The economic dimensions of interpersonal violence - libdoc.who.int ...

2. COSTS OF INTERPERSONAL VIOLENCEestimate the costs of intimate partner violence.The Centers for Disease Controland Prevention, Atlanta (CDC, 2003) used the 1995 NVAWS to show that anestimated 5.3 million incidents of intimate partner violence occur each yearamong USA women age 18 and older - resulting in nearly 2 million injuries,more than 550 000 of which required medical attention. Victims of intimatepartner violence lost a total of 8.0 million days of paid work. Total costsexceeded $5.8 billion each year, with $4.1 billion for direct medical and mentalhealth care services and $0.9 billion for lost productivity. Ulrich et al. (2003)used the 1998 NVAWS coupled with data from health maintenanceorganizations (HMOs) to estimate that women who are victims of intimatepartner violence have 1.6 times higher estimated medical costs compared toother women.Studies in the peer reviewed literature have documented per case directtreatment costs for intimate partner violence, but this type of study is onlypossible for those victims who have contact with the health care system. New &Berliner (2000) found that women who were compensated through the CrimeVictims Compensation Program in Washington state averaged $3 087 for mentalhealth treatment and counselling costs. Wisner et al. (1999) compared womenin a large health plan in Minnesota who were victims of intimate partnerviolence to other women in the plan. The intimate partner violence victims hadan annual average of $4 341 of health care costs, or $2 120 more on average thanother women in the plan.2.4 Sexual violenceAs with intimate partner violence, the costs of sexual assault are difficult todocument systematically since many such assaults go unreported. As a result,most documented calculations (see Table 4) are likely to be underestimates.The Children's Safety Network Economics and Insurance Resource Center(1997) estimated that sexual assault costs $159 million per year in the USA,with 79% of the costs due to quality of life factors and the remainder accountedfor by lost earnings and legal and medical costs. Cohen (1988a), using pain andsuffering awards from more than 100 000 jury decisions in the USA, calculatedthat the annual aggregate direct and indirect costs of rape were $14.9 billion -equivalent to 0.2% of the gross domestic product.The largest estimate is that ofPost et al. (2002), who calculated costs of $6.5 billion for rape and sexual assaultin 1996 in Michigan, or more than $700 per resident. Scaled-up to the nationallevel, they estimated a total loss of $261.3 billion, including productivity losses.Direct treatment costs related to sexual assault are relatively small incomparison. Several studies have used the NCVS, an annual survey based on100 000 interviews with crime victims, to estimate the incidence and calculatethe direct costs of sexual assault to the victims. The United States Departmentof Justice (1994) calculated the economic losses of rape as $33 million, based onreported direct medical costs and lost earnings. This estimate, however, did not21