Making the Case for Domestic Violence Prevention; What Are Direct And Indirect Costs?

Manual: Making the Cost Benefit Case for Domestic Violence Prevention

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Making the Case for Domestic Violence Prevention Through the Lens of Cost-Benefit

A Manual for Domestic Violence Prevention Practitioners
(and the State and Local Policy-Makers They Present to)

What Are Direct And Indirect Costs?

cost

cost estimates

cost analysis

cost-benefit

cost-effectiveness

However, costs are not so easily defined. Above, we define “cost” as the money and other resources spent on a program. A “cost” can also be the cost of a problem, such as the effect of domestic violence.

Accurately measuring the cost of ALL the numerous and diverse consequences of domestic violence is challenging, if not impossible. On the one hand, there are direct costs. These costs are the actual dollar expenditures that result from acts of domestic violence, such as medical care for victims (emergency department visits, hospitalizations, outpatient clinic visits, services of physicians, dentists, physical therapists, ambulance transport, and paramedic assistance); the actual dollar costs of involving law enforcement in domestic violence cases; legal costs; and the costs of sheltering victims and incarcerating perpetrators.

On the other hand, there are also indirect costs. These costs represent the value of something lost as a result of the violence. Lost productivity is an indirect cost, as is lost quality of life.

Comparing Direct and Indirect Costs

Ignoring the non-monetary benefits of crime reduction can lead to a misallocation of resources. For example, suppose that an additional year of incarceration for a rape offender would prevent one additional rape incident. Considering only tangible, out-of-pocket costs, the average rape (or attempted rape) costs $5,100 – less than the $15,000 - $20,000 annual cost of a prison cell. The bulk of these expenses are medical and mental health care costs to victims. However, if rape’s effect on the victim’s quality of life is quantified, the average rape costs $87,000 – many times greater than the cost of prison.

Victim Costs and Consequences: A New Look,
by Miller, Cohen, and Wiersema. U.S. Department of Justice,
Washington, D.C.: 1996, p. 1.

For example, victims of domestic violence may lose days, months, or years of income. This is lost productivity or loss of some or all of the victim’s lifetime earnings.

When the victim of domestic violence is disabled physically, cognitively, and/or emotionally by that violence, there may be long-term losses of income. When the victim of domestic violence is killed by that violence, this loss can be described in economic terms, such as lost lifetime earnings.

Often, the time or money people spend to reduce their risk of death is used to calculate a monetary estimate of lost quality of life due to fatalities. Such estimates of the monetary value of a fatality, including lost wages and other tangible losses, range from $500,000 to $7 million.

A Cost-Benefit Analysis of the Violence Against Women Act of 1994, by Clark, Biddle, and Martin. Violence Against Women, Vol. 8 No. 4, April 2002, p. 420.

The cost of domestic violence is nearly $67 billion per year, roughly 15% of total U.S. crime costs. Rape is a further $127 billion.

Victim Costs and Consequences: A New Look,
by Miller, Cohen, and Wiersema. U.S. Department of Justice,
Washington, D.C.: 1996.

Without measurement of social costs, any cost estimate of domestic violence will be underestimated.

Measuring the Costs of Domestic Violence Against Women and the Cost-Effectiveness of Interventions, by Laurence and Spalter-Roth. Washington: Institute for Women’s Policy Research. 1996, pp. 29-30.

There are also more subtle forms of indirect costs such as lost hours of household chores including caring for one’s family, home and well-being. Many indirect costs are difficult to measure and many have not yet been defined.

After all, how can we know TODAY the cost of all of the long range effects of domestic violence? How can we see unforeseen consequences NOW? What will be the indirect costs that surface later? Policy-makers struggle with the demand for funding programs that seek to prevent severe problems whose symptoms are only somewhat evident and measurable at the present time. Those making the case for domestic violence prevention programs do well to make this point clear.

It is impossible to assess the economic toll of sexual violence. Public and private funds are spent on crisis services, medical treatment, and the criminal justice responses. Work days are lost because of injury and illness. Businesses lose money through employee absences and sexual harassment suits. Victims pay for sexual violence out of their own pockets, and the public pays through provision of services to victims and their significant others. The cost for offenders’ incarceration, probation, treatment and other offender services adds to the total cost of sexual assault.

The Economic Costs of Sexual Assault Fact Sheet
Published by the Illinois Coalition Against Sexual Assault and available at: http://www.icasa.org/uploads/economic_costs.pdf.

Finally, among the many indirect costs of domestic violence are the intangible costs to the individual victim and the children of that victim, in terms of long-term mental, physical, and emotional trauma; later loss of life; and reduced or deteriorating quality of life. There are also forms of indirect, intangible, costs to the community and society in general.

For example, businesses have to pay for strengthened security in the workplace; our health care systems become burdened by increasing numbers of victims seeking help; our children are not able to focus in school; our law enforcement system is taxed; our prisons become over-crowded; and there are many other costs.

Costs of Domestic Violence and Intimate Partner Violence (IPV)

An estimated 5.3 million intimate partner violence victimizations occur among U.S. women ages 18 and older each year. This violence results in nearly two million injuries, more than 550,000 of which require medical attention. In addition, IPV victims lose a total of nearly eight million days of paid work – the equivalent of more than 32,000 full-time jobs – and nearly 5.6 million days of household productivity as a result of the violence.

The Prevalence of Domestic Violence in California by Alicia Bugarin,
California Research Bureau, California State Library, November 2002, p. 1.

The health-related costs of rape, physical assault, stalking and homicide committed by intimate partners exceed $5.8 billion each year. Of that amount, nearly $4.1 billion are for direct medical and mental health care services, and nearly $1.8 billion are for the indirect costs of lost productivity or wages. The estimated total days lost from employment and household chores is $858.6 million. The value of lost productivity from employment is $727.8 million. The value of lost productivity from household chores is $130.8 million.

Costs of Intimate Partner Violence Against Women in the United States,
Centers for Disease Control and Prevention, April 2003.

Costs of Sexual Assault

Rape is most costly of all crimes to its victims. Total costs are estimated to be $127 billion a year in the United States, excluding the costs of child sexual abuse (Miller & Wiersema, 1996).

The cost for each sexual assault is $110,000; because many rape victims are subjected to more than one sexual assault, the cost per rape is estimated to be $87,000. The cost per sexual assault is broken down as follows:

Cost per sexual assault
Short-term medical care	$500
Mental health services	$2,400
Lost productivity	$2,200
Pain and suffering	$104,900

The pain and suffering cost is based on these facts:

Up to half of all victims suffer from at least one symptom of rape trauma syndrome;
Rape victims are four times more likely to have an emotional breakdown than are non victims;
25% to 50% of sexual assault victims are likely to seek mental health services and victims often suffer from lifelong physical manifestations of sexual trauma.
Rape and sexual assault account for 9% of the 16 million violent crimes in the U.S.

Economic Costs of Sexual Assault Fact Sheet, by the Illinois Coalition Against Sexual Assault http://www.icasa.org/uploads/economic_costs.pdf.

Certainly, seeing things only in economic terms is not the way we take to heart and truly respond to the effects of a domestic violence-related injury or death. Indeed, one might argue that things like safety and freedom cannot be given a monetary value. There are also dangers in assuming that economic efficiency is the goal, at the expense of other socially desirable goals such as equity or fairness. (Cohen, Mark A. Measuring the Costs and Benefits of Crime and Justice. Criminal Justice 2000, Vol. 4, p. 280.) However, the economic loss is one way the effects of domestic violence can be measured and expressed to policy-makers who are explaining their decisions based on dollar costs and benefits to society. For a detailed list of the costs of domestic violence, the costs of society’s response to this violence, and who pays for these costs, see Appendix C: Costs of Domestic Violence.

The Cost of Domestic Violence

Services

Criminal justice system (police, prosecution, courts, probation, legal aid);
Health care (general practitioners, hospitals. Includes physical injuries and mental health care);
Social services;
Housing;

Civil legal (specialist legal actions such as injunctions to restrain or expel a violent partner, as well as actions consequent on the disentangling of marriages and relationships such as divorce and child custody). About half of civil legal services costs are borne by the public sector and half by the individual.

Economic output loss cost

This is the cost of time off work due to injuries. It is estimated that around half of the costs of such absences is borne by the employer and half by the individual in lost wages.

Human and emotional cost

Domestic violence leads to pain and suffering that is not counted in the cost of services. It has become usual to include an estimate for human and emotional costs so that this impact is not ignored in public policy.

Service use cost

The level of service use is higher among those who are more heavily abused, that is, those who suffer more frequent acts, more severe acts and more serious injuries. This is an important part of the gender asymmetry in service use and costs, since on each dimension of severity of abuse, women are more heavily abused than men.

From The Cost of Domestic Violence, by S. Walby. Women and Equality Unit, London, September 2004.