The health-related costs of rape, physical assault, stalking and homicide committed by intimate partners exceed $5.8 billion each year, according to a report released last week by the Centers for Disease Control and Prevention (CDC). Costs of Intimate Partner Violence Against Women in the United States estimates the incidence, prevalence and health-related costs of non-fatal and fatal intimate partner violence against women. It also identifies future research needs and highlights CDC priorities for violence prevention research.

"CDC is actively involved in ongoing efforts to prevent violence against women," said Sue Binder, MD, Director of the CDC's National Center for Injury Prevention and Control. "This report provides information that is crucial in helping communities demonstrate the impact violence against women has on society."

Costs of Intimate Partner Violence was released on April 28, in conjunction with the Center for Injury Prevention and Control's national conference, "Safety in Numbers." It is based on data from the 1995 National Violence Against Women Survey, as well as other federal sources.

Direct Health Costs

Victims of intimate partner violence often seek medical attention as a result of the violence. Costs of Intimate Partner Violence estimates these health-related costs to be more than $5.8 billion annually. 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.

Nearly 90 percent of these costs are attributable to intimate partner physical assaults, 6.7 percent to intimate partner rape and 3.7 percent to stalking, according to the report.

The study breaks down the direct health costs of intimate partner violence by type of assault. The total medical and mental health care cost per victimization by an intimate partner is $838 per rape, $816 per physical assault and $294 per stalking.

Indirect Costs/Lost Earnings

The indirect health-related costs of intimate partner violence represent the value of lost productivity from paid work, household work and child care for injured victims. Costs of Intimate Partner Violence estimates that the total value of days lost from employment and household chores as a result of intimate partner violence comes to $858.6 million. Of that amount, the value of lost productivity from employment is $727.8 million and the value of lost productivity from household chores is $130.8 million.

Each year, victims of intimate partner rape lose an estimated 1.1 million days of activity, according to the study. Based on research that shows that 21.5 percent of women raped by an intimate partner report time lost from paid work, and 13.5 percent report time lost from household chores, the study estimates that the mean daily earnings lost to intimate partner rape victims is $69. The mean daily value of time lost from household chores is $19.

Each year, victims of physical assaults committed by intimate partners lose an estimated 9.5 million days of activity. Costs of Intimate Partner Violence finds that the mean daily earnings lost because of these assaults is $93, and the mean daily value of time lost from household chores is $24.

Each year, stalking victims lose an average of 2.9 million days of activity. The mean daily earnings lost for stalking is $93 and the mean daily value of time lost from household chores is $24, according to the report.

Costs of Intimate Partner Violence also estimates the indirect costs of intimate partner violence based on the present value of lifetime earnings (PVLE) for victims of intimate partner homicide. It measures the expected value of the lost earnings that victims would have contributed to society if they had lived out their full life expectancies. The total annual PVLE is $892.7 million and the average PVLE per fatality is more than $713,000, according to the report.

Data Limitations

Costs of Intimate Partner Violence notes limitations in its data. First, the report is based on reported incidents of intimate partner violence in 1995. Often victims of violence do not report their crimes to law enforcement officials, nor do they disclose abuse in surveys. This means that incidents of domestic and sexual violence are more prevalent than are reported. In fact, a recent study from the U.S. Department of Justice found that slightly less than one-quarter of the rapes/sexual assaults and just over half of the simple assaults committed by intimate partners were reported.

Second, the study likely underestimates the economic burden of intimate partner violence in the U.S. because the costs it considers are not comprehensive. For instance, it excludes costs related to the legal and judicial systems. Its figures also do not include the costs of pain and suffering associated with intimate partner violence, and some medical costs such as home care visits and treatment for sexually transmitted diseases that were excluded due to lack of data.

Intimate Partner Violence Prevention

The report cautions that, because of its limitations, its figures should not be used to analyze benefit-cost ratios for all intimate partner violence prevention programs. But its findings can be used to: calculate the savings from reducing injuries resulting from intimate partner violence; demonstrate the economic magnitude of intimate partner violence in the U.S.; and evaluate the impact of intimate partner violence on specific sub-sectors of the economy.

Advocates say the data provide a valuable starting point for demonstrating the health savings that come with reducing intimate partner violence and the benefit of prevention. "The new CDC report underscores what advocates have been saying for years: that intimate partner violence costs our society in myriad ways," said Family Violence Prevention Fund President Esta Soler. "It clearly illustrates that abuse has a devastating financial impact on the health care system and on families, communities and our nation. This provides a powerful argument for more adequate funding for the prevention programs that can reduce the incidence, and thus the cost, of intimate partner violence."

Costs of Intimate Partner Violence concludes that more research is needed to fully understand the economic and human costs of intimate partner violence. "Significant resources for research are needed to better understand the magnitude, causes and risk factors of intimate partner violence and to develop and disseminate effective primary prevention strategies," it says. "Until we reduce the incidents of intimate partner violence in the United States, we will not reduce the economic and social burden of this problem."

Costs of Intimate Partner Violence Against Women in the United States is available through the CDC's web site, www.cdc.gov/ncipc/pub-res/ipv_cost/ipv.htm. Additional information about the health care costs of domestic violence and programs that address abuse in the health care setting can be found on the Family Violence Prevention Fund's web site.

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