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

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

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.