World Conference on Injury Prevention Report Authored by School Faculty (web article)

Hugh Waters, PhD, and Adnan A. Hyder, MD, MPH, PhD, both assistant professors in the Johns Hopkins Bloomberg School of Public Health’s Department of International Health, co-authored a new report on the cost of violence. It was released at the 7th World Conference on Injury Prevention and Safety Promotion in Austria on June 8, 2004. The authors found that estimates of the cost of interpersonal violence in the United States equal 3.3 percent of the gross domestic product. They also noted that violence disproportionately affects low- and middle-income countries, where few studies are completed.

Adnan A. Hyder, MD, MPH, PhD

The researchers found the following injury costs in the United States:

• Child abuse results in $94 billion in annual costs to the U.S. economy--one percent of GDP.
• Direct medical treatment costs per abused child have been calculated by different studies to range from $13,781 to $42,518 per child.
• Intimate partner violence costs the U.S. economy $12.6 billion on an annual basis – 0.1 percent of GDP--compared to 1.6 percent of GDP in Nicaragua and 2.0 percent of GDP in Chile.
• Gun violence--which includes suicides--has alone been calculated at $155 billion annually in the U.S., with lifetime medical treatment costs per victim ranging from $37,000 to $42,000.

They also found evidence that 56 percent to 80 percent of the direct medical costs caused by gun and stabbing injuries are either directly paid by public financing or are not paid at all, with government and the health care system absorbing the cost.

Hugh Waters, PhD

Past studies have shown that preventive programs are much less expensive than the cost of treating the injuries. The authors compared the price of implementing a Canadian gun registration law--$70 million--to the $5.6 billion annual cost of firearm-related injuries in that country. The researchers also noted that juvenile offender interventions have resulted in economic benefits that are more than 30 times greater than the corresponding costs.

The report was based on an extensive review of peer-reviewed articles and published and unpublished reports. It looked into the economic effects of interpersonal violence in a variety of socio-economic and cultural settings and the economic effects of interventions intended to reduce interpersonal violence. It also examined the effects of economic conditions and policies on interpersonal violence.

Dr. Waters, lead author of the study, wrote in the study, “Given the wide range of procedural differences and extensive gaps in the existing literature on the economics of interpersonal violence, there is a clear need for future research into the costs of violence.”

“The World Report on Violence and Health has also shown that effective interventions are available--particularly in the areas of youth violence and gun-related violence. The evidence of the high costs of interpersonal violence is overwhelming. Detailed analysis of the economic feasibility of interventions is a very clear research priority,” added Dr. Hyder.

Suprotik Basu, MHS, and Julia Ann Rehwinkel, MPH, co-authored the report.