Effects of Maltreatment : Consequences for Society

Question 1

Why Consider Economic Disparities?

Answer 1

• Many of the outcomes affected by maltreatment are also affected by other social problems

ex:
- Educational and job opportunities
- Mental well-being
- Physical health

Question 2

How can we quantify the prevalence of child maltreatment on society?

Answer 2

Prevalence: In 2012:

• 3.4 million referrals (for 6.3 million children)
• 62% of these investigated
  Of those investigated, about 20% substantiated
• 686,000 substantiated cases (just in 2012)

Question 3

How can we quantify the effects of child maltreatment on society?

Answer 3

Effects on individuals
- Behavior and mental health outcomes
- Delinquency, school drop-out, criminality
- Chronic diseases and physical health
- Academic, occupational, and economic success

All of these have costs

Question 4

How do children who have been maltreated, economically affect Crime?

Answer 4

• Children who are maltreated are more than twice as likely to engage in a number of crimes
• This estimate is higher for more severe abuse

Question 5

How do children who have been maltreated, economically affect Schooling?

Answer 5

Child maltreatment strongly affects school performance
- Lower GPA
- Lower rates of homework completion
- Higher dropout rates
- Neurocognitive deficits

Question 6

How do children who have been maltreated, economically affect Health?

Answer 6

Maltreated children have significantly more short-term and long-term health problems

Question 7

What are the short term health problems for children who have been maltreated?

Answer 7

• Physical injury from physical abuse
• Slow rate of growth resulting from neglect

Question 8

What are the long term health problems for children who have been maltreated?

Answer 8

• Chronic health conditions (obesity, diabetes, hypertension, cardiovascular disease, asthma)
• Substance abuse and psychiatric problems

Question 9

In the Economic Burden Study conducted by Fang et al, what is the Incidence based approach?

Answer 9

• Considers short-term and long-term costs associated with each case of maltreatment
• Can estimate cost per individual, and cost within a year for all new cases
• Given median age of 6 for victims (in 2008), based lifetime estimates of costs starting at age 6

Question 10

In the Economic Burden Study conducted by Fang et al, How would you know how much $$ being maltreated adds to average expenses?

Answer 10

Compare average costs between groups
- Maltreated versus non-maltreated

• Estimated cost for an outcome times incremental effect of maltreatment on outcome

Question 11

In the Economic Burden Study conducted by Fang et al, what were the direct costs?

Answer 11

• Short-term health care costs
• Child welfare costs
• Criminal justice costs

Question 12

In the Economic Burden Study conducted by Fang et al, what were the indirect costs?

Answer 12

• Long-term medical costs
• Productivity losses
• Special education costs
• Criminal justice (later outcomes)

Question 13

What were the findings in the Economic Burden Study?

Answer 13

• Based on 2008 estimate of 579,000 new cases, aggregate lifetime costs would be $121.6 BILLION!!!
  ($124 billion if include fatal cases)
• If you use rates of all cases that are investigated (rather than just substantiated), estimate increases to $585 billion.

Question 14

How does maltreatment pose a high financial burden on a societal level?

Answer 14

• Due to child welfare, education, and criminal justice costs
• Mental and physical health care costs
• Loss of productivity