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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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Wherry, J. N., Huffhines, L. P., & Walisky, D. N. (2015) · Child Maltreatment · doi:10.1177/1077559515619487 · Cited by 18
Imagawa, K. K., Hamilton, A. H., Ceschin, R. C., Tokar, E., Pham, P. K., Blüml, S., Wisnowski, J. L., & Panigrahy, A. (2014) · Journal of Neurotrauma · doi:10.1089/neu.2013.3228 · Cited by 18
“economic burden of new fatal and nonfatal child maltreatment cases, including AHT, is approximately 124 billion dollars.(17)”
BackgroundThe Cost-effectiveness Analysis of Nurse-Family Partnership in the United States
Wu, J., Dean, K. S., Rosen, Z., & Muennig, P. A. (2017) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2017.0134 · Cited by 18
Child Maltreatment as a Root Cause of Mortality Disparities
Shalev, I., Heim, C. C., & Noll, J. G. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.1748 · Cited by 18
The economic cost of child maltreatment in the UK
Conti, G. (2017) · doi:10.1920/re.ifs.2081.0143 · Cited by 18
Burghart, M., & Backhaus, S. (2024) · Journal of Family Violence · doi:10.1007/s10896-024-00768-y · Cited by 24
“This stresses the urgent need for effective pre - vention and early intervention strategies that will directly benefit millions of individuals as well as society at large (Fang et al., 2012; Peterson et al., 2018).”
Brown, D. S., Meinhart, M., Poulton, C., & Stark, L. (2022) · Journal of Interpersonal Violence · doi:10.1177/08862605221104531 · Cited by 18
“In some studies (Fang et al., 2012; Letourneau et al., 2018), productivity costs far exceed the health impacts.”
BackgroundSelf-citationTechnology-Based Innovations in Child Maltreatment Prevention Programs: Examples from SafeCare®
Cowart-Osborne, M., Jackson, M., Chege, E., Baker, E., Whitaker, D. J., & Self‐Brown, S. (2014) · Social Sciences · doi:10.3390/socsci3030427 · Cited by 17
“This figure, while staggering, is based on conservative assumptions, underscoring the importance and cost-effectiveness of CM prevention [2].”
BackgroundLannen, P., & Ziswiler, M. (2014) · Aggression and Violent Behavior · doi:10.1016/j.avb.2014.09.014 · Cited by 17
Corso, P. S., Ingels, J. B., & Roldós, M. I. (2013) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph10041342 · Cited by 17
“, valuing medical costs and productivity losses averted) [2–6], these estimates are”
BackgroundTrauma-Informed Care Is the Best Clinical Practice in Rehabilitation Nursing
Williamson, L. F., & Kautz, D. D. (2018) · Rehabilitation Nursing · doi:10.1097/rnj.0000000000000091 · Cited by 17
Díaz, M. J., Wolfersteig, W., Moreland, D., Yoder, G., Dustman, P. A., & Harthun, M. L. (2020) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-020-00304-2 · Cited by 18
“), is responsible for substantial mortality (Fang et al. 2012).”
BackgroundCOLLATERAL ISSUES IN TIMES OF COVID-19: CHILD ABUSE, DOMESTIC VIOLENCE AND FEMICIDE
Lund, R. G., Mânica, S., & Mânica, G. (2020) · Revista Brasileira de Odontologia Legal · doi:10.21117/rbol-v7n22020-318 · Cited by 21
Walker, H. E., Wamser‐Nanney, R. A., & Howell, K. H. (2021) · Journal of Interpersonal Violence · doi:10.1177/0886260521991883 · Cited by 17
“Although this number is staggering, researchers believe it to be a glaring underestimate of the rates of childhood trauma (Fang et al., 2012).”
BackgroundViolence Against Children: A Critical Issue for Development
Hoeffler, A. (2017) · European Journal of Development Research · doi:10.1057/s41287-017-0107-2 · Cited by 18
“…on mental health, school achievement, substance abuse, risky sexual behaviour, obesity and criminal behaviour, which persist into adulthood (e.g. Fang et al, 2012, 2015; Dube et al, 2003; Gershoff, 2002; Hecker et al, 2016; Nemeroff, 2004, 2016; Norman et al, 2012).10 Presumably, parents use…”
BackgroundKaye, M. P., Faber, A., Davenport, K. E., & Perkins, D. F. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.05.009 · Cited by 17
Integration of Adverse Childhood Experiences Across Nursing Curriculum
Gill, M. E., Zhan, L., Rosenberg, J., & Breckenridge, L. A. (2018) · Journal of Professional Nursing · doi:10.1016/j.profnurs.2018.07.003 · Cited by 17
Introduction: Child Abuse and Neglect
Giardino, A. P., Lyn, M. A., & Giardino, E. R. (2010) · Springer eBooks · doi:10.1007/978-1-4419-0702-8_1 · Cited by 16
Glick, J. C., Lorand, M. A., & Bilka, K. R. (2016) · Pediatrics in Review · doi:10.1542/pir.2015-0012 · Cited by 17
Caro, P., Turner, W., Caldwell, D. M., & Macdonald, G. M. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013361.pub2 · Cited by 19
Initial development of tools to identify child abuse and neglect in pediatric primary care
Hanson, R. F., Zhu, V. J., Are, F. G., Espeleta, H. C., Wallis, E., Heider, P. M., Kautz, M. M., & Lenert, L. A. (2023) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-023-02361-7 · Cited by 16
Interest in child molestation among a community sample of men sexually attracted to children
Mitchell, R. C., & Galupo, M. P. (2015) · Journal of Sexual Aggression · doi:10.1080/13552600.2015.1056263 · Cited by 16
Crouch, E. L., Radcliff, E., Strompolis, M., & Hartley, S. N. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.06.024 · Cited by 16
Violence against Children and Human Capital in South Africa
Zheng, X., Fang, X., Ugboke, H., & Fry, D. A. (2018) · Journal of Family Violence · doi:10.1007/s10896-018-0008-y · Cited by 16
“According to the the Organisation for Economic Co-operation and Development (OECD 2007), human capital is defined as people’s skills, learning, talents and attributes and this plays a significant role in the well-being of individuals, families, organizations and countries with the effect that even low levels of human…”
MethodSelf-citation
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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