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Abstract
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This DataWatch estimates the costs and monetary value of lost quality of life due to death and nonfatal physical and psychological injury resulting from violent crime. In 1987 physical injury to people age twelve and older resulting from rape, robbery, assault, murder, and arson caused about $10 billion in potential health-related costs, including some unmet mental health care needs. It led to $23 billion in lost productivity and almost $145 billion in reduced quality of life (in 1989 dollars). If associated deaths and cases resulting in psychological injury only are included, costs average $47,000 for rape, $19,000 for robbery, $15,000 for assault, and $25,000 for arson. Considering only survivors with physical injury, rape cost $60,000, robberies $25,000, assaults $22,000, and arson $50,000. Costs are almost $2.4 million per murder. Lifetime costs for all intentional injuries totaled $178 billion during 1987-1990.
VioLit summary:
OBJECTIVE:
The aim of this article by Miller et al. was to estimate the costs of lost quality of life due to death and nonfatal physical and psychological injury resulting from violent crime.
METHODOLOGY:
A quasi-experimental design was employed where secondary data were utilized. The authors estimated the cost of violent crime against victims based on data from several national data sets. The most important data set was the National Crime Survey (NCS) which provided the frequency and outcomes of nonfatal rape, robbery, and assault from 1987 to 1990 (an average of the three years was used). The NCS data was collected through face to face interviews with victims who reported nonfatal victimization, physical injury, work losses, and selected costs.
The authors stated the limitations of the NCS data. The limitations included: 1) incidents of familial violence were probably underreported, 2) incident recall could have been hindered due to the six month recall period (small costs could have been forgotten), 3) those with serious injury may not have been aware of the cumulative costs if the bills went straight to the insurance company, and 4) inaccurate costs could have been reported due to the short reporting period which generally only included costs three months after the incident.
The National Fire Incident Reporting System (NFIRS) was the source used for data on fatal and nonfatal injuries due to arson fires. A non-random estimate was made based on reports from about half of all fire department in the U.S. The authors stated that the use of non-random sampling limits the estimates.
The last source used was the Federal Bureau of Investigation's (FBI's) Crime Reports, which accounts for fatal injuries.
Costs were estimated for the following categories: 1) direct losses other than property losses-including costs of medical, mental health, and emergency response services, as well as insurance administration, 2) productivity losses-wages, fringe benefits, and housework, and 3) nonmonetary losses-pain, suffering, and lost quality of life.
Medical costs were estimated based on average medical costs per fatal injury. The Detailed Claims Information database of the National Council on Compensation Insurance was the secondary source of data used.
Mental health costs were based on frequencies derived from the literature on the psychological injury rate for crimes plus an average of mental health costs that were based on data gathered of people who won jury verdicts for emotional distress and severely disabling psychological injuries.
Emergency response costs were derived from reported crimes based on a survey of eight police departments which reported on primary response and follow-up investigative times. Calculations were based on costs of police responses derived from salary plus fringe benefits and administrative overhead multiplied by the average time spent on a case per category of crime.
Productivity losses were estimated by costs per homicide and by costs for non fatal injury. Costs per homicide came to an average of $610,000 and were based on the victim's age and sex; income levels and other demographic characteristics were not included. For nonfatal injuries the NCS described workdays lost during the first few months after the injury. Lost wages were assumed to equal average daily earnings in private nonagricultural industries. They used John Douglass and colleagues estimates for annual housekeeping values, which came to $5,169 for the employed, and $9,131 for the unemployed.
Program administration costs of health and disability insurance were estimated by multiplying the appropriate costs times the percentage reimbursed by each type of payer times type-specific insurance loss-adjustment expense ratio.
Lost quality of life costs were based on jury compensation and willingness to pay. Jury compensation data was gathered from the National Crime Survey. Willingness to pay-value of life estimates were derived from the amount people willingly paid for safety when, for example, buying a smoke detector, or an automobile with air bags. For non fatal quality of life cost estimates, quality-adjusted life years lost (based on a physicians ratings of typical functional capacity loss by injury on six dimensions: cognitive, mobility, sensory, cosmetic, pain, and activities of daily living--bending, lifting, gasping) were calculated then multiplied by a value per life year.
FINDINGS/DISCUSSION:
The authors first included average annual victimization totals for the different crime categories during the years 1987-1990. There was a total of 10,942,000 victimizations, with assaults having the highest total of 9,126,000 victimizations, robbery was second with 9,126,000 victimizations, then rape with 229,000 victimizations, and lastly arson had a total of 105,000 victimizations.
The authors broke down the costs estimates into two sets. The first set showed the cost per physically injured crime victim, with murder treated as a separate category. The second set showed costs per victimization associated with completed or attempted crime. Costs approached $2.4 million per murder in 1989 dollars. For the nonfatal physically injured, costs for rapes were $60,000, robberies $25,000, assaults $22,000, and arson almost $50,000. Lost quality of life was generally about three-fourths of the total cost of each crime. The second set of figures showed that rapes had the highest average cost at $47,000, followed by arson at $25,000, robbery at $19,000, and assault at $15,000. The authors also included a set of figures that showed the lifetime costs for injuries to persons age twelve and older due to rape, robbery, assault, arson, and murder, computed from average annual incidence during 1987-1990. The total lifetime costs for those injuries was $178 billion. Of that amount, $10 billion was for rape, $23 billion for robbery, $96 billion for assault, close to $1 billion for arson, and $48 billion for murder. The estimates excluded property losses.
The authors found that including administrative costs, lifetime medical costs of intentional injury for persons age twelve and older due to rape, robbery, assault, and arson totaled $2.9 billion. Violent crime accounted for about 5% of injury treatment costs for a total of $10 billion dollars. Productivity costs exceeded $23 billion. The total mental health costs came to $7.2 billion.
The authors concluded by noting that costs associated with mental health far exceeded the medical costs. The authors suggested that one reason for the difference was that many victims only suffer psychological injury. The authors asserted that mental health figures should be included when estimating costs due to violent crimes, as they are typically not included.
AUTHORS' RECOMMENDATIONS:
The authors suggested that policy makers should take mental health costs due to violent crimes into consideration when debating health care reform.
(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
Violence Effects
Public Health Approach
Adult Victim
Cost Analysis
Crime Effects
Crime Victim
Homicide Effects
Homicide Victim
Sexual Assault Effects
Sexual Assault Victim
Rape Effects
Rape Victim
Robbery Effects
Robbery Victim
Physical Assault Effects
Physical Assault Victim
Adult Adjustment
Adult Mental Health
Adult Injury
Psychological Victimization Effects
Injury Effects
Victim Adjustment
Victim Mental Health
Victim Injury
Emotional Adjustment |