The Very Early Antecedents of NEET: Understanding the Role of Birthweight

This blog post is based on an article published in the Journal of Social Policy by Niko Eskelinen, Laura Salonen, Sanni Kotimäki, Matti Lindberg, and Juho Härkönen.

Completing education, entering the labour market and achieving financial independence are key milestones in the transition to adulthood. When these transitions fail, the consequences can be severe and long-lasting, affecting not only material living conditions but wellbeing, life satisfaction, social participation and health. One of the most widely used indicators for capturing such disruptions is NEET status: not in education, employment, or training. Research shows that NEET spells in early adulthood carry scarring effects on later employment, earnings and mental health. Beyond the individual level costs, exclusion from education and the labour market imposes significant societal costs, which is why NEET has become an important indicator of social vulnerability and disengagement among young people in both policy and research.

Previous research has pointed to low socioeconomic background, immigrant status, poor school performance and mental health problems as the most robust risk factors for NEET. Yet, how deep into the life-course do the roots of exclusion actually run? Our research suggests the origins may reach back even to birth: health conditions at the starting gates of life. Life-course epidemiology has long shown that the perinatal period is a sensitive developmental window during which adverse conditions can leave lasting marks on cognitive functioning and health. These marks may still be visible decades later, for example in the skills that education and the labour market reward. If the foundations of learning and wellbeing are laid this early, health disadvantages at birth may leave lasting traces on later social outcomes.

In our recent study, we examined whether low (under 2500 g) and very low (under 1500 g) birth weight affect the incidence of NEET in young adulthood between the ages of 21 and 27. We also studied whether the effects of (very) low birth weight varied by socioeconomic background, measured as maternal education. For our analysis, we used high-quality Finnish birth registers nearly 350,000 individuals born in 1987–1992, linked to register data on later life economic activity and educational enrolment. Our data allowed us to link siblings, which we used to run sibling fixed effects models. These models help control for confounding factors that siblings share, such as family background, neighbourhood environment, and genetics, that might otherwise bias our estimates.

The earliest environment: how conditions at birth shape life chances

How exactly do birth conditions leave traces that are still visible two decades later? One of the most influential theories addressing this question is the fetal origins hypothesis, developed by the epidemiologist David Barker. Barker proposed that when conditions during pregnancy are adverse, due to poor nutrition for example, the fetus adapts to survive, but at a cost: these adaptations can permanently alter development in ways that affect health and life chances long after birth. Birthweight is one of the clearest observable signals of whether this early developmental window has been disrupted.  Low and very low birthweight, typically resulting from preterm birth or poor fetal growth, impair brain development and are well-documented to have broad consequences for health and cognitive functioning, increasing the risk of learning disabilities and psychiatric disorders such as depression, anxiety, and attention deficit and hyperactivity disorder, all of which raise the likelihood of poorer academic achievement, school dropout and difficulties in labour market attachment.

Later, what began as an epidemiological insight has since crossed disciplinary boundaries: economists, sociologists and social scientists have taken up the fetal origins framework to understand how the very early environment shapes not only health but the development of human capital and socioeconomic outcomes across the life course. From this perspective, low birthweight is not merely a medical concern, but it can be seen as an early marker of social risk.

The weight of beginnings: low birthweight as an early antecedent of NEET

Our key findings point to a consistent pattern: the smaller a child was at birth, the greater their risk of NEET in early adulthood. Main results show that children born with low birthweight were 26 per cent more likely to spend time in NEET status compared to their normal birthweight siblings, after accounting for shared family background. For those born with very low birthweight, the risk was approximately doubled. These effects held up under the conservative within-family comparison: even among siblings born to the same mother, the child born smaller faced meaningfully worse outcomes in early adulthood. The effect sizes are comparable to those of some of the most established predictors of NEET, including low parental education.

Can family resources compensate?

A natural follow-up question for a social scientist and stratification researcher is whether a more advantaged family background can cushion these early life-course risks. Compensatory advantage theory suggests it can: parents with higher socioeconomic status have more economic, social and cultural resources at their disposal, making them better equipped to support their vulnerable children and use different compensatory strategies against the long-term consequences of a difficult start. Yet the opposite is also theoretically plausible. Children from disadvantaged backgrounds already face elevated baseline rates of NEET, meaning that additional risk factors such as low birthweight may add relatively little on top of an already high baseline. Higher-SES children, by contrast, start from a lower baseline, and low birthweight may therefore represent a more consequential shock, leaving them paradoxically more exposed to NEET risk.

Our findings show that low birthweight was equally consequential regardless of whether a child grew up in a socioeconomically advantaged or disadvantaged family. This challenges compensatory advantage models and suggests that family resources cannot always buffer the effects of biological disadvantage. Health at birth matters, and poor health at birth leaves marks that socioeconomic advantage alone cannot fully erase.

Earlier than early: health at birth from a social policy perspective?

If the roots of social vulnerability and disengagement reach back to birth, the debate around early intervention must reach back further than traditionally assumed. Much of the recent discussion has focused on high-quality affordable childcare and early childhood education as tools for equalising human capital development, and clearly these remain important. However, our findings suggest that even earlier investments matter. From this perspective, obstetric, neonatal and infant healthcare are not only medical expenditures; they are social investments that may help prevent the kind of disadvantaged trajectories, disengagement from education, precarious labour market attachment, social exclusion, that NEET both reflects and reinforces. Policies targeting health during pregnancy and at birth do not replace early childhood interventions, but they precede and complement them. Seen through a life-course lens, investing in the health of newborns and their expecting mothers is also investing in the adults they will become.

Reference

Eskelinen, Niko et al. 2026. “The Very Early Antecedents of NEET: Understanding the Role of Birthweight.” Journal of Social Policy: 1–18. doi: 10.1017/S0047279426101299.

About the Authors

Niko Eskelinen is Doctoral Researcher in the INVEST Research Flagship Centre, University of Turku, Finland.

Laura Salonen is Senior Researcher at the Finnish Institute of Occupational Health, Helsinki, Finland.

Sanni Kotimäki is University Lecturer in the INVEST Research Flagship Centre, University of Turku, Finland.

Matti Lindberg is Research Manager in the INVEST Research Flagship Centre, University of Turku, Finland.

Juho Härkönen is Professor in the Department of Political and Social Sciences, European University Institute, Florence, Italy.