The need to act early in life is clearly supported by research. The Dunedin Multidisciplinary Health and Development Study followed a large cohort of New Zealanders from early childhood to age 38. A subgroup analysis of the cohort identified a group at higher risk as early as age 3 years, and these people were assessed to contribute to the highest economic and social burdens. This group went on to occupy the most hospital inpatient beds and accounted for the highest healthcare costs and other non-healthcare related governmental spending in adulthood. They were also far more likely to have modifiable healthcare risk factors including obesity and tobacco smoking.
The call for, and evidence behind, tackling the socioeconomic determinants of health is overwhelming, yet it remains far from being included in routine clinical practice.
We must make greater progress towards optimising and prioritising preventive healthcare strategies as a matter of social justice for all members of society and for the sustainability of quality healthcare.