Research Watch

The economic burden of child maltreatment: Preventive measures could yield huge savings

Year of Publication
Reviewed By
Sydney Duder

Fang, X., Brown, D.S., Florence, C.S., & Mercy, J.A. (2012). The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse & Neglect, 36, 156-165.


Child maltreatment (CM) is a serious and prevalent public health problem, which can result in both individual trauma and also huge financial costs for society. This article estimates the economic burden in the U.S., and suggests the possible benefits of preventive measures.

The best available secondary data were used to estimate costs per case. Whenever possible, studies based on quasi-experimental longitudinal prospective designs were used; no relevant studies could be found that were based on experimental designs. The authors argue that these estimates are significant new contributions that use a consistent robust approach in incidence-based costing methods; this directly facilitates comparison with other health conditions.

The following are the estimated social costs of CM (in 2010 dollars):

-Average lifetime cost per victim of nonfatal CM = $210,012 (includes the costs of short-term child health care, long-term adult medical care, productivity losses, child welfare services, criminal justice and special education)
-Average lifetime cost per victim of fatal CM = $1,272,900 (includes the costs of medical care and productivity losses)

As a result, the total lifetime cost of all new cases in 2008 (estimated to be 579,000 nonfatal and 1,740 fatal cases of CM) = $124 billion. The figure of $210,012 for nonfatal CM is comparable to the costs of other high profile public health problems (e.g., stroke, $159,846; type 2 diabetes, $181,000 - $253,000), which certainly suggests that costs are high enough to justify allocating resources to effective prevention and mitigation strategies. Though this study is based on incidence and costs in the U.S., it seems reasonable to expect that the implications for Canada would be similar.

Methodological Notes

The authors list a number of methodological problems; some of the more significant were: (1) the above figure of 579,000 new substantiated cases is very likely to be too low, as not all maltreated cases may have been reported, and state trimming of social service budgets may have artificially reduced the number of cases that could be substantiated; (2) the costs of some additional adverse outcomes (e.g., reduced life expectancy, decreased quality of life, and negative parenting behaviors, which can lead to negative intergenerational outcomes) were not included, as sufficient data were not available on the magnitude of these effects and their costs; (3) In most of the studies used, the estimates of long-term medical costs did not include the impact of  psychological abuse; (4) data were not available to allow reliable estimates of burden by type and severity of maltreatment; (5) long-term medical costs for adults 65 or older could not be estimated.  As a result, the cost estimates reported above almost certainly underestimate the true costs to society of child maltreatment.