In Dollars Alone, Cost of U.S. Child Abuse High

CDC: Cost of Child Abuse Higher Than Cost of Diabetes or Stroke

By Daniel J. DeNoon
WebMD Health News

Reviewed by Laura J. Martin, MD

Feb. 1, 2012 -- Child abuse and neglect are rampant in the U.S., and the annual cost is as high or higher than the cost of other major health problems, the CDC reports.

In 2008, based on data from child protective services, there were about 579,000 new cases of child abuse. But based on earlier U.S. survey data, there are as many as 2.8 million new cases a year.

The annual cost is between $124 billion and $585 billion. The lifetime cost of each case -- the CDC's low-end estimate is $210,012 -- outstrips the lifetime cost of diabetes or stroke cases.

"Compared with other health problems, the burden of child maltreatment is substantial, even after conservative assumptions are used," conclude CDC researcher Xiangming Fang, PhD, and colleagues.

Using 2008 data, Fang's team added up the lifetime dollar cost (in 2010 dollars) of the average case of child abuse. They looked at health care costs, productivity losses, child welfare costs, criminal justice costs, and special education costs. They were unable to determine other important costs, such as the impact of psychological abuse or costs linked to reduced life expectancy, poor quality of life, and future negative parenting behaviors by the abused person.

They also counted only cases of child abuse confirmed by state and local child welfare departments. Data suggest that the actual number of cases is much higher than this, Fang and colleagues note, "implying that our baseline results are probably conservative, lower-bound estimates."

'Costs Can Be Prevented Through Prevention of Child Maltreatment'

Child abuse often is fatal. When it is not, abused children suffer lifelong consequences. These can include poor health, poor social adjustment, lower earnings, and mental health conditions such as posttraumatic stress disorder, adult criminality, and violent behavior.

There are many forms of child abuse. These include:

  • Physical assault, including excessive corporal punishment
  • Sexual abuse or exploitation
  • Close confinement, such as tying the hands or feet or locking in a closet
  • Threats of assault, threats of abandonment, or other extreme verbal abuse
  • Abandonment or expulsion from home
  • Permitting or encouraging behaviors such as skipping school, prostitution, or drug abuse
  • Refusing to allow treatment for professionally diagnosed physical, educational, emotional, or behavioral problems
  • Failure to seek or unwarranted delay in seeking competent medical care
  • Consistent inattention to the child's physical or emotional needs
  • Failure to enroll the child in school as required by state law

"No child should ever be the victim of abuse or neglect -- nor do they have to be. The human and financial costs can be prevented through prevention of child maltreatment," Linda C. Degutis, DrPH, director of the CDC's National Center for Injury Prevention and Control.

Degutis points to programs through which communities, local governments, and even individual parents can get help. These include the health program called the Nurse-Family Partnership and the educational program Triple P America.

Do you know or suspect a child is being abused? Call the National Child Abuse Hotline at 800-4-A-CHILD or visit Childhelp online at

The Fang study appears in the current online issue of the journal Child Abuse & Neglect.

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SOURCES: Fang, X. Child Abuse & Neglect, published online Feb. 1, 2012.News release, CDC.Childhelp web site.Fourth National Incidence Study web site.Triple P America web site.Nurse-Family Partnership web site.

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