The Economic Burden of Fetal Alcohol Spectrum Disorder in Canada in 2013.
OBJECTIVE
To estimate the economic burden and cost attributable to Fetal Alcohol Spectrum Disorder (FASD) in Canada in 2013.


METHODS
This cost-of-illness study examined the impact of FASD on the material welfare of the Canadian society in 2013 by analyzing the direct costs of resources expended on health care, law enforcement, children and youth in care, special education, supportive housing, long-term care, prevention and research, as well as the indirect costs of productivity losses of individuals with FASD due to their increased morbidity and premature mortality.


RESULTS
The costs totaled approximately $1.8 billion (from about $1.3 billion as the lower estimate up to $2.3 billion as the upper estimate). The highest contributor to the overall FASD-attributable cost was the cost of productivity losses due to morbidity and premature mortality, which accounted for 41% ($532 million-$1.2 billion) of the overall cost. The second highest contributor to the total cost was the cost of corrections, accounting for 29% ($378.3 million). The third highest contributor was the cost of health care at 10% ($128.5-$226.3 million).


CONCLUSIONS
FASD is a significant public health and social problem that consumes resources, both economic and societal, in Canada. Many of the costs could be reduced with the implementation of effective social policies and intervention programs.
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON Canada M5S 2S1 Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON Canada M5T 3M7 Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W., Toronto, ON Canada M5S 1V4 Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON Canada M5S 1A8 lana.popova@camh.ca.
Svetlana
S
Popova
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON Canada M5S 2S1 Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON Canada M5S 1A8.
Shannon
S
Lange
Department of Pediatrics, University of North Dakota School of Medicine, Grand Forks, ND, USA.
Larry
L
Burd
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON Canada M5S 2S1 Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON Canada M5T 3M7 Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON Canada M5S 1A8 Epidemiological Research Unit, Klinische Psychologie and Psychotherapie, Technische Universität Dresden, Chemnitzer Str. 46. 01187 Dresden, Germany.
Jürgen
J
Rehm
D002170:Canada; D017281:Cost of Illness; D004519:Education, Special / Q000191:economics; D063647:Fetal Alcohol Spectrum Disorders / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006798:Housing / Q000191:economics; D006801:Humans; D035846:Law Enforcement