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

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3. ECONOMIC EFFECTS OF INTERVENTIONS TO REDUCE INTERPERSONAL VIOLENCEStudy Study location Cost categories included Total annual costsand population (indirectcosts in italics) (2001 US$)Peer reviewed articles and government studiesChapdelaine &Maurice (1996)Canada. Compares costs ofuniversal licensing and registrationof guns with the benefitsDirect medical,productivity costsCost of universal licensingand registration system:$70 million; annual directcost of firearm-relatedinjury to the health caresystem: $50 million; totalcost of firearm-relatedinjury in Canada: $5.6billion (Miller 1995)Daley et al. (2000)US, Massachusetts, 1998. Substanceabuse treatment for 439 pregnantwomenLegal services, medical,policing, incarceration,other monetary costs(value of stolen property),lost earnings, productivityNet gain in terms ofreduced crime per year perwoman treated: $11 816Olds et al. (1986);Olds & Kitzman(1993)US. Elmira Prenatal/Early InfancyProjectProgramme costs,reduction in healthservices, welfare, criminaljustice system, taxesPublic sector savings perchild: $27 854; costs of$6861 and benefits of$20 993 (project lifetime)Studies conducted by advocacy groupsAos et al. (2001)US comparative costs and benefitsof crime prevention programmes.Direct medicalNet benefits per participant(lower range includes publicsector benefits; upper endincludes public sector andvictim costs):Mentoring: $231-$4 651;family therapy: $14 545-$60 721; aggressionreplacement therapy:$8 519-$34 071; intensiveprobation as alternative toincarceration: $19 106-$19 382Chanley, Chanley &Campbell (2001)US, Arizona. Economic impact ofshelters for victims of domesticviolence.Costs and benefits ofrefuge shelters for victimsof domestic violenceNet social gain of$3.4 million; benefit tocost ratio ranging from 6.8to 18.4Donato & Shanahan(1999)Australia. Costs of benefits of ahypothetical in-prison sex offendertreatment programmeCosts of incarceration,psychological costs, othernon-monetary costsCosts per sex offense:$105 324; net savings peroffender: $26 698Greenwood et al.(1996)US. Comparison of interventions toreduce child crimeProgramme (intervention)costs onlyParent training andgraduation incentives 5-7times more cost-effective inachieving 10% crimereduction than increasedincarceration.29
THE ECONOMIC DIMENSIONS OF INTERPERSONAL VIOLENCESeveral of the studies done in the USA have focused on programmes to reducechild abuse. Dubowitz (1990) reviewed four different interventions involvingcounselling and therapy for families at high risk of child abuse.The programmescost between $299 and $2 927 per family treated per year, with no comparisonsmade of their financial benefits. Caldwell (1992) estimated that the cost of childabuse and neglect in Michigan was $1.0 billion a year, including the costs ofcrime and incarceration committed by the victims of child abuse later in life. Onthe other hand, he calculated that a home visitor prevention programme forevery family in the state when they have their first baby would cost $70.6million. A comprehensive parent education programme would cost $35.2million and a prevention programme combining both home visits and parenteducation would cost $52.9 million. Prevention costs are just one-nineteenth ofthe cost of child abuse. This direct comparison implicitly assumed that theprevention programmes would eliminate child abuse.Armstrong (1983) carried out a cost-benefit analysis of a child abuse preventionprogramme in Yeardon in Pennsylvania. The programme involved home-basedcounselling and neighbourhood support groups. The study followed 103children considered to be at-risk for child abuse and neglect. Based onprobabilities of adverse outcomes from the literature - including the need foroutpatient care, hospitalization, foster care and special education services - thestudy concluded that $1.2 million in costs to society were prevented by theprogramme, for a net savings of $647 000 per year and a benefit to cost ratio of1.86. Similarly, the Prenatal/Early Infancy Project - a home visit programme forhigh-risk families in Elmira in New York state - was found to generate significantsavings for the government. Including programme costs, reduced health andsocial service use, savings to the criminal justice system and additional taxes, theprogramme resulted in overall public sector savings of $27 854 per child (Oldset al., 1986; Olds & Kitzman, 1993). Karoly et al. (1998) published a differentestimate, finding that the Elmira Prenatal/Early Infancy Project cost the publicsector $6 550 per participant while generating savings to the government of $26200, for a net savings of $19 650 per participant.A similar programme at Perry Pre-school in Michigan that enrolled 123disadvantaged African American children and included weekly home visits byteachers resulted in net savings to the government of $13 100 per participant.Olds et al. (1999) also studied nurse home visitation programmes throughrandomized trials in Elmira and in Memphis in Tennessee and found that theseprogrammes helped reduce rates of childhood injuries that may be associatedwith child abuse and neglect.In Canada, Chapdelaine & Maurice (1996) quantified the costs of the benefitsof a law regulating firearm ownership. The law required that all gun ownersregister and license their guns by 1 January 2001. The cost of implementing auniversal licensing and registration system was estimated to be $70 million -30
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Page 6 and 7: ContentsAbbreviations..............
Page 8 and 9: AbbreviationsCBACDCCEACUADALYHMOIAD
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Page 58 and 59: APPENDIX 1Appendix 1Types of cost e
Page 60 and 61: APPENDIX 2National Crime Prevention
Page 62 and 63: REFERENCESReferencesAos S et al. (2
Page 64 and 65: REFERENCESEngstrom K, Diderichsen F
Page 66 and 67: REFERENCESKorf DJ et al. (1997). Ec
Page 68 and 69: REFERENCESRudmond WJ, Davey D (2000
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