By Sarah Gonzalez Bocinski and Malore Dusenbery
Sexual violence continues to be an epidemic in the United States: one in five women (19.3 percent) and 1.7 percent of men have been raped in their lifetime, and approximately 43.9 percent of women, and 23.4 percent of men will experience other forms of sexual violence. The effects of sexual victimization on survivors are significant and long-lasting. Physical and psychological trauma can diminish quality of life, and survivors incur significant economic costs in the immediate aftermath of an assault and across their lifespan. Direct costs may include short and long-term physical or mental health care, damaged property, and fees associated with the justice system. Sexual violence can also lead to long-term mental health issues, such as Post-Traumatic Stress Disorder, depression or anxiety, and risky coping behaviors, such as smoking, drug or alcohol use, or unsafe sex. These consequences of the violence can make it difficult for survivors to complete their education and maintain employment.
While several studies have examined the economic impact of rape on victims and society, including through health care costs, productivity losses, and justice system costs, much of this research is dated. Two new studies explored the financial cost of rape to survivors. The first study, “The Monetary Cost of Sexual Assault to Privately Insured U.S. Women in 2013,” calculated victims’ out-of-pocket health costs within the first 30 days following initial treatment. The second study, “Lifetime Economic Burden of Rape Among U.S. Adults,” estimated health care utilization, lost productivity, and criminal justice costs incurred by rape victims.
Out-of-Pocket Health Costs
To determine the out-of-pocket costs associated with the treatment of sexual assault, the authors reviewed payment data from the Truven Analytics Health MarketScan database, associated with 1,355 female rape patients in the United States seeking medical attention in 2013. Of the 1,355 patients, 32 were admitted as inpatients, and paid an average of $788 for their stay. Those who were treated as outpatients paid an average of $316 for related care. Patients also incurred an average of $56 in prescription drug costs for antibiotics, HIV prevention, pain medication, anxiety medication, and emergency contraception. In total, the authors found the average medical cost of rape within the first 30 days following treatment to be $6,737 – 14 percent ($948) of which was paid by the victim.
In a previous study using data from the 1996 National Violence Against Women Survey and Medical Expenditure Panel Survey, researchers estimated that the mean cost of medical care for intimate partner rape victims who sustained injuries during their most recent victimization and received treatment was $2,084, or $3,191 in 2013 dollars, with victims paying 29.2 percent of the costs. Of those receiving mental health services, the mean cost was $978 ($1,497 in 2013 dollars), with victims paying 33.6 percent out-of-pocket. The combined out-of-pocket medical and mental health costs to victims was $1,435 in 2013 dollars.
A recent study estimated the lifetime cost of rape per victim with new analysis of the 2011 National Intimate Partner and Sexual Violence Survey (NISVS) in combination with administrative data from government and non-government agencies including the U.S. Department of Justice, emergency room departments, the International Federation of Health Plans, Substance Abuse and Mental Health Services Administration, and Web-based Injury Statistics Query and Reporting System. The authors calculated total physical and mental health costs, productivity losses resulting from fewer hours worked or maintaining the household, criminal justice costs, and other costs such as property loss. They estimated that the average lifetime cost of rape is $122,461 per victim, with an economic burden for the population of close to $3.1 trillion over victims’ lifetimes, based on data indicating that an estimated 23 million U.S. women and two million men will experience rape.
Other researchers have also examined the cost of rape. Analysis of the monetary costs of crimes committed by homicide offenders in eight states found that the average cost to society per rape was $448,532, including criminal justice costs, cost of incarceration, time served, and lost productivity. The average lifetime victim costs were estimated to be $138,310 in 2008 dollars. Another study also measured costs to both victim and society by combining victim injury data, medical costs data, and jury awards. Using data from the 2006 National Crime Victimization Survey, medical unit costs from Corso et al., and Jury Verdict Research the authors estimated the total societal cost per rape was $240,776 in 2008 dollars.
Financial Recovery is Unlikely
Obtaining assistance through Crime Victims Compensation (CVC) and restitution can be challenging for rape survivors. Many of the eligibility requirements for CVC, such as reporting to police and cooperating with investigations, require survivors to engage in a system they may want to avoid. Approximately 60 percent of victims do not report to the police, for reasons such as fear of retaliation, or of not being helped. According to the National Association of Crime Victim Compensation Boards, eight percent of CVC funds go to victims of sexual assault. Even when victims do pursue criminal justice, restitution is often an unlikely prospect for them because of low conviction rates – less than one percent of perpetrators receive a felony conviction.
Corso, P, J Mercy, T Simon, E Finkelstein, and T Miller. 2007. “Medical Costs and Productivity Losses Due to Interpersonal and Self-Directed Violence in the United States.” American Journal of Preventive Medicine 32 (6): 474–482.e2.
DeLisi, Matt, Anna Kosloski, Molly Sween, Emily Hachmeister, Matt Moore, and Alan Drury. 2010. “Murder by Numbers: Monetary Costs Imposed by a Sample of Homicide Offenders.” Journal of Forensic Psychiatry & Psychology 21 (4): 501–13.
McCollister, Kathryn E., Michael T. French, and Hai Fang. 2010. “The Cost of Crime to Society: New Crime-Specific Estimates for Policy and Program Evaluation.” Drug and Alcohol Dependence 108 (1–2): 98–109.
National Center for Injury Prevention and Control. Costs of Intimate Partner Violence Against Women in the United States. Atlanta (GA): Centers for Disease Control and Prevention; 2003.
Peterson, Cora, Sarah DeGue, Curtis Florence, and Colby Lokey. 2017. “Lifetime Economic Burden of Rape Among U.S. Adults.” American Journal of Preventive Medicine, Jun; 52 (6): 691-701.
Tennessee, Ashley, Tamala Bradham, Brandi White, and Kit Simpson. 2017. “The Monetary Cost of Sexual Assault to Privately Insured US Women in 2013.” American Journal of Public Health 107, no. 6 (June 1, 2017): 983-988.
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