Economic burden of childhood verbal abuse by aduts estimated at $300 billion

Childhood verbal abuse by adults costs society an estimated $300 billion (£239 billion) a year globally, show findings (not yet published) presented at the first international conference on childhood verbal abuse, hosted by the World Health Organization (WHO).

The Words Matter: Impact and Prevention of Childhood Verbal Abuse conference marks the first time that experts from around the world have come together to focus attention on the lifetime damage of childhood verbal abuse and the need to develop solutions.

Childhood verbal abuse involves behaviors that can be detrimental to a child’s wellbeing, such as belittling, shouting and threatening language.

The new study used data from the US Centers for Disease Control and Prevention’s Violence Against Children Surveys, in four countries: Cambodia (1212 participants), Kenya (1099 participants), Colombia (1415 participants) and Moldova (906 participants), to analyze the effects of childhood verbal abuse on selected health outcomes, including mental distress, self-harm, drug use and problem drinking.

The study then estimated the Disability-Adjusted Life Years (DALY) lost (the total amount of healthy life years lost due to people dying prematurely or living with a disability caused by a common disease or health problem in the community) due to health outcomes attributed to childhood verbal abuse to estimate its economic burden.

These DALY losses were then converted into monetary value – assuming that one DALY was equal to the country’s per-capita Gross Domestic Product (GDP).

The mean economic burden of childhood verbal abuse across the four countries was found to be 0.34% of GDP. When this figure was applied to global GDP, it equated to approximately $300 billion every year.

Meanwhile, the DALY losses for outcomes attributed to childhood verbal abuse were significantly greater than corresponding estimates for breast cancer and liver cancer in the four countries studied, and similar to the Disability-Adjusted Life Years lost to hypertensive heart disease.

What the researchers say: “Verbal abuse of children by adults is all too common but is one of the most significant modifiable causes of life-long mental health disorders,” the conference chair explained. “Tackling it gives us a powerful lever to prevent mental health disorders and their enormous cost to both the UK and global economy. Bringing greater awareness to childhood verbal abuse has the potential to dramatically reduce the economic and psychological burden of psychiatric disorders.”

Previous research found that childhood verbal abuse can be as harmful as other forms of abuse and have significant adverse impacts on children’s mental and physical health and development—leading to anxiety, depression, eating disorders, self-harm, substance abuse, a variety of physical disorders and even suicide.

“The economic burden of childhood verbal abuse by adults that we have quantified clearly highlights the shocking hidden cost of the damage it causes to children throughout their lifetime,” the lead author said. “However, this is likely a considerable underestimate given the impact of childhood verbal abuse on several outcomes including healthcare utilization costs and legal system expenses, which were not included in the analysis due to data unavailability.

“There is clearly a significant opportunity for economic growth by ending childhood verbal abuse, and by revealing these figures, we hope this form of childhood maltreatment will be given the attention it deserves. Vital now is undertaking more research and devoting funds and resources to preventing it, so the cost to society can be reduced.”

“We all have a duty of care to treat children with respect and that includes the words and language we use with them. This conference highlights how much words really do matter and how if used poorly, they can have lasting implications for children and our economy,” the researchers added.

“All children deserve to grow up happy and healthy, but millions are suffering verbal abuse by adults which has for far too long been hidden in the shadows. We now know that this is not only impacting children's mental health and development but is also, as this new study shows, having a huge cost on society as a whole. We all want children to develop armed with the tools to lead confident and productive adult lives and the words they hear from adults are so important in building self-esteem and confidence. By shining a light on this abuse, lives can and will be changed.”

So, what? The $300 billion is likely a considerable underestimate given the impact of childhood verbal abuse on several outcomes, including healthcare utilization costs and legal system expenses, which were not included in the analysis. Additionally, costs associated with chronic illnesses such as diabetes, heart disease, and cancer, all of which are either caused or exacerbated by stress, were not taken into account.

Verbal abuse by parents (or those in loco parentis) is highly stressful to children since it makes them feel unsafe—after all they see parents as their means of survival. Thus, to be abused by them is a survival threat. When I worked as a clinical psychologist, I encountered many clients with PTSD who had been verbally abused as children.