Healthy Kids, Less Crime? Part I of II

There’s one issue that hasn’t seen much airtime during the Presidential election, and you probably didn’t even realize its absence. That issue is crime, and it hasn’t come up because it’s just not as scary as it was in the past. In one of the great mysteries of criminology, crime began to fall in 1993 and continued to plummet throughout the 1990s and into the 21st century.

Experts have offered explanations ranging from higher incarceration rates to more cops on the streets to the legalization of abortion (this last theory, put forth by economist Steven Levitt in the best-selling Freakonomics, has since been disproved). But ultimately no one can pinpoint exactly what happened, mostly because no one really knows what causes crime as a broad, social phenomenon. If we can’t explain what causes it, we can’t understand what causes it to decline—and thus politicians can’t take credit for it or offer solutions.

But for all the head-scratching, there is one promising line of inquiry that’s only now beginning to see scholarly attention: the link between peoples’ health as children and their criminal activity as adults. Believe it or not, there’s been relatively little empirical work done to link childhood mental disorders and adult offenses. That’s changing. In November, The American Journal of Psychiatry published a study that asked whether “the national crisis in child community mental health services” contributes to “delinquency,” and whether more robust, timely responses to “youths with mental disorders” can reduce adult crime. The answers were “yes” on both points.

The study, carried out by researchers at Duke University, consisted of interviews with a cohort of 1,420 children aged 9 to 13 and a reassessment of these kids every year through the age of 16. During those years, the team identified those youths with mental health problems and diagnosed them. Everyone was tracked until 21 to identify arrests (criminal involvement is far more common between 16 and 20, and drops off sharply when people move into their twenties). The findings were telling.

About one-third of the cohort was arrested in young adulthood. Within
the arrested sample, 51.4 percent of males and 43.6 percent of females
were diagnosed with mental disorders, proportions which were
“significantly greater than those for youths who were not arrested as
adults, even with statistical controls for history of delinquency in
adolescence.” Thus, as the authors put it, “childhood psychiatric profiles predicted all levels of criminality.”

A word of caution: the results don’t mean that somehow flicking a
switch and eliminating mental disorders in kids would extinguish crime
in their generation. After all, half of the offenders didn’t have
mental disorders, and those that did
suffered from a complex mix of emotional disorders (such as anxiety or
depression) and behavioral disorders (such as substance abuse or
conduct disorder). It’d be wrong to over-simplify things and claim that
only ill people engage in crime or that we can isolate the illness that
leads to crime.

But what this study does show is that, when observed in children, this
complex mix of emotion and behavior has "special significance" in
determining future criminality. This may seem like a conceptual
no-brainer–everyone knows that troubled kids become unruly adults,
right? But the reality is that our system does little to engage with
this fact: according to the National Center for Children in Poverty, 75 to 80 percent of children and youth in need of mental health services do not receive

This is an appalling statistic, but perhaps more importantly, it’s a
daunting one. How the heck do we ensure that the two solutions offered
by the Duke study–"prevention" and "psychiatric management" of at risk
youth–are effectively carried out? Where do we start?

Ideally, at the beginning. The Duke study looked at kids who were aged
9 and above and was primarily concerned with identifying disorders so
that they could observe future consequences. To actually prevent what
the researchers observed, we’d have to intervene earlier than that:
before, or at least during, preschool.

Enter quality child care. A good program that fosters development in
young children has a big impact on reducing crime later on. Back in 2000,
the non-profit organization Fight Crime: Invest in Kids, published a
report detailing the powerful impact child care can have on future
crime. The group reported that a 14-year study shows children enrolled
in government funded Child-Parent centers have 70 percent less arrests
for violent crime than similar kids outside the program. A 22-year
study of a preschool program concluded that “denying at-risk children
quality child development programs may multiply by five times our risk
that they will be chronic lawbreakers as adults.”

Early investment prevents crime by socializing children and allowing
coordinated interventions over time in order to identify and engage
with children who have mental, behavioral, or emotional problems.
Unfortunately, a lot of children—primarily poor children—are denied
quality child care, largely because it is so expensive. According to the National Association of Child Care Resource & Referral Agencies,
in 2007 the average yearly cost of having a 4-year-old child in day
care can run as much as twenty-nine percent of the media household
income in the U.S., depending on the state. And in all but two states,
the average cost of caring for an infant and a preschooler is more than
50 percent the median household income for single parents—the very
households which studies show have the highest prevalence of problem
behaviors in children. While universal preschool is one way of giving
struggling families access to child care services, as of now it only
operates in a few states. Today, good help is hard to find—and harder
to afford.

It’s true that there are strategies in place to help shoulder child
care costs, most notably the Child and Dependent Care Tax Credit. The
credit gives households a percentage of their child care costs back in
the form of a tax credit. How much you get back is based on income (the
less you make, the greater the share of your costs are returned to
you). But there’s a catch, and it’s a big one: the credit is
nonrefundable, which means no one can get reimbursed for more than they
pay in taxes. Thus the poorest families, who owe little or nothing in
taxes, can’t receive the credit—even if they’ve spent money on child

Thanks to this loophole, the Urban Institute and Brookings Institution Tax Policy Center concludes that
“only 8 percent of the [credit’s] benefits go to households with
incomes less than $30,000” while the top 11 percent of income earners
get almost a quarter of the total benefits. Those parents who need the
most help don’t get it.

Another potential safety net for struggling parents is Head Start, a
publicly-funded program meant to give young children developmental and
educational guidance in order to prepare them for school. But Head
Start has become a sinking ship under the Bush Administration: since
fiscal year 2002, the program has seen a shortfall of $1 billion due to
budget cuts. Activists are also frustrated
because in December, Congress cut the program’s funding by $10 million
while adding on new regulations that are said to cost hundred of
millions of dollars.

When it comes to child care, the options for poor families are bad and
getting worse. This is problematic because poor children are at a high
risk of those mental disorders that the Duke study links to crime.
Another study from the University of Alberta
shows that long-term poverty worsens the mental health of children
because “poverty early in life helps to set into motion a consistent
pattern of antisocial behaviors that are difficult to change once
learned.” According to numbers from the Urban Institute,
21 percent of low-income children (poor or near-poor) between the ages
of 6 to 17 have emotional and behavioral problems, as opposed of only 6
percent of non-poor children. Statistically speaking, low-income
children need the benefits of child care the most.

What’s particularly frightening about the link between poverty and
childhood mental disorders is that children under five are the
demographic most likely to be poor. If we know poor kids are more
likely to suffer from mental disorders, and kids with mental disorders
are more likely to get involved in crime, what does this high rate of
child poverty portend for crime rates of the future?

Clearly, combating poverty needs to go hand-in-hand with providing more
opportunities for child care. Anti-poverty strategies vary widely, from
boosting income with a higher minimum wage or Earned Income Tax Credit
(EITC) to helping families built assets through Individual Development
Accounts—matched savings accounts for low-income earners.  But that’s
not all we need to do. Let’s give some serious thought to instituting
universal preschool, making the Child Care tax credit refundable, and
revitalizing—and, where necessary, reconfiguring—Head Start.

This is Part I of a two-part post. Part II will appear later this week.

One thought on “Healthy Kids, Less Crime? Part I of II

  1. Thank you for a fascinating article, Niko. The importance of high quality child care for low-income children has been demonstrated in study after study.
    I’m hoping that part II will address suggestions for addressing pediatric mental health issues.