NASHVILLE — A new study estimates Tennessee children have a 1 in 8 chance of being abused by the time they reach adulthood, with the report also revealing huge and sometimes life-long economic costs associated with abuse, neglect and exposure to drugs.
The study was conducted by the University of Tennessee's Boyd Center for Business and Economic Research and sponsored by the Tennessee Commission on Children and Youth's Second Look Commission. It pegs annual economic costs in Tennessee between $3.33 billion and $4.97 billion annually. The effects of abuse often follow a child into adulthood.
Calling even the nearly $5 billion figure "extremely conservative," the study says it is likely an understatement of the economic costs of child maltreatment. The dollar amount of abuse costs is around 1.3% of Tennessee's annual gross domestic product.
Cost estimate factors include child deaths and premature adult mortality as well as decreased wages and workforce productivity in adulthood among survivors.
According to the study, abuse also increases medical costs both in childhood and into adulthood along with increased demands for special education, residential care costs for dependency and juvenile delinquency as well as additional costs associated with criminality that can carry into adulthood.
"Economically, there is a strong case for additional resources being made available to help victims of child abuse and neglect receive therapy and recover," Matt Harris, business professor at the University of Tennessee and author of the study, said in a news release. "However, we must acknowledge that therapy and treatment will only partially offset the economic and personal harm done."
The economic harm from a child's maltreatment continues over his or her life, Harris said. So would the benefits from therapy and treatment. Thus, those efforts should be recognized as a long-term endeavor from an economic perspective, he said.
Maltreatment is divided into four types in the study — physical abuse, sexual abuse, drug exposure and neglect — and categorized as severe or nonsevere. From 2019 through 2022, data from the Tennessee Department of Children's Services showed an average of 11,668 children a year were first-time victims of abuse or severe neglect.
The study focuses only on first-time victims to prevent double-counting children who are victims in multiple years. While Children's Services receives $1.35 billion in annual funding from state and federal funding and other sources, most of that money goes to crisis management, residential placements and foster care, according to the study.
The study says efforts to prevent child maltreatment and help young victims recover would yield a lifetime of benefits stemming from greater labor force participation, improved population health, decreased rates of substance use disorders, lower incarceration rates, reduced demand for state services and greater life expectancy.
"These efforts can include economic supports for families, education efforts for parents and greater access to mental health and counseling services for both parents and children," according to a summary.
In a phone interview Tuesday, Harris said having been able to develop sound estimates for total costs is important.
"Unless you can put a dollar figure on a problem, that's a real inhibiting factor," Harris said. "That is the main thing we want people to know, that one, the number per year."
Harris, who said the study took a conservative approach in cost estimates, said the report is not about castigating anybody.
"The key aspect is that top-line cost," Harris said. "We need to have policy conversations."
The study also reviewed cases of abuse by county. Half the counties in Tennessee have over 1% of children becoming first-time victims of abuse each year.
County-level data in the study shows the total number of victims and the number of victims suffering from severe abuse are higher in more rural counties. Cases involving drug exposure are more prevalent in East Tennessee, while physical abuse is higher in Middle and West Tennessee. Cases of sexual abuse tend to be higher in rural counties and border counties, raising concern about human trafficking in Tennessee.
The study estimates the lifetime cost per case of documented child abuse at $285,000.
There were more than 163,000 reports of abuse to Child Protective Services in 2022, and over 70,000 cases or assessments were opened based on those initial reports. The agency's budget allows for 832 case managers, and state law allows 20 open cases per case manager at a time.
During the pandemic, a rise in case numbers accompanied by an exodus of staff departures resulted in the Department of Children's Services becoming overwhelmed with children consigned to sleeping in state offices and harsh criticisms in a state audit.
The Boyd Center study notes budgetary constraints and the difficulty of detecting child abuse in many cases result in counts of substantiated cases not capturing the full scope of the problem. According to the U.S. Department of Health and Human Services, rates of child maltreatment could be three times higher than the number of substantiated cases across the nation.
"The impact of maltreatment reverberates through so many aspects of a child's life — their physical health, mental health, educational attainment and community involvement," Kylie Graves, director of the Tennessee Second Look Commission, said in a statement. "This report provides critical economic data, highlighting not only the impact on each child but our state and community as a whole. Moving forward, the need for investment in prevention cannot be more clear."
The study was co-authored by Emily Pratt, a research associate with the Boyd Center for Business and Economic Research.
In Southeast Tennessee, first-time victims per 1,000 children per year:
— Hamilton County: 6.1
— Marion County: 6.9
— Bradley County: 8.6
— Grundy County: 10.6
— Rhea County: 12
— Bledsoe County: 12.6
— Polk County: 13.3
— McMinn County: 14.2
— Meigs County: 16.1
— Monroe County: 18
— Sequatchie: 19.1
In the state's largest counties, first-time victims per 1,000 children per year:
— Rutherford County: 4.1
— Davidson County: 4.6
— Shelby County: 4.8
— Hamilton County: 6.1
— Knox County: 10.1
Source: The Economic Cost of Child Abuse and Neglect in Tennessee