Clustering of health, crime and social-welfare inequality in 4 million citizens from 2 nations

Health and social scientists have documented the hospital revolving-door problem, the concentration of crime, and long-term welfare-dependence. Have these distinct fields identified the same citizens? Using administrative databases linked to 1.7-million New Zealanders, we quantified and monetized inequality in distributions of health and social problems and tested whether they aggregate within individuals. Marked inequality was observed: Gini coefficients equaled 0.96 for criminal-convictions, 0.91 for public-hospital-nights, 0.86 for welfare-benefits, 0.74 for prescription-drug-fills, and 0.54 for injury-insurance-claims. Marked aggregation was uncovered: a small population segment accounted for a disproportionate share of use-events and costs across multiple sectors. Findings replicated in 2.3-million Danes. We then integrated the New Zealand databases with the four-decade-long Dunedin Study. The high-need/high-cost population segment experienced early-life factors that reduce workforce-readiness, including low education and poor mental-health. In midlife they reported low life-satisfaction. Investing in young people’s education/training potential could reduce health and social inequalities and enhance population wellbeing.