FASD Thou­sands of lives, bil­lions of dol­lars

im­poses a stag­ger­ing bill on Cana­di­ans

Winnipeg Free Press - Section H - - FRONT PAGE - By Mia Rab­son

SOME call them mil­lion-dol­lar ba­bies. Oth­ers re­fer to it as a multi­bil­lion-dol­lar prob­lem. Any way you slice it, when a child in Canada is born with fe­tal al­co­hol spec­trum dis­or­der, the bills pile up.

Ex­tra vis­its to the doc­tor. Psy­chi­atric care. Spe­cial ed­u­ca­tion fees. Fos­ter care. Pris­ons and polic­ing. Dam­aged prop­erty. Lost wages.

Ac­cord­ing to one study, Cana­dian tax­pay­ers and fam­i­lies shoul­der a $5.3-bil­lion bur­den each year just for the health care, ed­u­ca­tion and so­cial ser­vice needs of peo­ple liv­ing with FASD.

“It’s stag­ger­ing,” said Brenda Stade, a nurse and FASD re­searcher at St. Michael’s Hos­pi­tal in Toronto.

FASD is the lead­ing cause of de­vel­op­men­tal and cog­ni­tive dis­abil­i­ties in Canada. It is en­tirely pre­ventable and if chil­dren are as­sessed and di­ag­nosed early in life, it is also po­ten­tially treat­able. With the right help, most kids born with al­co­hol-re­lated birth de­fects can learn, hold jobs and, de­pend­ing on their level of dis­abil­ity, live in­de­pen­dently.

Stade was the lead re­searcher on a study look­ing at the eco­nomic bur­den of FASD for chil­dren from one day old to 53 years old. Us­ing the only known in­ci­dence rate for FASD in Canada — one in 100 live births — Stade ex­trap­o­lated that there are 242,906 peo­ple age 53 and un­der liv­ing with FASD in Canada to­day.

It is likely a con­ser­va­tive es­ti­mate since most FASD ex­perts be­lieve a sig­nif­i­cant num­ber of chil­dren is never di­ag­nosed.

Stade sur­veyed 250 par­ents and care­givers as well as some FASD pa­tients them­selves about doc­tor vis­its, ther­apy needs, ed­u­ca­tion ex­tras, fos­ter care costs, even things such as lost wages for care­givers and park­ing fees paid to take kids to see the doc­tor.

All told, Stade found the av­er­age an­nual cost for a per­son with FASD ex­ceeded $21,600 a year.

Younger kids and those with se­vere dis­abil­i­ties can rack up an­nual tal­lies of more than $30,000.

By the time a child with FASD turns 18, the spe­cial costs associated with their dis­abil­i­ties will reach nearly $400,000 on av­er­age. They’ll hit the mil­lion-dol­lar mark by the time they turn 46.

Tax­pay­ers foot the bill for about 75 per cent of that. Stade said while she is more con­cerned with the cost to qual­ity of life of a child with FASD, fig­ur­ing out the dol­lars and cents gets the at­ten­tion of both pol­icy-mak­ers and the pub­lic. “We had to look at a cost-ben­e­fit anal­y­sis,” said Stade. The cost driv­ers of FASD evolve from the dis­abil­i­ties the con­di­tion im­poses on its vic­tims.

Stud­ies have shown that more than 90 per cent of kids with FASD will have men­tal-health dis­or­ders in­clud­ing at­ten­tion and mood dis­or­ders. They see doc­tors more of­ten, are pre­scribed more med­i­ca­tion and have more needs for ther­a­pies such as speech and oc­cu­pa­tional ther­apy than other kids.

Peo­ple with FASD are also more likely to end up in fos­ter care, have trou­ble in school, de­velop sub­stance abuse prob­lems of their own and get into trou­ble with the law. Each is­sue brings its own ad­di­tional bills.

Stade notes her study did not in­clude the jus­tice sys­tem costs be­cause at the mo­ment, re­searchers have not been able to ad­e­quately as­sess it. It likely would bump up the $5-bil­lion fig­ure sig­nif­i­cantly. As many as 25 per cent of young of­fend­ers are be­lieved to have symp­toms or a diagnosis of FASD. A well-re­spected Amer­i­can study found 60 per cent of kids with FASD had been in trou­ble with the law. A study in Man­i­toba found at least 10 per cent of of­fend­ers in Stony Moun­tain Pen­i­ten­tiary had FASD.

Man­i­toba Lib­eral Leader Jon Ger­rard es­ti­mates of­fend­ers with FASD likely ac­count for 25 to 50 per cent of what Man­i­toba Jus­tice spends on its jus­tice sys­tem.

His re­port also sug­gests be­tween 20 and 33 per cent of the costs of the child wel­fare sys­tem, and up to 10 per cent of the cost of both the ed­u­ca­tion and health care sys­tems can be at­trib­uted to peo­ple with FASD.

All to­talled, Ger­rard es­ti­mates a hit to the pro­vin­cial bud­get of some­where be­tween $426 mil­lion and $924 mil­lion in a sin­gle year — or be­tween five and 11 per cent of the bud­get.

In other words, some­where be­tween $5 and $10 of ev­ery $100 the prov­ince spends can be traced back to FASD.

“When I did the arith­metic, I was blown away,” said Ger­rard. “I hes­i­tated to even write (the num­bers) down be­cause they were so huge.”

But Ger­rard said the es­ti­mates show Man­i­toba has a ma­jor prob­lem and the re­sponses to date are just not ad­e­quate.

In 2007-08, pro­vin­cial and ter­ri­to­rial gov­ern­ments to­gether bud­geted more than $26 mil­lion on FASD preven­tion and treat­ment pro­grams. Four prov­inces and two ter­ri­to­ries didn’t bud­get a cent.

Man­i­toba, at $7.5 mil­lion, was sec­ond only to Bri­tish Columbia which spends $10 mil­lion.

Man­i­toba Healthy Liv­ing Min­is­ter Jim Ron­deau said the prov­ince’s spend­ing on FASD now tops $11 mil­lion an­nu­ally. “The pro­gram is ex­pand­ing dras­ti­cally,” said Ron­deau. He said the gov­ern­ment knows FASD is a long-term is­sue that af­fects ev­ery­thing, but the prob­lem can’t be fixed overnight. “There isn’t a sim­ple so­lu­tion to a com­plex is­sue,” he said. The big­gest is­sue raised by al­most any­one work­ing with peo­ple with FASD is whether they are di­ag­nosed early enough and that pro­grams that help are made avail­able to them.

“There are in­ter­ven­tions that can help,” said Stade. “I’m just not sure how we’re spend­ing money to re­ally help.”

— with files from Mary Agnes Welch

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