Childhood exposure to trauma costs society $458 billion annually

Bureaucratic hurdles block access to treatment services, so they tend to go unused. This leads to adverse outcomes that put stress on public systems like social services and law enforcement.

A young child sits in a hallway burying their head in their arms on a rather dirty carpet

Children are exposed to crime in a number of ways. They become victims themselves or witness violence against a family member or someone in their community. Sometimes they feel the aftershocks simply by having a parent who experienced such an event firsthand. 

This is true for millions of children in the United States each year, and the consequences are well-documented: The children suffer physically and mentally, and they’re at greater risk for behavioral problems and repeat victimization. They often come into contact with the criminal justice system, both as juveniles and later in life, and they’re more likely to use substances. 

What’s less understood, however, is how much access people have to treatment following these incidents and what this problem costs. Penn Law doctoral student Michal Gilad and Abraham Gutman, an economist and health policy expert now at The Philadelphia Inquirer, spent several years conducting a three-part analysis to answer these questions. 

The researchers discovered that although most states do offer services to children exposed to crime, bureaucratic hurdles make them difficult to access. Adverse outcomes that result from a lack of treatment cost society more than $458 billion each year, with a lifetime tally of more than $194,000 per individual. That’s about $3,300 annually per person. Beyond that, there are societal costs that are harder to quantify. The researchers published their results in the University of Illinois Law Review and the Fordham Urban Law Journal, and they have a third paper forthcoming

Baseline measurements
The work evolved as part of Gilad’s doctoral dissertation. “I wanted to take a comprehensive look at the different ways that children are affected by crime and violence and how it can be corrected,” she says. 

Before arriving at Penn in 2010, Gilad had been a prosecutor in Israel, where many of her cases involved child witnesses or victims. “I started to notice that often, laws or policies are written with adults in mind,” Gilad says. “When they’re applied in children without some sort of adaptation, they’re not as effective and create injustices and negative results.”  

Often, laws or policies are written with adults in mind. When they’re applied in children without some sort of adaptation, they’re not as effective and create injustices. Michal Gilad, Penn Law doctoral researcher

She realized to get any further with this research, she needed a baseline for what kind of services exist for children exposed to crime and violence. So, she created a comprehensive survey that asked questions about the availability of state-level resources, agencies responsible, and mechanisms in place to identify children in need. The District of Columbia and every state but Maryland responded to the electronic questionnaire. 

Initially, Gilad hypothesized that such resources simply weren’t widespread. But the survey results surprised her. “In most states, services are available and state laws do recognize this as something that makes a child eligible for compensation for therapeutic services,” she says. “But the system is designed in a way that’s not easy. The services are out there, but they’re not being used.”  

Gilad provides California as an example: In 2015, 1.6 million children in the state were exposed to community violence of some sort, yet the state received just 35 compensation claims. Other states experience similar numbers, with few or no claims filed in a given year, despite the availability of services. 

“Everything falls on the parents, and the parents often come from disadvantaged communities or have language barriers or economic barriers,” she says. “It took me a year of full-time work to figure all of this out, and I know where to look; I know how to read the law. Imagine a parent with no knowledge trying to do that.” 

Societal costs
After she published this work, Gilad partnered with Gutman to delve into the social and economic costs of childhood trauma. They first looked at the snowball effect of childhood exposure to violence and crime. 

For example, exposure might result in health problems that lead to many days of school missed. Academic performance suffers, which makes it difficult to obtain a job. This affects not only individuals but their families, communities, and, eventually, society by placing a financial burden on public systems like child welfare, social services, law enforcement, and education. “It’s a cycle that carries throughout life,” she says. 

Exactly how much does this cost in dollars? To find out, Gilad and Gutman built an economic model that incorporated prevalence of exposure using data from the National Survey of Children’s Exposure to Violence III and the U.S. Census; attributable risk, to account for how the level by which crime exposure increases the likelihood for a child to experience each adverse outcome; and cost to the states and society for each outcome. 

Their analysis determined that every year the United States spends $458,750,671,262 on elements related to the problem of childhood crime exposure. At the individual level, the total cost comes to $194,413 during each person’s lifetime. 

“If we know how much this costs us, then we can calculate more accurately how much we could save if we have policies in place to mitigate some of the negative outcomes,” Gilad says. “Basically, we can compare the cost of investing in treatment polices to the cost of the problem itself.” 

From here, Gilad says, her aim is to create budget-conscious policies that identify children in need and refer them to the appropriate services. “My hope is that this economic analysis can provide support for what’s in the works already in places like California and Delaware,” she says. “This is not only beneficial for the children and the communities—beyond the moral arguments—it can be economical, too.” 

Michal Gilad is a doctoral researcher with the University of Pennsylvania Law School. She is also an associate fellow with Penn’s Leonard Davis Institute of Health Economics. She previously earned master’s degrees from Penn in law and in criminology