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Child Abuse Negl. 2018 May;79:413-422. doi: 10.1016/j.chiabu.2018.02.020. Epub 2018 Mar 20.

The economic burden of child sexual abuse in the United States.

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Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington St., Suite 531, Baltimore, MD, 21231, USA. Electronic address:
Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA. Electronic address:
College of Economics and Management, China Agricultural University, Beijing, 100083, China; School of Public Health, Georgia State University, Atlanta, GA, 30303, USA. Electronic address:
Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada.
Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA, 30341, USA.


The present study provides an estimate of the U.S. economic impact of child sexual abuse (CSA). Costs of CSA were measured from the societal perspective and include health care costs, productivity losses, child welfare costs, violence/crime costs, special education costs, and suicide death costs. We separately estimated quality-adjusted life year (QALY) losses. For each category, we used the best available secondary data to develop cost per case estimates. All costs were estimated in U.S. dollars and adjusted to the reference year 2015. Estimating 20 new cases of fatal and 40,387 new substantiated cases of nonfatal CSA that occurred in 2015, the lifetime economic burden of CSA is approximately $9.3 billion, the lifetime cost for victims of fatal CSA per female and male victim is on average $1,128,334 and $1,482,933, respectively, and the average lifetime cost for victims of nonfatal CSA is of $282,734 per female victim. For male victims of nonfatal CSA, there was insufficient information on productivity losses, contributing to a lower average estimated lifetime cost of $74,691 per male victim. If we included QALYs, these costs would increase by approximately $40,000 per victim. With the exception of male productivity losses, all estimates were based on robust, replicable incidence-based costing methods. The availability of accurate, up-to-date estimates should contribute to policy analysis, facilitate comparisons with other public health problems, and support future economic evaluations of CSA-specific policy and practice. In particular, we hope the availability of credible and contemporary estimates will support increased attention to primary prevention of CSA.


Child sexual abuse; Cost analysis; Economic burden

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