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Tables
Table 1. Estimates of the Total U.S. Annual Cost of Fetal Alcohol Syndrome Ranked by Prevalence Rate
| Source |
Prevalence Rate (per 1,000) |
Annual Cost |
Year |
Types of Services Included |
| Abel and Sokol |
0.33 |
$75 million |
1984 |
A1, B1 |
| Harwood and Napolitano |
1.67 |
$3.235 billion |
1980 |
A2, B2, B3, C, D |
| Abel and Sokol |
1.9 |
$321 million |
1984 |
A1, B1 |
| Abel and Sokol |
1.9 |
$250 million |
1987 |
A1, B1 |
| Rice, et al. |
1.9 |
$1.611 billion |
1985 |
A1, B4 |
| Rice; update of 1985 study |
1.9 |
$2.089 billion |
1990 |
A1, B4 |
| Harwood, et al. |
2.0/1.0* |
$2.934 billion |
1992 |
A3, B2, B3, D |
| Harwood; update of 1992 study |
2.0/1.0* |
$4.022 billion |
1998 |
A3, B2, B3, D |
Service Codes
| Service Code |
Description |
| A1 |
Medical treatment services to age 21 for pre- and postnatal growth retardation, heart defects requiring surgery, spina bifida, cleft palate, surgery and treatment for audiologic deficits, inguinal hernia, and hypospadias |
| A2 |
Medical treatment services to age 21 for pre- and postnatal growth retardation, heart defects requiring surgery, cleft palate, surgery and treatment for audiologic deficits, kidney defects, and neural tube defects |
| A3 |
Medical treatment services to age 21 for pre- and postnatal growth retardation, cleft palate, surgery and treatment for audiologic deficits, and neural tube defects |
| B1 |
Residential care due to mental retardation for ages 5 to 21 |
| B2 |
Residential and home care for mild to moderate mental retardation for ages 22 to 65 |
| B3 |
Institutionalization for severe mental retardation for ages 5 to 65 |
| B4 |
Residential care and support services for persons with mild to moderate mental retardation over the age of 21 and full residential care for persons with severe mental retardation over the age of 5 |
| C |
Special education resource room for individuals with minimal brain dysfunction for ages 5 to 18 and ambulatory care with special education for ages 3 to 21 |
| D |
Lost employment and reduced productivity |
Table 2. 2002 U.S. Annual Cost Adjusted by Population Growth and Inflation
| Source |
Type of Cost |
Costs (in billions) |
Year |
Percent Increase in Population* |
Percent Change in Inflation† |
2002 Adjusted Estimate‡
(in billions) |
| Abel and Sokol |
Treatment costs for medical services |
$0.017 |
1984 |
1.223 |
2.745 |
$0.06 |
| Residential care for mental retardation |
$0.058 |
1.223 |
1.731 |
$0.12 |
| Total |
$0.075 |
|
|
$0.18 |
| Harwood and Napolitano |
Treatment costs for medical services |
$1.209 |
1980 |
1.269 |
3.916 |
$6.01 |
| Residential care for mental retardation |
$1.174 |
1.269 |
2.183 |
$3.25 |
| Lost productivity |
$0.853 |
1.269 |
2.218 |
$2.40 |
| Total |
$3.235 |
|
|
$11.66 |
| Abel and Sokol |
Treatment costs for medical services |
$0.135 |
1984 |
1.223 |
2.745 |
$0.45 |
| Residential care for mental retardation |
$0.186 |
1.223 |
1.731 |
$0.39 |
| Total |
$0.321 |
|
|
$0.85 |
| Abel and Sokol |
Treatment costs for medical services |
$0.105 |
1987 |
1.190 |
2.253 |
$0.28 |
| Residential care for mental retardation |
$0.145 |
1.190 |
1.584 |
$0.27 |
| Total |
$0.250 |
|
|
$0.55 |
| Rice, et al |
Treatment costs for medical services |
$0.138 |
1985 |
1.212 |
2.587 |
$0.43 |
| Residential care for mental retardation |
$1.473 |
1.212 |
1.672 |
$2.99 |
| Total |
$1.611 |
|
|
$3.42 |
| Harwood, et al. |
Treatment costs for medical services |
$0.600 |
1992 |
1.124 |
1.537 |
$1.04 |
| Residential care for mental retardation |
$1.344 |
1.124 |
1.282 |
$1.94 |
| Lost productivity |
$0.990 |
1.124 |
1.397 |
$1.56 |
| Total |
$2.934 |
|
|
$4.53 |
*Population change is determined using U.S. population figures from the Bureau of the Census for July 1 of each year.
†Inflation change is determined based on the Medical Services Price Index from the Bureau of Labor Statistics for treatment services, the Consumer Price Index for care, and the Average Hourly Wage for Production Workers for productivity.
‡Totals may vary due to rounding.
Table 3. Comparable Adjusted Estimates of the Total 2002 U.S. Annual Cost for Treatment and Care Costs Only Based on Prevalence Rate of 2/1,000 and Residential Care for Mentally Retarded Individuals of All Ages
Source |
Adjusted Estimates (in billions) |
Increase Factor for Prevalence Rate |
Increase Factor for Residential
and Support Care for Mentally Retarded Age 21+ |
Normalized Estimates of Annual Cost(in billions) |
| Abel and Sokol, 1984 |
$0.18 |
6.061 |
4 |
$4.7 |
| Harwood and Napolitano, 1980 |
$5.45 |
2 |
1 |
$11.1 |
| Harwood and Napolitano, 1980 |
$9.26 |
1.198 |
1 |
$11.1 |
| Abel and Sokol, 1984 |
$0.85 |
1.053 |
4 |
$3.6 |
| Abel and Sokol, 1987 |
$0.55 |
1.053 |
4 |
$2.3 |
| Rice, et al., 1985 |
$3.42 |
1.053 |
1 |
$3.6 |
| Harwood, et al., 1992 |
$4.53 |
1 |
1 |
$4.5 |
Note: Total may vary slightly due to rounding of estimated total 2002 U.S. annual costs, as well as the increase factors for prevalence rate and mental retardation care.
Table 4. Estimates of the Total U.S. Lifetime Cost of Each Child with FAS
| Source of Estimate |
Date |
Costs Included |
Undiscounted Estimate of Total U.S. Lifetime Cost of Child With FAS |
| Harwood and Napolitano1 |
1980 |
A1, B1, C, D, F |
$596,000 |
| Alaska State Legislature |
1988 |
A2, B2, C, E, F |
$1,373,836 |
Service Codes
| Service Code |
Description |
| A1 |
Medical treatment services to age 21 for pre- and postnatal growth retardation, heart defects requiring surgery, spina bifida, cleft palate, surgery and treatment for audiologic deficits, inguinal hernia and hypospadias |
| A2 |
Medical treatment costs for pre- and postnatal growth retardation, heart defects requiring surgery, cleft palate, and surgery and treatment for audiologic deficits |
| B1 |
Ambulatory, home and residential care for individuals with mild to moderate mental retardation |
| B2 |
Infant learning, handicapped children, youth initiative, and developmentally disabled children's services |
| C |
Special education services |
| D |
Lost employment and reduced productivity |
| E |
Social service costs, such as training and supervised work services |
| F |
Institutional care for mental retardation to age 65 |
Sources
- Harwood, H.J., and Napolitano, D.M. 1985. Economic implications of the fetal alcohol syndrome. Alcohol Health & Research World, 10(1):38-43; 74-75.
- Abel, E.L., and Sokol, R.J. 1987. Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence, 19:1024-1031.
- Rice, D.P.; Kelman, S.; Miller, L.S.; et al. 1990. The Economic Costs of Alcohol and Drug Abuse and Mental Illness: 1985. DHHS Publication No. (ADM) 90-1694. Rockville, MD: U.S. Department of Health and Human Services.
- Abel, E.L., and Sokol, R.J. 1991. A revised estimate of the economic impact of fetal alcohol syndrome. In: Galanter, M. (ed.). Recent Developments in Alcoholism: Volume 9, Children of Alcoholics. New York: Plenum Press, pp 117-125.
- Abel, E.L., and Sokol, R.J. 1991. A revised conservative estimate of the incidence of FAS and its economic impact. Alcoholism: Clinical and Experimental Research, 15:514-524.
- Streissguth, A.P. 1991. What every community should know about drinking during pregnancy and the lifelong consequences for society. Substance Abuse, 12(3):114-127.
- Rice, D.P. 1993. The economic costs of alcohol abuse and dependence: 1990. Alcohol Health & Research World, 17(1):10-11.
- Harwood, H.; Fountain, D.; and Livermore, G. 1998. The Economic Costs of Alcohol and Drug Abuse in the United States, 1992. Washington, DC: National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism.