Summer/Fall 2004 Article
 

Total Estimated Cost of Child Abuse and Neglect
In the United States
By Suzette Fromm, Ph.D., Vice President of Planning,
Program Evaluation and Quality Improvement, ChildServ*

Introduction
For years, we have recognized the tragic effects of abuse and neglect on the children against which it is perpetrated. Innumerable scientific studies have documented the link between the abuse and neglect of children and a wide range of medical, emotional, psychological and behavioral disorders. For example, abused and neglected children are more likely to suffer from depression, alcoholism, drug abuse and severe obesity. They are also more likely to require special education in school and to become juvenile delinquents and adult criminals.

This data represents the first attempt to document the nationwide costs resulting from abuse and neglect. These costs can be placed in one of two categories: direct (those costs associated with the immediate needs of abused or neglected children) and indirect (those costs associated with the long-term and/or secondary effects of child abuse and neglect).

The data cited in the following pages has been drawn from a variety of sources, including the Department of Health and Human Services, the Department of Justice, the U.S. Census and others. Appropriate data citations are included throughout the report.

In all instances, we have opted to use conservative estimates. For instance, only children who could be classified as being abused or neglected according to the harm standard were included in the analysis. The harm standard is the U.S. Department of Health and Human Services' more stringent classification category. In addition, we have not attempted to quantify all of the indirect costs of abuse and neglect including, for example, the provision of Welfare benefits to adults whose economic condition is a direct result of the abuse and neglect they suffered as children. For this reason, we believe the estimate of $92 billion per year is conservative.

Regardless of the economic costs associated with child abuse and neglect, it is impossible to overstate the tragic consequences endured by the children themselves. Each year, more than three million children are reported as abused or neglected in the United States. And three children die each day from abuse and neglect in this country. The costs of such human suffering are incalculable.

Total Annual Cost of Child Abuse and Neglect in the United States
DIRECT COSTS
Statistical Justification Data

Direct Costs Estimated
Annual Cost
Hospitalization

Rationale: 565,000 children were reported as suffering serious harm from abuse in 1993 (1). One of the less severe injuries is a broken or fractured bone. Cost of treating a fracture or dislocation of the radius or ulna per incident is $10,983 (2).

Calculation: 565,000 x $10,983		 $6,205,395,000
Chronic Health Problems

Rationale: 30% of maltreated children suffer chronic medical problems (3). The cost of treating a child with asthma per incident in the hospital is $6,410.

Calculations: .30 x 1,553,800 = 446,140; 446,140 x $6,410		 2,987,957,400
Mental Health Care System

Rationale: 743,200 children were abused in 1993 (4). For purposes of obtaining a conservative estimate, neglected children are not included. One of the costs to the mental health care system is counseling. Estimated cost per family for counseling is $2,860 (5). One in five abused children is estimated to receive these services.

Calculations: 743,200/5 = 148,640; 148,640 x $2,860		 425,110,400
Child Welfare System

Rationale: The Urban Institute published a paper in 1999 reporting on the results of a study it conducted estimating child welfare costs associated with child abuse and neglect to be $14.4 billion (6).		 14,400,000,000
Law Enforcement

Rationale: The National Institute of Justice estimates the following costs of police services for each of the following interventions: child sexual abuse ($56); physical abuse ($20); emotional abuse ($20) and child educational neglect ($2) (7). Cross referenced against DHHS statistics on number of each incidents occurring annually (8).

Calculations: Physical Abuse - 381,700 x $20 = $7,634,000; Sexual Abuse - 217,700 x $56 = $12,191,200;
Emotional Abuse - 204,500 x $20 = $4,090,000;
and Educational Neglect - 397,300 x $2 = $794,600		 24,709,800
Judicial System

Rationale: The Dallas Commission on Children and Youth determined the cost per initiated court action for each case of child maltreatment was $1,372.34 (9). Approximately 16% of child abuse victims have court action taken on their behalf.

Calculations: 1,553,800 cases nationwide (10) x .16 = 248,608 victims with court action; 248,608 x $1,372.34		 341,174,702
Total Direct Costs $24,384,347,302
 
Indirect Costs Estimated
Annual Cost
Special Education

Rationale: More than 22% of abused children have a learning disorder requiring special education (11). Total cost per child for learning disorders is $655 per year.

Calculations: 1,553,800 (12) x .22 = 341,386; 341,386 x $655		 $223,607,830
Mental Health and Health Care

Rationale: The health care cost per woman related to
child abuse and neglect is $8,175,816/163,844=$50 (13).
If the costs were similar for men, we could estimate that
$50 x 185,105,441 (14) adults in the U.S. cost the nation $9,255,272,050. However, the costs for men are likely to be very different and a more conservative estimate would be half of that amount.		 4,627,636,025
Juvenile Delinquency

Rationale: 26% of children who are abused or neglected become delinquents, compared to 17% of children as a
whole (15), for a difference of 9%. Cost per year per child for incarceration is $62,966. Average length of incarceration in Michigan is 15 months (16).

Calculations: 0.09 x 1,553,800 (17) = 139,842; 139,842
x $62,966 = $8,805,291,372		 8,805,291,372
Lost Productivity to Society

Rationale: Abused and neglected children grow up to be disproportionately affected by unemployment and underemployment. Lost productivity has been estimated at $656 million to $1.3 billion (18). Conservative estimate is used.		 656,000,000
Adult Criminality

Rationale: Violent crime in U.S. costs $426 billion per year (19). According to the National Institute of Justice, 13% of all violence can be linked to earlier child maltreatment (20).

Calculations: $426 billion x .13		 55,380,000,000
Total Indirect Costs $69,692,535,227
TOTAL COST $94,076,882,529

References
1. Sedlak, A. & Broadhurst, D. (1996). The Third National Incidence Study of Child Abuse and Neglect: NIS 3. U.S. Department of Health and Human Services.
2. HCUPnet (2000). Available on-line at http://www.ahrq.gov/data/hcup/hcupnet.htm.
3. Hammerle (1992) as cited in Myles, K.T. (2001) Disabilities Caused by Child Maltreatment: Incidence, Prevalence and Financial Data.
4. Sedlak, A. & Broadhurst, D. (1996). The Third National Incidence Study of Child Abuse and Neglect: NIS 3. U.S. Department of Health and Human Services.
5. Daro, D. Confronting Child Abuse (New York, NY: The Free Press, 1988).
6. Geen, Waters Boots and Tumlin (March 1999). The Cost of Protecting Vulnerable Children: Understanding Federal, State, and Local Child Welfare Spending. The Urban Institute.
7. Miller, T., Cohen, M. & Wiersema (1996). Victims' Cost and Consequences: A New Look. The National Institute of Justice. Available on-line at www.nij.com.
8. Sedlak, A. & Broadhurst, D. (1996). The Third National Incidence Study of Child Abuse and Neglect: NIS 3. U.S. Department of Health and Human Services.
9. Dallas Commission on Children and Youth (1988). A Step Towards a Business Plan for Children in Dallas County: Technical Report Child Abuse and Neglect. Available on-line at www.ccgd.org.
10. Sedlak, A. & Broadhurst, D. (1996). The Third National Incidence Study of Child Abuse and Neglect: NIS 3. U.S. Department of Health and Human Services.
11. Hammerle (1992) as cited in Daro, D., Confronting Child Abuse (New York, NY: The Free Press, 1988).
12. Sedlak, A. & Broadhurst, D. (1996). The Third National Incidence Study of Child Abuse and Neglect: NIS 3. U.S. Department of Health and Human Services.
13. Walker, E, Unutzer, J., Rutter, C., Gelfand, A. Saunders, K., VonKorff, M. Koss, M. & Katon, W. (1997). Cost of Health Care Use by Women HMO Members with a History of Childhood Abuse and Neglect. Arc General Psychiatry, Vol 56, 609-613.
14. US Census. Available on-line at www.census.gov.
15. Widom (2000). The Cycle of Violence. Available on-line. U.S. Department of Justice, National Institute of Justice.
16. Caldwell, R.A. (1992). The Costs of Child Abuse vs. Child Abuse Prevention: Michigan's Experience. Michigan Children's Trust Fund and Michigan State University.
17. Sedlak, A. & Broadhurst, D. (1996). The Third National Incidence Study of Child Abuse and Neglect: NIS 3. U.S. Department of Health and Human Services.
18. Widom (2000). The Cycle of Violence. Available on-line. U.S. Department of Justice, National Institute of Justice.
19. Trends to Watch: 1998 and Beyond: Readers Digest. Ministry Development Division: Washington D.C, 1998.
20. Miller, T., Cohen, M. & Wiersema (1996). Victims Cost and Consequences: A New Look. The National Institute of Justice. Available on-line at www.nij.com.
*Suzette Fromm, Ph.D.
Ms. Fromm is the Vice President of Planning, Program Evaluation and Quality Improvement for ChildServ in Chicago. Ms. Fromm received her Ph.D. in psychology at North Carolina State University. She has a Bachelor of Arts degree from the University of Illinois at Chicago and a Master of Arts from the California School of Professional Psychology.