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The economic burden of child maltreatment in the United States and implications for prevention
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OBJECTIVES: To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. METHODS: This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008. RESULTS: The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion. CONCLUSIONS: Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment.
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“These consequences are far-reaching into families and communities, with significant costs for institutions in terms of primary and rehabilitative health care, education and welfare assistance, child protection, and justice system costs (Fang 2012).”
From School-based education programmes for the prevention of child sexual abuse (2015) · cites this paper as Fang 2012
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“These conditions exact costs in excess of $124 billion through suffering, disability, treatment, and loss of productivity over the lifespan (Fang et al., 2012), making early stress exposures an important public health problem.”
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Patterns of maltreatment and diagnosis across levels of care in group homes
Seifert, H. T. P., Farmer, E. M. Z., Wagner, H. R., Maultsby, L. T., & Burns, B. J. (2015) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2014.12.008 · Cited by 29
School-based Education Programmes for the Prevention of Child Sexual Abuse: A Systematic Review
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Children and US Federal Policy on Health and Health Care
Flores, G., & Lesley, B. (2014) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2014.1701 · Cited by 29
Risk factors for child abuse: quantitative correlational design.
Ben-Natan, M., Sharon, I., Barbashov, P., Minasyan, Y., Hanukayev, I., Kajdan, D., & Klein-Kremer, A. (2014) · Journal of pediatric nursing · doi:10.1016/j.pedn.2013.10.009 · Cited by 27
The Benefits and Costs of a U.S. Child AllowancePreprint
Garfinkel, I., Sariscsany, L., Ananat, E., Collyer, S. M., Hartley, R. P., Wang, B., & Wimer, C. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4062405 · Cited by 29
Lee, N., Massetti, G. M., Perry, E. W., & Self-Brown, S. (2022) · Journal of Interpersonal Violence · doi:10.1177/08862605211056726 · Cited by 27
“Additionally, ACEs can hinder economic productivity and social outcomes such as educational achievement and employment (Fang et al., 2012; Soares et al., 2016).”
BackgroundSexual Abuse and Exploitation of PreK-12 Students by School Personnel
Grant, B.-J., Shakeshaft, C., & Mueller, J. (2019) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2019.1567139 · Cited by 28
Durrant, J. E., Plateau, D. P., Ateah, C. A., Holden, G. W., Barker, L., Stewart-Tufescu, A., Jones, A. D., Ly, G., & Ahmed, R. (2017) · International Journal of Behavioral Development · doi:10.1177/0165025416687415 · Cited by 28
Adverse childhood experiences in NSCAW
Stambaugh, L. F., Ringeisen, H. L., Casanueva, C. E., Tueller, S., Smith, K., & Dolan, M. (2013) · Cited by 28
Early childhood maltreatment and profiles of resilience among child welfare-involved children
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“The economic burden of child maltreatment in the United States is substantial, with the estimated average lifetime cost per victim being over $200,000 (Fang et al., 2012).”
BackgroundImproving Child Welfare Outcomes: Balancing Investments in Prevention and Treatment
Ringel, J., Schultz, D. J., Mendelsohn, J., Holliday, S. B., Sieck, K., Edochie, I. N., & Davis, L. (2017) · Rand health quarterly · doi:10.7249/rhq-07-04-04 · Cited by 28
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“The cost of lifetime care for these victims is enormous [4, 5].”
The association between elder abuse and childhood adversity: A study of older adults in Malaysia
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“TF-CBT is one of the leading evidence-based treatments for traumatic stress among youth in HICs and has also been found to be effective in several LMICs.”
BackgroundInfluentialEconomic Impact of Multisystemic Therapy for Child Abuse and Neglect
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“As a result of these effects, child maltreatment incurs a substantial economic burden to society in expenses associated with social services, health care, lost productivity, and decreased quality of life (Fang et al. 2012; Gelles and Perlman 2012; Habetha et al. 2012).”
BackgroundThe economic costs of childhood socio-economic disadvantage in European OECD countries
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“Direct and indirect economic costs in various countries have been estimated in the billions (Fang et al., 2012; Taylor et al., 2008).”
BackgroundThe relationship between child welfare financing, screening, and substantiation
Mclaughlin, M. P., & Jonson‐Reid, M. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2017.10.013 · Cited by 26
Liming, K. W. (2018) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-018-0230-z · Cited by 30
“…burden with confirmed cases of child maltreatment, including ACEs such as child physical, sexual and emotional abuse, and physical and emotional neglect, estimated to have an aggregated lifetime economic cost of $124 billion, totaling to a lifetime cost of $210,000 per child (Fang et al. 2012).”
BackgroundIncome and Child Maltreatment: Evidence from a Discontinuity in Tax Benefits
Rittenhouse, K. (2025) · The Review of Economics and Statistics · doi:10.1162/rest.a.1690 · Cited by 26
Aspects of Abuse: Consequences of Childhood Victimization
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Adverse Childhood Experiences and E‐Cigarette Use During Young Adulthood
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A Strengths-based Approach to Supervised Visitation in Child Welfare
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Metadata
- Authors
- Fang, X., Brown, D. S., Florence, C. S., & Mercy, J. A.
- Affiliations
- Centers for Disease Control and Prevention (US)
- RTI International (US)
- Corresponding author
- Fang, Xiangming
- Venue
- Child Abuse & Neglect
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 36
- Issue
- 2
- Pages
- 156-165
- ISSN
- 0145-2134 (ISSN-L)
- PMC
- PMC3776454
- OpenAlex
- W2167783241
- Cited by
- 1,122
- References
- 62
- Citations by year
- 2026: 30 · 2025: 41 · 2024: 47 · 2023: 65 · 2022: 95 · 2021: 75 · 2020: 111 · 2019: 91 · 2018: 111 · 2017: 112 · 2016: 101 · 2015: 100 · 2014: 69 · 2013: 52 · 2012: 16
- FWCI
- 86.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Child Abuse & Neglect (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Centers for Disease Control and Prevention (200-2008-M-28149)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child Abuse and Related Trauma
- Keywords
- child abuse, economic burden, lifetime costs, child abuse prevention, productivity loss, criminal justice costs, special education costs, cost estimation
- MeSH terms
- Adolescent, Adult, Child, Child Abuse, Child, Preschool, Costs and Cost Analysis, Female, Humans, Infant, Male, Middle Aged, United States, Health Care Costs, Young Adult
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