google Scholar
- Hawkins, J. D., Oesterle, S., Brown, E. C., Arthur, M. W., Abbott, R. D., Fagan, A. A., et al. (2009). Results of a type 2 translational research trial to prevent adolescent drug use and delinquency: A test of Communities That Care. Archives of Pediatrics and Adolescent Medicine, 163, 789–798.PubMedCrossRefGoogle Scholar
- Hawkins, J. D., Oesterle, S., Brown, E. C., Monahan, K. C., Abbott, R. D., Arthur, M. W., et al. (in press). Sustained decreases in risk exposure and youth problem behaviors after installation of the Communities That Care prevention system in a randomized trial. Archives of Pediatrics and Adolescent Medicine, available online Oct 3, 2011; doi: 10.1001/archpediatrics.2011.183.
- Karoly, L. A., Kilburn, M. R., & Cannon, J. S. (2005). Early childhood interventions: Proven results, future promise. Santa Monica, CA: RAND.Google Scholar
- Miller, T. R., & Hendrie, D. (2008). Substance abuse dollars and cents: A cost-benefit analysis (DHHS Publication No. (SMA) 07–4298). Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration.Google Scholar
- Miller, T. R., Cohen, M. A., & Wiersema, B. (1996). Victim costs and consequences: A new look. National Institute of Justice Research Report, NCJ 155282. Washington, DC: National Institute of Justice.Google Scholar
- National Bureau of Economic Analysis. (2010). Table 2.3.4. Price Indexes for Personal Consumption Expenditures by Major Type of Product. Line 1: Personal Consumption Expenditures, 2004–2008. Retrieved from http://www.bea.gov/national/nipaweb/TableView.asp?SelectedTable=64&ViewSeries=NO&Java=no&Request3Place=N&3Place=N&FromView=YES&Freq=Year&FirstYear=2000&LastYear=2009&3Place=N&Update=Update&JavaBox=no
- National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. (M. E. O’Connell, T. F. Boat, & K.W. Warner, Eds.). Washington, DC: The National Academies Press.Google Scholar
- Piquero, A., Hawkins, J. D., & Kazemian, L. (in press). Criminal career patterns between adolescence and emerging adulthood. In R. Loeber & D. P. Farrington (Eds.), Transitions from juvenile delinquency to adult crime: Criminal careers, justice policy and prevention. Oxford: Oxford University Press.Google Scholar
- Plotnick, R. D., Young, D. S., Catalano, R. F., & Haggerty, K. P. (1998). Benefits and costs of a family-focused methadone treatment and drug abuse prevention program: Preliminary findings. In W. J. Bukoski & R. I. Evans (Eds.), NIDA Research Monograph: Vol. 176. Cost benefit/cost effectiveness research of drug abuse prevention: Implications for programming and policy (pp. 161–183). Rockville, MD: National Institute on Drug Abuse.Google Scholar
- Sloan, F. A., Ostermann, J., Conover, C., Taylor, D. H., Jr., & Picone, G. (2004). The price of smoking. Cambridge, MA: MIT.Google Scholar