Victims of Sexual Abuse Face a Lifetime of Costly Problems

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My latest research, published this month in the journal Child Abuse and Neglect, describes the impact of child sexual abuse from a perspective that researchers don’t often talk about — the economic burden of violence and abuse in the U.S.

I frequently speak about, write about, and study the impact that child sexual abuse has on victims, those who have committed offenses, families, communities, and policies. But I don’t often get to argue for prevention through the lens of economics — namely the expensive burden that child sexual abuse has on victims, government, and society. My colleagues and I estimate that we spend an average $9.3 billion per year in the U.S. due to the victimization-related costs associated with health care, child welfare, violence and crime, and a number of other expenditures, as well as productivity losses.

These economic losses are wholly preventable.

Why are these costs so high?

I don’t think most people realize just how many children and adults are victims of child sexual abuse. Based on federal reporting data, tens of thousands of children are exposed to child sexual abuse each year.

Children who experience sexual abuse are at increased risk for problems across their lifetimes, including mental health issues like PTSD and depression; chronic physical health problems, like diabetes, heart disease, and an increased risk for acquiring HIV; and social problems including involvement in crime. Girls exposed to child sexual abuse also have substantially lower lifetime earnings than girls not similarly exposed. These costs quickly add up.

For women (who composed 75 percent of the reported cases of child sexual abuse survivors we used for this study), we estimated an individual lifetime cost of approximately $283,000. (Lifetime costs for men in the study were lower, because the economic impact of child sexual abuse on male victims is sorely under-researched.)

What can we do to address child sexual abuse more effectively and more efficiently? To start, we can stop spending money on policies that just don't work, like sex offender registration. Numerous studies document the failure of sex offender registration and notification policies to improve public safety. Indeed, our research suggests that subjecting children to sex offender registration is not only ineffective, but also associated with greater risk for sexual victimization — the very type of harm these policies were intended to prevent. The enormous resources currently devoted to this failed policy could be reallocated to support proven prevention and treatment policies that effectively reduce the likelihood of sexual abuse perpetration.

My colleagues and I at the Moore Center for the Prevention of Child Sexual Abuse at the Johns Hopkins Bloomberg School of Public Health are developing and evaluating preventions to intervene with those most at risk for committing such abuse, including (but not limited to) young adolescents, who often make mistakes as they begin sexual explorations, and young people with an unwanted attraction to younger children who are seeking help so they don’t offend.

There is, of course, no price tag to victimization, and we are mindful that victims of child sexual abuse need our help. They need easy access to effective mental and physical health care and other services.

But we can do much more to prevent that abuse from occurring in the first place, thus avoiding the need for so many to struggle with the extended and extensive effects of abuse. If the idea of preventing child sexual abuse programmatically seems esoteric, perhaps an economic frame will help make the case that it's time for the U.S. to get serious about preventing child sexual abuse.