US Cost of Child Sexual Abuse Over $9 Billion in 2015; Or was it Over $150 Billion?

I have been waiting a long time for a study like this. It seems comprehensive enough but, unfortunately, the premise is based on completely inadequate numbers. Nevertheless, it is a place to start.

Letourneau EJ, et al. Child Abuse Negl. 2018

The total lifetime economic burden of child sexual abuse in the United States was estimated at about $9.3 billion in 2015, according to findings published in Child Abuse and Neglect.

"Most people appreciate the immense mental and physical health toll of child sexual abuse on victims, but that knowledge has been insufficient to prompt serious investment in primary prevention efforts," Elizabeth J. Letourneau, PhD, professor in the department of mental health at Johns Hopkins Bloomberg School of Public Health and director of the Moore Center for the Prevention of Child Sexual Abuse, said in a press release.

I am not convinced that 'most people appreciate the immense mental and physical health toll of child sexual abuse on victims'. There is actually very little written about the extent of the damage it does to kids and subsequent adult survivors. Most of it comes from survivors themselves and few of those are widely read. The damage is exponentially greater than any done to those who 'come out' under the #MeToo banner.

In their study, Letourneau and colleagues examined data from the National Child Abuse and Neglect Data System to gather a full census of all child sexual abuse cases reported to child protective agencies across the U.S. and provide an estimate of the economic impact of child sexual abuse, according to the press release.

Unfortunately, this data system estimates the number of abused children to be in the vicinity of just under 10 per 1000. That's less than 1%. That is absurd! Darkness to Light  is the most conservative resource in the country and it estimates child sex abuse rates at 10% of all children. D2L told me specifically that they do not include peer-on-peer child sex abuse in their statistics or the numbers would go way up. Those resources who do include peer-on-peer abuse report numbers like 1 in 3 girls and 1 in 5 boys. Those resources include CDC, and Journalist Resource where they report: U.S. rates were 7.5% for males and 25.3% for females.

The researchers measured health care costs, productivity losses, child welfare costs, violence/crime costs, special education costs and suicide death costs, and separately estimated quality-adjusted life-year losses. Using the best available secondary data, they also developed cost per case estimates for the 2015 annual cost and for each category. All costs were measured in U.S. dollars and adjusted to the reference year.

Letourneau and colleagues found the lifetime economic burden of child sexual abuse was roughly $9.3 billion in 2015 ($8.6 billion for female victims and $758 million for male victims), based on 20 new cases of fatal and 40,387 new substantiated cases of nonfatal abuse that occurred that year. 

The lifetime cost related to fatal child sexual abuse was $1,128,334 and $1,482,933 per female and male victim, according to the researchers. The cost for female victims includes $22,730 in medical costs and $1,105,604 in productivity losses, whereas the cost for males includes $21,751 in medical costs and $1,461,182 in productivity losses. These costs increased by about $40,000 per victim when including quality-adjusted life-years.

The average lifetime cost for victims of nonfatal abuse was $282,734 per female victim; however, for male victims of nonfatal child sexual abuse, there was not enough information on productivity losses, therefore it yielded a lower average estimated lifetime cost — $74,691 per male victim. According to the results, childhood health care costs accounted for $580 million, adulthood medical costs for $399 million, productivity losses for $6.8 billion, child welfare costs for $337 million, violence/crime costs for $98 million, special education costs for $152 million and suicide death costs for $980 million of the total costs associated with nonfatal cases.

Estimates of the number of children having been sexually abused differ for reasons stated above as well as there being a variety of definitions as to what defines sexual abuse. Name calling, crude remarks are rude in my books but not sexual abuse. Pornography of any description is sexual abuse to a child. 

I use somewhat conservative numbers of 1 in 4 to 1 in 5 girls and 1 in 6 to 1 in 10 boys. For both sexes then approximately 1 in 6 would be a conservative estimate. That's about 17% of all kids and is 17 times greater than Latourneau's study. That means a conservative value of $153 Billion is spent or not realized on child sex abuse and its effects. 

A conservative value of $153 Billion is spent or not realized

on child sex abuse and its effects 

“The U.S. now focuses broadly on proven and promising child maltreatment prevention policies and practices targeted primarily toward new and expecting parents and young children. The U.S. has not, however, focused broadly on the prevention of [child sexual abuse],” Letourneau and colleagues wrote.

“Despite the obvious appeal of preventing sexual harm from occurring in the first place, many people view [child sexual abuse] as uniquely unpreventable and, therefore, most efforts involve after-the-fact criminal justice interventions that target known offenders,” they continued. “It is hoped that a credible, comprehensive and current estimate of the national financial burden of [child sexual abuse] will bring attention to the high but unmet potential of [child sexual abuse] prevention programming and serve as a benchmark against which to evaluate cost effectiveness of subsequent prevention efforts.” – by Savannah Demko

Disclosures: Healio Psychiatry was unable to confirm any relevant financial disclosures at the time of publication.

The True Cost of Child Sexual Abuse

BY NIKKI DUBOSE
NEW YORK DAILY NEWS

After failing to change the law last year, New York State is set once again to consider doing away with the statute of limitations on prosecuting sex crimes against children — this time with Gov. Cuomo hopefully leading the reform charge against a likely intransigent state Senate.

Under current statutes, a victim must seek justice in criminal or civil court by her 23rd birthday, or she loses the opportunity to do so forever.

To understand why this is so perverse, you have to try to grasp the psychological impact that child sex abuse has on those subjected to it.

I was sexually abused at age 8 by a male figure, and then again by my mother from the ages of 9 to 13 until the police removed me from my home. There was a lot of domestic violence and physical abuse, but the sexual abuse impacted me the most. I developed eating disorders, depression, psychosis, post-traumatic stress disorder and suicidal ideation. I dropped out of high school and failed out of college twice.

I ultimately managed to get my high school diploma and eventually succeeded at college, but not before I became addicted to drugs, alcohol and sex, and was nearly homeless in my early 20s. I had no direction and zero self-esteem.

It wasn’t until after my mother died an alcoholic almost five years ago and I left my modeling career due to anorexia nervosa that therapy finally helped me to uncover the repressed memories of sexual abuse.

By this time, I had blown through hundreds of thousands of dollars due to my mental illnesses, including the loss of my house. It took everything I had to get better, and with eating disorder treatment costing anywhere from $500 a day to $30,000 a month, I had to search for alternative care.

I hope my experience sheds light on why it is cruel and unrealistic to expect people violated as boys and girls to be emotionally ready to face their abusers by the time they turn 23.

But if that doesn’t persuade the state Senate, led by Sen. John Flanagan of Long Island, to join Cuomo and finally change the statute of limitations, I’d like to make an appeal on other grounds that fiscal conservatives might appreciate: the huge and largely hidden costs to society.

What a sad commentary on Republican lawmakers that one has to appeal to the bottom line rather than the rights of a victim of pedophilia to get some form of justice! Without that right, what incentive does the Catholic Church or the Jewish Yeshivas have to ensure the safety of children now in their care? Why do Republicans protect the criminals at the expense of the victims? The answer is, unfortunately, too obvious.

Child sexual trauma is immensely expensive, carrying an average lifetime fiscal impact of more than $210,000 per child, according to the most recent study published in the journal Child Abuse and Neglect.

That includes the not-insubstantial costs of dealing with learning disabilities and mental illnesses such as depression, suicide, eating disorders and more, many of which result from child sexual abuse.

Tack on other indirect costs, such as depleted jobs and the strain on public health programs, and sexual abuse costs society billions of dollars a year, much of which is shouldered by taxpayers.

It just happened that I was thinking about this last night and the medical costs must be staggering, but the costs in lost productivity from people who have to live with depression, anxiety, PTSD, inability to concentrate, poor memories, and a host of other ailments must be incredible. And that's not to mention the creativity that might have been.

I don’t mean to suggest that we can put a price tag on having your soul taken away. As advocate June Busacco of Brooklyn puts it, “No amount (of money) can compare to the brutal treatment” she received as a child. But the unacceptably high price society pays can and should underline the unfathomable pain subjected upon thousands of individuals — pain that society has an obligation to face, not ignore.

I give Cuomo additional credit for pushing to open a one-year window during which those who suffered from past abuse can pursue claims, even as he works to lengthen the statute of limitations going forward.

I have heard the claims from those who say that lengthening statutes of limitations will make it too easy for innocent people to get dragged through the mud. That’s just not true. The high standard of proving a case in a court of law will still apply. The only thing adjusting the statute does is give people who were victimized the opportunity to seek justice.

An old proverb says, “The best time to plant a tree was 20 years ago. The second-best time is now.” That is how we must view fixing the state’s statute of limitations on sexual abuse committed against children. No one, particularly New York’s boys and girls, can afford to wait any longer.

DuBose is a former model turned author and activist. And one of my favorite people.