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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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“The costs associated with child protection services, foster care placements, legal proceedings, and social welfare programs place a substantial burden on public resources, leading to a cycle of intergenerational burden on public resources [26,27].”
Şahin, M., & Kartal, O. Y. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1760670 · Cited by 5
“This cascade of adverse effects diminishes individual potential while imposing a heavy economic burden on public systems for healthcare, social welfare, and criminal justice (18, 20, 23).”
Mora-Theuer, E. A., Klomfar, S., Krall, C., Grylli, C., Doppler, K., Kletečka-Pulker, M., Völkl-Kernstock, S., Otterman, G. J., Plener, P. L., Simon, J., et al. (2026) · European Journal of Pediatrics · doi:10.1007/s00431-026-06803-y · Cited by 1
“The resulting societal burden includes trauma-related costs of healthcare, social and educational services, and productivity losses from poor vocational skills, unemployment, and disability [2, 3].”
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A Different Perspective on Managing Child Welfare in Turbulent Times
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“Studies in the US have shown that substantial costs are associated with the impact of child maltreatment [24,25].”
BackgroundBest violence research of 2012: Selections from an invited panel of researchers.
Kendall-Tackett, K. A., L.Edleson, J., Collin‐Vézina, D., Mankowski, E. S., & Vaughan-Eden, V. (2013) · Psychology of Violence · doi:10.1037/a0033373 · Cited by 1
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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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