Victim Costs and Consequences: A New Look.
Series: NIJ Research Report
Published: January 1996
43 pages
93,916 bytes

Victim Costs and Consequences: A New Look

About the National Institute of Justice

The National Institute of Justice, a component of
the Office of Justice Programs, is the research and
development agency of the U.S. Department of
Justice. NIJ was established to prevent and reduce
crime and to improve the criminal justice system.
Specific mandates established by Congress in the
Omnibus Crime Control and Safe Streets Act of 1968,
as amended, and the Anti-Drug Abuse Act of 1988
direct the National Institute of Justice to:

o  Sponsor special projects and research and
development programs that will improve and
strengthen the criminal justice system and reduce
or prevent crime.

o  Conduct national demonstration projects that
employ innovative or promising approaches for
improving criminal justice.

o  Develop new technologies to fight crime and
improve criminal justice.

o  Evaluate the effectiveness of criminal justice
programs and identify programs that promise to be
successful if continued or repeated.

o  Recommend actions that can be taken by Federal,
State, and local governments as well as private
organizations to improve criminal justice.

o  Carry out research on criminal behavior.

o  Develop new methods of crime prevention and
reduction of crime and delinquency.

The National Institute of Justice has a long
history of accomplishments, including the
following:

o  Basic research on career criminals that led to
the development of special police and prosecutor
units to deal with repeat offenders.

o  Research that confirmed the link between drugs
and crime.

o  The research and development program that
resulted in the creation of police body armor that
has meant the difference between life and death to
hundreds of police officers.

o  Pioneering scientific advances such as the
research and development of DNA analysis to
positively identify suspects and eliminate the
innocent from suspicion.

o  The evaluation of innovative justice programs to
determine what works, including drug enforcement,
community policing, community anti-drug
initiatives, prosecution of complex drug cases,
drug testing throughout the criminal justice
system, and user accountability programs.

o  Creation of a corrections information-sharing
system that enables State and local officials to
exchange more efficient and cost-effective concepts
and techniques for planning, financing, and
constructing new prisons and jails.

o  Operation of the world's largest criminal
justice information clearinghouse, a resource used
by State and local officials across the Nation and
by criminal justice agencies in foreign countries.

The Institute Director, who is appointed by the
President and confirmed by the Senate, establishes
the Institute's objectives, guided by the
priorities of the Office of Justice Programs, the
Department of Justice, and the needs of the
criminal justice field. The Institute actively
solicits the views of criminal justice
professionals to identify their most critical
problems. Dedicated to the priorities of Federal,
State, and local criminal justice agencies,
research and development at the National Institute
of Justice continues to search for answers to what
works and why in the Nation's war on drugs and
crime.

U.S. Department of Justice
Office of Justice Programs

National Institute of Justice
Jeremy Travis
Director
Richard Titus, Ph.D.
Project Monitor

Ted R. Miller, Ph.D., is associate director of the
National Public Services Research Institute in
Landover, Maryland. 

Mark A. Cohen, Ph.D., is associate professor at
the Owen Graduate School of Management, Vanderbilt
University, Nashville, 
Tennessee. 

Brian Wiersema is research coordinator for the
Violence Research Group, Department of Criminology
and Criminal Justice, University of Maryland at
College Park.

This project was supported under award number 90-
IJ-CX-0050 by the National Institute of Justice, 
Office of Justice Programs, U.S. Department of
Justice, and by the Maternal and Child Health
Bureau, U.S. Department of Health and Human
Services. Opinions or points of view expressed in
this document are those of the authors and do not
necessarily reflect the official position of the
sponsoring agencies.
NCJ 155282  


Table of Contents

Introduction   
The incidents of crime
Costs and Consequences of Victimization
Tangible losses
Intangible losses
Victimization and victim costs per crime
Aggregate annual victim costs in the United
  States  
Special breakdown of cost estimates: domestic
  crime and crimes against children
Who pays the crime bill? 
Uncertainty of the estimates and sensitivity
  analysis
Number of victimizations
Monetary valuation of intangible losses
Comparison with prior estimates
Future Research
References     
------------------------------------

Introduction

This Research Report documents the results of a
2-year multidisciplinary research effort to
estimate the costs and consequences of personal
crime for Americans. Personal crime is estimated
to cost $105 billion annually in medical costs,
lost earnings, and public program costs related to
victim assistance. These tangible losses do not
account for the full impact of crime on victims,
however, because they ignore pain, suffering, and
lost quality of life. Including pain, suffering,
and the reduced quality of life increases the cost
of crime to victims to an estimated $450 billion
annually. Violent crime (including drunk driving
and arson) accounts for $426 billion of this
total, property crime $24 billion. These estimates
exclude several crimes that were not included in
this study but that also have large impacts,
notably many forms of white collar crime
(including personal fraud) and drug crimes. 

Below are some yardsticks that put the costs into
context.

o  Violent crime causes 3 percent of U.S. medical
spending and 14 percent of injury-related medical
spending.

o  Violent crime results in wage losses equivalent
to 1 percent of American earnings. 

o  Violent crime is a significant factor in mental
health care usage. As much as 10 to 20 percent of
mental health care expenditures in the United
States may be attributable to crime, primarily for
victims treated as a result of their
victimization. About half of these expenditures
are for child abuse victims who are receiving
treatment for abuse experienced years earlier.
These estimates do not include any treatment for
perpetrators of violence.

o  Personal crime reduces the average American's
quality of life by 1.8 percent. Violence alone
causes a 1.7 percent loss. These estimates are
conservative. They include only costs to
victimized households, ignoring the broader 
impact of crime-induced fear on our society.

This study highlights the importance of explicitly
considering crime victims' pain, suffering, and
lost quality of life when analyzing public policy.
A complete characterization of criminal
victimization costs can be an important tool in
formulating criminal justice policy. Identifying
and quantifying costs and consequences of
victimization may be helpful both in
characterizing the crime problem and in examining
ways to address it. Ignoring the nonmonetary
benefits of crime reduction can lead to a
misallocation of resources. For example, suppose
that an additional year of incarceration for a
rape offender would prevent one additional rape
incident. Considering only tangible, out-of-pocket
costs, the average rape (or attempted rape) costs
$5,100--less than the $15,000-$20,000 annual cost
of a prison cell. The bulk of these expenses are
medical and mental health care costs to victims.
However, if rape's effect on the victim's quality
of life is quantified, the average rape costs
$87,000--many times greater than the cost of
prison.

By allowing analysts to combine statistics on
disparate crimes into a single, readily understood
metric, monetary valuations of crime costs can
help guide resource allocations across crimes. For
example, is a patrol pattern that prevents a rape
better than one that prevents three burglaries?
One way to answer such a question is to ask
residents of the affected area, through polling or
referendums, which they prefer. In many instances,
however, policymakers must rely on less direct
methods of determining an appropriate choice. In
such cases, one would need to have a metric that
allows for comparisons between rapes and
burglaries.

Although placing a dollar value on the suffering
resulting from violent crime may seem cold and
impersonal, such information is useful in the
public policy arena. Without a common metric to
compare various crimes, it is difficult to assess
the merits of criminal justice or victim
assistance programs. For example, the aggregate
out-of-pocket costs of rape are about $7.5
billion, roughly equal to the out-of-pocket costs
to burglary victims and less than the
approximately $9 billion cost to larceny victims.
Yet the crimes of burglary and larceny have much
less severe psychological effects on victims. When
pain, suffering, and lost quality of life are
quantified, the cost of rape--$127 billion--dwarfs
the estimated costs of either burglary or larceny.

Violence against children is one of the least
well-documented areas of personal crime. This
Research Report presents several new estimates of
the incidence, costs, and consequences of violence
against children. Although this study's results
should be viewed as preliminary, they 
suggest that violence against children accounts
for a significant portion of our nationwide victim
costs. Out-of-pocket costs for child victims are
estimated to be more than 20 percent of all
out-of-pocket crime victim costs and more than 35
percent of all costs (including pain, suffering,
and lost quality of life).

The National Crime Victimization Survey (NCVS) is
the government's main source of information about
criminal victimization. To collect information for
the NCVS, the Bureau of Justice Statistics polls
people over age 12 about rape, robbery, assault,
larceny, burglary, and motor vehicle theft. Partly
because of the difficulty in obtaining certain
information in a survey format, the NCVS does not
collect data on certain crime categories (such as
child abuse and drug abuse) and undercounts others
(such as rape and domestic violence). The NCVS
format does not attempt to comprehensively measure
crime costs and consequences or document and
assess crime-induced permanent disability and
mental health treatment, which would cover such
intangibles as the pain, suffering, fear, and lost
quality of life that victimization brings. The
survey documents numbers of crimes as reported by
households and asks victims to quantify their
short-term out-of-pocket losses due to
victimization. This Research Report aims to add
valuable information to the findings of the NCVS
by estimating the full cost of crime to victims
and by including many other types of crime.

The incidents of crime

Number of victimizations. It is difficult to know
how much crime is committed in the United States.
The Federal Bureau of Investigation's Uniform
Crime Reports (UCR) collect data from police
departments about the number of crimes reported or
known to the police. The NCVS survey of households
also obtains information about crimes not known to
the police and thus identifies more criminal
offenses than the UCR, but it still probably
undercounts the total crimes, especially those
regarding gunshot and knife assaults, domestic
violence, and rape (National Research Council,
1993). As mentioned previously, the NCVS also
excludes many crimes, among them murder, arson,
drunk driving, child abuse and neglect, and crimes
against children under 12. Also, the survey sample
of U.S. households largely omits the homeless and
others not attached to traditional households.

This project reviewed available estimates of the
under-reported crimes, seeking more comprehensive
incidence data. The data sources included national
surveys and local studies. One difficulty with
analyzing these studies was the variety of
definitions used for the same crime. For example,
some researchers defined rape as any unwanted
sexual encounter, whether or not the victim
believed she had been raped. Others were more
restrictive, including only forced penetration
that the victim characterized as rape. Another
problem is that many studies have not used
nationally representative samples; also, rape
surveys have often polled only women. Ultimately,
the researchers for this project focused almost
entirely on data from nationally representative
surveys where the crime definition was clearly
reported. In some cases, they generated new
estimates of crime incidence based on an analysis
of earlier studies.

Total crimes. People and households in the United
States faced more than 49 million crime attempts
annually in 1987-1990. The annual toll includes
more than 16 million violent crimes and attempted
crimes (murder, rape, robbery, assault, child
abuse, drunk driving, and arson). In 1990, 31,000
deaths resulted.

The victimization counts differ from most
published NCVS counts. The reason is that the
researchers included series victimizations, a
chain of three or more similar crimes that
respondents did not describe in detail. The NCVS
asks series victims to estimate how many times
they were victimized. Recent NCVS validation
efforts suggest respondents can remember details
of up to six related victimizations if pressed.
This study accepted the serial victimization
counts to a maximum of 10 per series but examined
the effect of more and less aggressive choices in
sensitivity analysis. 

The victim counts generally are not additive
between crime types. The same person may be the
victim of a rape and a burglary during one year,
so the sum would double count. Duplication was
eliminated within the NCVS data, however. The
unduplicated annual victim count for NCVS crimes
alone approaches 31 million.

The section that follows systematically describes
the findings about crimes for which this study's
incidence estimates go beyond those of the NCVS.

Fatal crimes. Including victims of drunk drivers,
crime took 31,079 lives in 1990. This count
largely derives from Vital Statistics data, which
recorded 4,500 crime deaths, primarily negligent
manslaughter cases, excluded from the 
Federal Bureau of Investigation's Uniform Crime
Reports. The number excluded deaths due to legal
intervention, as well as 2,376 deaths of unknown
intent, many of them poisonings and firearm
deaths. Some of the latter deaths probably were
homicides. For example, child abuse deaths are
likely to be undercounted because some children
who allegedly die of Sudden Infant Death Syndrome
(SIDS) are actually abuse victims. Vital
Statistics data also exclude victims whose bodies
are never recovered. The drunk driving count
excludes intoxicated drivers and nonoccupants. As
described below, the number further reduces the
victim count in an attempt to remove crash deaths
that would have happened even if everyone involved
had been sober.

Child abuse. Existing estimates of child abuse
vary considerably. The two main sources of
national information on child abuse are the
National Incidence and Prevalence 
Survey of Child Abuse and Neglect (NIS) (Sedlak,
1991) and the National Family Violence Surveys
(Gelles and Straus, 1985; Straus and Gelles,
1976). The latter produce estimates far greater
than the former, mainly due to differences in the
samples employed. Gelles and Straus used a
probability sample of adults with children, and
Sedlak relied on a sample of child protective
services (CPS) and other government agencies to
generate counts of actual cases that came to their
attention. The CPS-based estimate undoubtedly
represented only serious cases and is thus an
underestimate of the total number of child abuse
victims. The Gelles and Straus estimates were
based on self-reported behaviors that are
difficult to validate with external measures.

This study's researchers base estimates on data
from the 1986 NIS but use a statistical technique,
capture-recapture modeling, that estimates the
number of people unknown to the system from the
number detected by various sources (Miller,
Kilpatrick, and Resnick, 1994). The estimates are
conservative. They largely exclude the 1.3 million
cases annually that child protective services
agencies are unable to substantiate or do not
classify as abuse and neglect using NIS
definitions.

The unduplicated count of 1990 abuse victims is at
least 794,000. In order of precedence for victims
of multiple types of abuse, 185,000 children were
sexually abused, 308,000 were physically abused,
and 301,000 were emotionally abused. Unlike the
victim count, the victimization count treats a
child who was the victim of both physical and
sexual abuse as being victimized twice.

The estimate is thus higher than Sedlak's estimate
of 590,800 total abuse cases (of which 133,600
were sexual abuse victims) but lower than Straus
and Gelles' estimates. Straus and Gelles (1986,
1987) estimated about 1.3 million children are
physically abused annually, including children
targeted with thrown objects that missed their
mark.

This project's estimate equates to about 13-17
million adults who were physically abused by
parents or adult caretakers as children and
355,000 new physical abuse cases annually. The
Commonwealth Fund (1993) estimated that 20 million
adults were "physically abused" by someone as
children. The Family Violence Prevention Fund (EDK
Associates, 1993) estimate is that 15 million
adults were "beaten by their parents or witnessed
a sibling's beating." This estimate probably is
low since people who had never witnessed a parent
beating a child were not asked if they personally
had been beaten. 

More recently, Finkelhor and Dziuba-Leatherman
(1994) used a telephone survey of youths to
estimate the criminal victimizations of children
ages 10-16 during 1991. They estimated that 0.5
percent of children ages 10-16 were victimized by
a parent or parent-substitute. Based on Sedlak's
(1991) estimate that 89 percent of child physical
abuse was by a parent or substitute, and an
estimated 24.3 million children ages 10-16, the
Finkelhor and Dziuba-Leatherman estimate
translates into 246,000 child abuse victims (with
95 percent confidence limits of 137,000 to
355,000). By comparison, the present study
estimates 170,000 child physical abuse victims
ages 10-16 (out of 308,000 child abuse victims).

Rape. Until 1992, the NCVS did not ask directly
about rape, but left it to the victim to mention
(and define), a method that resulted in criticism
for undercounting rape. After an extensive
redesign process, a new NCVS questionnaire was
fielded in 1992 that, among other things, directly
asks about rape. Preliminary data released in the
fall of 1994 suggest that estimates of completed
and attempted rape are about 2.7 times higher than
those based on the older questionnaire. In
addition, the new form developed estimates of
nonrape sexual assault for the first time.
Together, 607,000 rapes and other sexual assaults
were estimated to have occurred in 1992 (BJS,
October 1994). This amount excludes about 114,000
rape or sexual assault victims who were subject to
series rapes in excess of six or more times and an
additional 113,000 victims of "unwanted sexual
contact without force." If these estimates are
added together, there were approximately 834,000
victims in 1992.

Because the redesigned NCVS instrument had not yet
been implemented at the time of this research
(i.e., as of May 1995, the 1992 data files had not
yet been released), alternative national estimates
of rape were used. The best data the researchers
could find that coincided with the time period
under study were produced from the National
Women's Study (NWS) developed by Kilpatrick et al.
(1992). The NWS surveyed women age 18 years and
older in 1990 and found approximately 683,000
women had been raped or sexually assaulted in the
previous year. Followups of the same sample
(providing 1-year bounded reference periods) in
1991 and 1992 produced annual estimates averaging
632,000, an amount that closely matched the
original findings (Kilpatrick et al., 1994).
Kilpatrick's questions about rape were clear and
direct. They explicitly included vaginal
intercourse, oral and anal sex, and/or other
sexual penetration by force, threat of force, or
lack of consent. The Kilpatrick numbers are
similar to the preliminary estimates from the 1992
NCVS, even though the questions were worded
differently. Using the Kilpatrick estimates for
1990 is thus not an unreasonable approach to
avoiding the undercount in the pre-1992 NCVS.

Several adjustments to the Kilpatrick estimates
are necessary for comparability with the rest of
this study's incidence data. This research started
with the 1991-92 Kilpatrick estimate of the number
of adult female rape victims (632,000). Because
Kilpatrick surveyed only women, the ratio of
female to male rapes in the NCVS (17 percent of
victims are male) was used to inflate the
estimate. Next, because persons under 18 were not
included in the NWS, an adjustment for child rapes
was made. The NWS asked women if they were raped
as children. From these responses, the number of
children that would have been raped per year was
estimated in order to report such a response as
adults. Although the NWS did distinguish attempts
from completed rapes, it is not clear whether
respondents excluded attempts; it is also possible
that respondents to the pre-1992 NCVS considered
oral sex and other sexual assaults as attempted
assaults, events that Kilpatrick defines as rape.
To be conservative, this study did not, therefore,
increase the NWS completed rape estimate to
account for attempts. Finally, because the
Kilpatrick estimate is a prevalence estimate (a
count of victims) and not an incidence estimate (a
count of victimizations), the NWS figure was
multiplied by 1.27, the ratio of victimizations to
victims from NCVS. The result is an estimated 1.1
million rape and sexual assault victims--very
close to the recently released redesigned NCVS
preliminary estimates of 834,000 victims noted
above. 

Assault. There is no single source of data on
assaults. Based on NCVS data, an estimated 7.8
million assaults and attempted assaults occur
annually, representing about 4.4 million victims.
About 30 percent of these assaults involve injury.
The NCVS excludes children under age 12 and
undercounts domestic assaults. 

To supplement the data, this study estimates that
nonfatal assaults against children under age 12
number 139,000 annually (97,000 victims). To avoid
double counting, this estimate excludes physical
child abuse, defined as assault by adult
caretakers or by others who parents let assault
their children (Sedlak, 1991). This estimate was
computed by multiplying the NCVS count of
nondomestic assaults on children ages 12-17 times
the ratio of medically treated nondomestic
assaults for children ages 0-11 versus children
ages 12-17. That ratio came from proprietary
health care system data on 13,528 hospitalized
crime victims and 65,555 crime victims treated in
emergency rooms and released. (By comparison, the
unweighted 1987-91 NCVS data included fewer than
250 overnight hospital admissions and 1,000 other
victims treated in hospital emergency or
outpatient departments.) The hospitalized data
cover all victims admitted in California, Vermont,
and Washington at times when those States required
coding of injury causes. The nonhospitalized data
are from a convenience sample of 21 hospital
emergency departments spread across 9 cities. They
include all but one of the emergency departments
this study could identify nationally that coded
injury cause and type and maintained data on
extractable computer files. However, since these
emergency departments are not nationally
representative samples, the assault count for
children under age 12 should be viewed as
preliminary and is reported separately.

Nonfatal domestic assaults have been undercounted
in the NCVS. Of the 4.4 million assault victims
identified in the NCVS, only about 355,000 were
domestic assault cases. Straus and Gelles (1986)
estimated that 2 million people endure severe
spousal violence annually (interpreted here as
violence with at least minor physical injury),
with an additional 2 million subjected to less
severe violence. Straus and Gelles' estimates are
open to criticism (National Research Council,
1993). A further concern about these estimates is
that domestic rape often may be included. 

The Straus and Gelles severe violence estimate
appears to be better than its critics claim. Under
some reasonable assumptions, it proved consistent
with NCVS data. Assume the underreporting rate for
domestic rape relative to other rape in the NCVS
equals the underreporting rate for domestic
assault. Under this assumption, physically injured
domestic assault victims would number about 1.75
million annually. This estimate should be lower
than Straus' and Gelles' estimate; it excludes
assaults by unmarried partners, which Straus and
Gelles include.

The Straus and Gelles estimates also are
consistent with the 1993 Commonwealth Fund survey.
In this survey, 3.9 million women reported
physical abuse by their partners, with far more
reporting verbal or emotional abuse. As a final
confirmation of the Straus and Gelles estimates,
with the NCVS distribution of medical treatment
and victimizations per victim for domestic
assault, they imply 1.85 million emergency
department visits annually. For women, the total
would be 25 percent of injury visits, excluding
visits due to motor vehicle crashes--21 percent
including these visits (computed from the injury
visit count in McCaig, 1994).  Four emergency
department studies find this percentage ranges
from 16 to 30 percent.

Due to their tenuous nature, this study included
only the estimates of 2 million spousal victims
with severe enough violence to cause injury. This
number has been reduced by 355,000 victims of
domestic violence estimated in the NCVS data. 
 
Since NCVS undercounts gunshot and knife assaults
with physical injury, estimates of gunshot
assaults came from nationally representative
health care data. The knife assault estimate was
computed from the gun assault estimate and the
health care data used in the child assault
analysis (see Miller and Cohen, 1995).

Drunk driving. Drunk driving is illegal. This
study considers it a violent crime when a drunk
driver maims or kills innocent victims or damages
their property. Some crashes involving a drunk
driver, however, would have happened even if the
driver had been sober. They might have been due to
a mechanical failure, the error of another driver
or pedestrian, or an error the drunk driver would
have made even when sober. Therefore, simply
counting the number of crashes where one driver
had a blood alcohol content (BAC) of 0.1 percent
or more would overestimate the harm attributable
to drunk driving. To estimate attributable
crashes, this study relied on the methodology in
Levy and Miller (1995). These estimates are
somewhat tentative as they were based on a 1962
Michigan study that attempted to differentiate
between crashes that were "caused" by drunk
driving and those that would have occurred anyway.
The U.S. Department of Transportation is currently
updating that 1962 study.

Drunk drivers victimize almost 2.9 million
innocent people annually. Because they are driving
drunk, they kill about 6,150 people, physically
injure 500,000, involve another 2.4 million people
in sometimes psychologically devastating crashes,
and damage 1.15 million vehicles.

Arson. Arson injures relatively few people but can
be deadly. The arson counts are from the National
Fire Incident Reporting System. They include all
arson fires that damaged buildings or vehicles and
outdoor fires that resulted in death or physical
injury.

Excluded crime. This study focuses on crimes
against persons or households. Some incidents--
like child neglect--that may not be characterized
as crimes in all States and have varying
definitions are excluded. Also excluded are crimes
against business (theft, fraud, embezzlement,
etc.); crimes against the government (regulatory
offenses, fraud, tax evasion, etc.); all forms of
white collar crime (including fraud); and most
"victimless" crimes such as drug offenses,
gambling, loan sharking, and prostitution. Here
are some of the estimates on the prevalence of
these crimes:

Criminal child neglect. This form of child
maltreatment is defined by State laws in widely
varying ways and is generally a misdemeanor.
Several States' neglect statutes, for example,
include "environmental neglect," essentially
failure to provide shelter. That makes
homelessness a crime. Such neglect could be the
result of poverty and the inability of the social
services system to find the family a home rather
than a deliberate attempt to harm the child. Few
States require Child Protective Services (CPS) to
report cases that they substantiate to the police.
Instead, CPS and Family Courts resolve many cases.
Criminally neglected children are victims and may
require outside intervention if they are to become
productive members of society. However, using the
same methodology employed for child abuse
(applying capture-recapture modeling to the 1986
NIS data), an estimated 1.7 million children were
neglected. This includes about 1,236,000 children
who were physically neglected and another 475,000
who were subject to educational neglect. These
estimates are for children who were not otherwise
child abuse victims.

Personal fraud. According to a National Institute
of Justice survey (Titus, Heinzelmann, and Boyle,
1995), 24 million Americans experience more than
38 million fraud attempts annually. The survey
defined fraud as "involving the deliberate attempt
to deceive with promises of goods, services, or
other financial benefits that in fact do not exist
or that were never intended to be provided." 

Drug abuse. According to the 1992 National
Household Survey on Drug Abuse, about 11 percent
of Americans age 12 or older admitted using an
illicit drug at least once within the past year.
This translates into approximately 22.8 million
drug users. However, only about half of that
number reported using an illicit drug within the
past month. One estimate is that about 5.5 million
Americans are "in need of treatment" (ONDCP,
1991).

Costs and Consequences of Victimization

Crimes--both violent and nonviolent--impose many
different kinds of losses on both victims and
society. The costs and consequences of crime are
categorized in the section "Comprehensive List of
Costs and Consequences of Crime." This study
focuses on victims' costs; hence it ignores
society's response to victimization--including the
very real costs to the criminal justice system and
other social costs associated with the fear of
crime, such as changed behavior (failure to walk
outside at night, moving to safer neighborhoods,
etc.) and private security expenditures by the
general population who are concerned about crime.
More details about the nonvictim costs of crime
are contained in Cohen, Miller, and Rossman (1994)
and Cunningham, Strauchs, and Van Meter (1991). To
victims, the costs are mainly (1) out-of-pocket
expenses such as medical bills and property
losses, (2) reduced productivity at work, home,
and school, and (3) nonmonetary losses--such as
fear, pain, suffering, and lost quality of life.
Although some of these losses are tangible and
easily quantified, even the intangible losses
(such as lost quality of life) may be valued in
dollar terms (Cohen, 1988).

Each category of victimization produces cost on a
per-crime basis. These costs are averages and
include attempts that result in minimal
consequences as well as extremely violent crimes
that result in long hospital stays and devastate
victims' quality of life for years to come. Thus,
the fact that the average rape costs about $500 in
medical expenses reflects the fact that only about
25 percent of all rape victims in the NCVS
reported receiving any medical treatment; only
about 2 percent of rape victims stayed overnight
in a hospital. A brief explanation of what these
categories are and how they were estimated
follows.

Tangible losses

o Property damage and loss: the value of property
damaged and of property taken and not recovered,
plus insurance claims administration costs that
arise in compensating victims' property losses. 

Most of these losses are taken directly from NCVS
data. In cases where losses were insured, 16
percent was added to account for insurance claims
processing costs, a published loss-adjustment
expense ratio from Best (1993). Supplementary
published sources were also used for drunk driving
(Miller and Blincoe, 1994) and arson cases (Hall,
1993).

Property damage is typically a very small
percentage of the cost of violent crime, often
less than 1 percent of the total tangible costs.
However, costs related to property damage are
typically the bulk (60-80 percent) of the cost of
property/household crimes such as burglary,
larceny, and arson. The average arson victim
incurs $15,500 in property damage; the average
motor vehicle theft costs $3,300; while the
average property value loss to robbery victims is
$750.

o Medical care: payments for hospital and
physician care, as well as emergency medical
transport, rehabilitation, prescriptions, allied
health services, medical devices, coroner costs,
premature funeral expenses, and related insurance
claims processing costs. Also included in this
category are victim legal expenses incurred in
recovering medical costs from drunk drivers and
their insurers.

Although the NCVS contains estimates of medical
care costs, these estimates are self-reported by
victims and only include medical costs up to a few
months after the incident. This approach
underestimates medical costs because the victim
may not receive bills for the full cost of medical
care, and it does not consider long-term costs.
Although NCVS provides some details on the nature
of injury, the categories are quite broad, e.g.,
broken bones or gunshot wounds and hospitalized
versus nonhospitalized status. 

In order to estimate lifetime medical costs, this
study started with the distribution of injuries as
reported in NCVS and made several adjustments. For
hospitalized injuries, within the broad NCVS
injury categories, an estimate was developed of
the "ICD9" (International Classifications of
Diseases, Ninth Edition, Clinical Modification
Code) injury distribution by examining all
hospitalized injuries in California, Vermont, and
Washington, three States that have identified
injuries by ICD9 code and cause (allowing us to
isolate violence victims from unintentional
victims and suicide attempts). Using the actual
lengths of hospital stay from the State data and
the medical payments per day (and other injury
information) by ICD9 code from Miller, Pindus et
al. (1995), the treatment costs were estimated for
each hospitalized assault or rape victim. The
average cost per injury by NCVS injury category
was then computed. Although having a nationally
representative sample of hospitalized intentional
injuries would have been preferred, using all
hospitalized rape and assault cases in only States
that collected these data seemed reasonable. Since
the research started with NCVS broad injury
categories, the research team only used the
three-State injury data to estimate the body parts
and severity of injury within each category. It is
unlikely that the typical "broken bone" in these
three States is significantly more or less severe
than the typical broken bone elsewhere in the
United States. Data becoming available in 1994-
1996 from a dozen other States will allow
verification of this hypothesis. 

For nonhospitalized injuries a similar approach
was tried, but the estimated short-term medical
costs by injury category were so similar to the
NCVS estimates that the NCVS estimates of
short-term costs were used. These estimates were
multiplied by lifetime-to-short-term-cost ratios
for nonhospitalized injuries by ICD9 code
groupings (in the NCVS categories) computed from
the ratios in Miller, Pindus et al. (1995) and the
injury distribution from 21 hospital emergency
departments that code ICD9 nature of injury and
cause of injury for nonadmitted injuries. 

The researchers know of no estimates of the
medical costs associated with homicide victims.
Instead, medical costs for fatal injuries were
taken from Miller, Pindus et al. (1995), based on
all fatal workers' compensation cases in 41
States. Similarly, virtually no estimates of
medical costs are available for child abuse. Data
on medical costs per child abuse case were
obtained directly from the above-mentioned health
care data and an inferred hospitalization rate.
Thus, this study's estimates for child abuse
should be viewed as very rough and worthy of
further study. 

Insurance administrative costs were estimated to
be 7.5 percent of medical costs covered under
health insurance policies and 13 percent for
workers' compensation-related cases. These
estimates were based on insurance statistics as
explained in Miller (1992, volume 2). 

A final caveat on the costing methodology is that
managed care systems appear to be changing health
care utilization patterns and payments
dramatically (e.g., the distribution of
hospitalized versus nonhospitalized incidents,
length of stay, etc.). The estimates do not
reflect those changes.

o Mental health care: payments for services to
crime victims by psychiatrists, psychologists,
social workers, and pastoral counselors, and
associated insurance claims processing costs.

This cost category has been one of the least
studied areas of crime costs. Since there were no
known estimates available, the research team
conducted a pilot survey of 168 mental health care
professionals (Cohen and Miller, 1994b). This
survey, using a stratified random sample of
members of seven different professional
organizations, asked respondents to detail the
number of visits by clients being served primarily
as a result of crime victimization. (See "Mental
Health Care Following Victimization.") 

The average murder puts 1.5 to 2.5 people into
counseling. Rape and child abuse victims also
frequently obtain mental health care, with usage
rates approaching 25-50 percent or more. Thus,
mental health care costs are the largest component
of tangible losses for most forms of child abuse
and rape. For example, the cost of mental health
care for the typical child sexual abuse victim is
estimated to be $5,800. Mental health care usage
for other crimes is much lower, generally 1-4
percent of victims. Thus, the average cost per
victim is relatively small, generally under $100.

o Police and fire services: initial police
response and followup investigation, as well as
fire service costs related to arson and drunk
driving crashes. The cost of other aspects of the
criminal justice system is not included.

These estimates are derived from various surveys
and other published statistics on the cost of
police and emergency response costs, many of which
were reported in Cohen, Miller, and Rossman
(1994). Compared to the direct impact on victims,
police and fire service costs are a relatively
small portion of the cost of crime, generally
under $100 per case. However, they add up to about
$4 billion per year and may be a significant
portion of municipal budgets. Exceptions are the
costs of arson and murder, which each average
about $1,400 per incident. Unlike other crimes,
where less than half are even reported to police,
virtually all arson or murder cases involve fire
or police services. 

o Victim services: activities of Victim Services
Agencies and Child Protective Services agencies,
as well as foster care for maltreated children
removed from their homes, special education for
maltreated children, and services aimed at
reintegrating families with maltreatment problems.

Few data exist on the extent of victim services by
type of victim served. Since this study did not
attempt to do primary research in this area, the
researchers had to rely on a few existing studies.
For the crimes of rape, robbery, and assault,
victim service costs were based on the dollar
value of Federal Government grants to victim
service agencies. This estimate was inflated to
account for the non-Federal portion, as described
in Cohen, Miller, and Rossman (1994). The result
is an extremely conservative estimate that
undercounts many private organizations that do not
receive Federal funding and ignores the value of
time spent by volunteers in these organizations.
The estimate that the typical rape victim receives
$27 in victim services is clearly an
underestimate. Further research on the full extent
of victim services would be desirable.

Victim service costs for child abuse are much
larger ($1,000 to $2,000 per incident). However,
like victim services for adults, these estimates
are based on little hard data and several
reasonable and conservative assumptions. These
estimates primarily involve foster care stays and
child protective services for domestic child abuse
victims (see Daro, 1988; and McCurdy and Daro,
1993). 

o Productivity: wages, fringe benefits, housework,
and school days lost by victims and their
families. This category also includes productivity
lost by co-workers and supervisors recruiting and
training replacements for disabled workers,
worrying about an injured co-worker, etc., and by
people stuck in traffic jams caused by drunk
driving crashes. Finally, it includes insurance
claims processing costs (for example, life
insurance claims for fatalities and workers'
compensation disability claims for people
victimized while working) and legal expenses
incurred in recovering productivity losses from
drunk drivers and their insurers.

The NCVS data include estimates of the number of
hours of work and earnings lost due to medically
related problems associated with victimization.
The research team imputed this information when it
was missing. Following the procedure in Miller
(1993), they estimated days of household work lost
from days of work lost. Based on employment status
and age reported in NCVS, they estimated the value
of housework days lost by victims from the
regression equations in Douglass et al. (1990).
Since the NCVS only covers short-term costs, the
resulting data do not reflect lost productivity
that occurs more than a few months after the 
victimization. Although most crime victims have
few long-term productivity losses, some suffer
substantial wage losses. Thus, the researchers
used the expected lifetime earnings (absent an
injury) from a standard age-earnings model similar
to the model described in Rice et al. (1989) and
permanent disability probabilities from workers'
compensation claims (by body part and nature of
injury) to estimate long-term productivity losses
by body part and nature of injury. Those estimates
were then applied to the distribution of physical
injuries in criminal victimizations. 

Because of age-related differences in recuperative
power, the probabilities may underestimate the
disability impacts of crime against the elderly
and infants or overestimate the impacts of crime
against youths. They also may underestimate
disability probabilities due to the greater force
and targeting of vulnerable areas involving an
intentional injury as compared to a typical
workplace injury. For example, a knife that slips
while slicing a bagel is likely to inflict less
damage than a knife that disarms a robber. This
has a dramatic effect on estimated wage losses,
with long-term losses averaging 5 to 10 times the
short-term losses. For example, short-term
productivity loss for the average assault victim
was estimated to be $356, while long-term
productivity losses were estimated to be $2,035. 

Several smaller loss components were also
estimated. NCVS includes data on the number of
hours of work and wages lost by family members
aiding victims and being involved with victims in
the legal system. The first component adds about
$5 to $10 per victim and the second adds about $10
to $20 per victim. For victims under age 12, this
study assumed that an equal number of days of
parent productivity are lost when a child victim
is medically treated as when a family member loses
work due to victimization of an unmarried,
unemployed relative. The estimated losses average
$65 to $85 per child victim. Employers also suffer
indirect losses due to their employee's
victimization, such as management time hiring
replacements and otherwise dealing with the
emotional trauma associated with an employee
victimized by crime. Based on earlier studies by
Miller (1992) and Miller and Rossman (1990), this
study very roughly estimated these losses to be
approximately $120 to $140 per rape, robbery, or
assault victim.

Finally, school-age children who are victimized
may be absent from school while they are
recuperating. Based on the number of work days
lost for comparable crimes and injuries reported
in the NCVS, the number of school days lost for
child victims were estimated. The researchers
adopted a straightforward and conservative
approach to valuing a lost school day by using the
average amount spent on education per child per
day (see Cohen, Miller, and Rossman, 1994, for
details). Placing dollar values on the returns to
education is a more appropriate measure of the
loss but is a complicated theoretical and
empirical exercise that is beyond the scope of
this project. However, since the average number of
school days lost is relatively small, this cost
category will be a small portion of overall costs
regardless of the valuation approach.

Intangible losses 

Unlike tangible losses such as medical expenses or
lost wages, pain, suffering, and reduced quality
of life do not have a market price and cannot be
bought and sold. Nevertheless, these losses are
real. Victims would pay dearly to avoid them.

Economists use varied methods to place monetary
values on the intangible losses (see Cohen,
Miller, and Rossman, 1994). Monetary estimates of
lost quality of life due to fatalities are
generally based on the amount people routinely
spend (in dollars or time) to reduce their risk of
death. (Miller, 1990; and Viscusi, 1993, review
the extensive literature on this subject.) Typical
studies have assessed the market for safety by
examining the increased demand for smoke detectors
as prices dropped, the demand for safer cars, and
the differential in worker pay due to different
levels of risk exposure. Estimates of the monetary
value of a fatality (including lost wages and
other tangible losses) range from $500,000 to $7
million. This study adopted the mean estimate from
the literature review and synthesis by Miller
(1990-adjusted to reflect victims' life
expectancies), a total loss of about $2.7 million
(inflated to 1993 dollars), with the lost quality
of life component being about $1.9 million.

For nonfatal injuries, the research team estimated
values of pain, suffering, fear, and lost quality
of life by analyzing jury awards to crime victims
and burn victims (Cohen and Miller, 1994a; Miller,
Brigham et al., 1993). Although violent offenders
rarely have adequate assets and are thus
infrequently sued for damages, some victims are
able to sue third parties for inadequate security
or other forms of negligence. These suits have
become common enough that the researchers were
able to obtain data from 1,106 jury awards and
settlements to assault survivors and 361 to rape
survivors (including 39 assault awards and many
rape awards involving psychological injury only),
as well as 606 to burn survivors (used to compute
arson losses). This study ignored jury awards for
punitive damages and instead focused solely on
that portion of the jury verdict designed to
"compensate" the victim for pain, suffering, and
lost quality of life. Since cases brought to trial
are not necessarily representative of crime cases,
the researchers could not apply the pain and
suffering estimates directly. Instead, they
estimated the functional relationship between the
out-of-pocket costs of crime (lost wages and
medical expenses); characteristics of the victim
(age, sex, work status, etc.); severity of injury
(body part, hospitalization, etc.); and the jury's
award for pain and suffering. This functional
relationship was then applied to the actual
distribution of crime victims in the project's
data set. In this manner, the researchers were
able to estimate what the average jury award for
pain and suffering would be for the typical crime
in the project's data set. 

Analysis of jury awards was based on victims, not
victimizations. The data did not permit
disentanglement of the effect of series
victimizations on pain and suffering. Thus, the
lost quality of life estimates for nonfatal
injuries are lower than the estimated jury award
to a crime victim. For example, the researchers
estimated that the 1.1 million rape victims suffer
1.45 million rape victimizations annually. That
means annual rape victimizations average 1.27 per
victim. Multiplying 1.27 by the $81,400 quality of
life loss per rape victimization yields estimated
quality of life losses of $103,400 per rape
victim.

Serious errors can occur if policy analysts ignore
the intangibles when allocating resources. For
example, Cohen (1988) describes a study of an
early release program in which the authors
compared the out-of-pocket costs of crime
committed by early release recidivists to the
savings to the community that decided not to build
more prison space. That earlier study concluded
that the program passed a benefit-cost test.
However, when the value of pain, suffering, and
lost quality of life were added, the early release
program failed the benefit-cost test; more prison
space was preferable.

Today, benefit-cost analyses typically include the
intangible losses. Miller (1993) cites the
extensive theoretical literature supporting their
use. The U.S. Office of Management and Budget
(1989) requires regulatory analysts to use a
method that includes intangible losses whenever a
benefit-cost analysis values saving human lives.

Intangible costs--lost quality of life--are
clearly the largest cost component for crimes of
violence. They are also subject to the most
uncertainty, a subject that is discussed in a
later section. Perhaps more importantly, however,
intangible costs are less meaningful when applied
to any one particular crime victim. For example,
although the lost quality of life for a murder
victim is $1.9 million, that does not mean anyone
would voluntarily exchange their life for $1.9
million. Instead, that number is arrived at by
estimating the incremental amount that individuals
are willing to pay for a reduced risk of death,
where the commodity is "risk of death," not death
itself. Thus, if 100,000 people would collectively
pay $30 each to reduce their risk of dying from
1/100,000 to 0, one would say that the group
values the "statistical life" that is likely to be
saved by $3 million ($30 x 100,000 people).

Victimization and victim costs per crime 

Intangible costs are the largest component for all
but burglary, larceny, and motor vehicle theft.
Intangible pain, suffering, and lost quality of
life costs generally exceed all other tangible
categories combined. Within the tangible loss
category, productivity losses are generally the
largest, although medical costs are also
substantial. For example, the average rape victim
incurs about $500 in medical costs and $2,200 in
productivity losses. Drunk driving victims average
$1,400 in medical costs, while productivity losses
are $2,700. If only those with injury are
included, medical costs increase to $6,400, while
productivity losses increase to $15,400. 

Aside from murder, child sexual abuse is the most
serious crime, followed by rape, child physical
abuse, and arson. In terms of monetary and injury
consequences, drunk driving and arson are more
serious crimes than robbery or assault. Caution
should be used in drawing inferences from these
comparisons, however, since the researchers could
not always use consistent crime definitions. In
particular, this study's NCVS crime estimates
include attempts that may result in little or no
physical contact or injury. The cost per arson
case, however, does not include attempted arsons.
Drunk driving costs are somewhat unique. Since
only the cost of actual crashes is included, there
is no cost estimate associated with drunk drivers
who pose only a risk of crash and injury. However,
the study includes drunk driving crashes that
result in property damages but no physical injury.
Conceptually, one could argue that this is similar
to including "attempts" since nobody is actually
injured. Following that line of reasoning, threats
or verbal assaults (which are not often included
in the NCVS data and hence are not in the cost
estimates of assault) are similar to drunk driving
incidents that result in no crash.

Excluded costs. As mentioned above, this study
deliberately excludes two of the largest costs
associated with crime--the cost of operating the
criminal justice system and the cost of actions
taken to reduce the risk of becoming a crime
victim. Instead, the focus is on quantifying the
costs incurred directly by or on behalf of the
crime victim. 

For lack of solid data, this study also omits some
victimization costs. Major omissions include (1)
expenses for processing public and private
disability insurance payments and welfare payments
to those permanently disabled by crime, (2)
long-term effects on victim earnings resulting
from psychological injury caused by domestic
violence, and (3) "second generation costs" such
as crimes committed by persons who were themselves
victims (such as juveniles or adults who became
criminals because they were neglected or abused as
children). See "Comprehensive List of Costs and
Consequences of Crime." 

Aggregate annual victim costs in the United States

The data can be combined to estimate the total
cost of crime to victims in the United States.
Including the value of intangible quality of life
losses, victim losses due to crimes against
individuals and households amounted to $450
billion annually during the 1987-1990 time period.
This equals about $1,800 per U.S. resident.
Tangible costs alone exceed $400 per resident.
These losses included $18 billion in medical and
mental heath care spending; $87 billion in other
tangible costs; and pain, suffering, and reduced
quality of life valued at $345 billion. The
largest tangible expense is property damage and
loss. The second 
major tangible cost component is lost
productivity.

All of the cost estimates reported here are
expressed in discounted present value terms. In
other words, although medical and wage losses are
labeled "annual" costs due to crime, more
precisely, they are the "total discounted present
value of short-term and long-term costs associated
with 1 year of crime." Thus, they are the total
losses imposed by crimes that occur in a given
year--regardless of when the losses 
actually occurred. 

Overall, rape has the highest annual victim costs
at $127 billion per year (excluding child sex
abuse), followed by assault at $93 billion, murder
(excluding arson and drunk driving deaths) at $71
billion, drunk driving (including fatalities) at
$61 billion, and child abuse at $56 billion. 

Excluded crimes. As mentioned earlier, several
crime categories were not included in this study.
However, other estimates of two common crimes--
fraud and drug abuse--are reported, as is a
preliminary estimate of the cost of child neglect.

Personal fraud. A recent survey of personal fraud
victimization estimated the annual tangible costs
for fraud to be $45 billion (Titus et al., 1995). 

Drug abuse. Although drug abuse might lead to
other forms of crime (either through violence
associated with the distribution process or
property crimes in support of a drug habit), these
costs are already included in this study's victim
cost estimates. The cost of illegal drug abuse
itself, however, was not estimated. According to
data published by the Bureau of Justice Statistics
(1992), the annual health care costs for illegal
drug users were $5.2 billion in 1985, and drug
treatment costs were an estimated $1.73 billion in
1989. Other costs not included were property
losses caused by drug abuse and lost labor
productivity due to drug abuse of those in (or who
would otherwise have been in) the legitimate labor
force. One other indicator of the cost of drug
abuse is the value of sales, estimated at $40
billion to $50 billion annually. 

Child neglect. As mentioned above, although some
preliminary estimates of child neglect were made,
they were excluded from total crime estimates due
to definitional and consistency concerns.
Following the same methodology as for child abuse,
the researchers estimated the cost per child
neglect case and the aggregate cost of child
neglect. The estimated total cost of educational
neglect is $3 billion, while the annual cost of
other forms of child neglect is $12 billion. These
are very tentative estimates.

Special breakdown of cost estimates: domestic
crime and crimes against children

Domestic crime against adults accounts for almost
15 percent of total crime costs--$67 billion per
year. Children under age 18 suffer at least 4.9
million personal crimes annually. Losses due to
these crimes exceed $164 billion, of which about
40 percent results from domestic crime. 

Who pays the crime bill?

Insurers pay $45 billion annually due to crime.
That's $265 per American adult. Government pays $8
billion annually for restorative and emergency
services to victims, plus perhaps one-fourth of
the $11 billion in health insurance payments.
Crime victims and their families pay the bill for
some crimes, while the public largely pays the
bill for others. Taxpayers and insurance
purchasers cover almost all the tangible victim
costs of arson and drunk driving. They cover $9
billion of the $19 billion in tangible nonservice
costs of larceny, burglary, and motor vehicle
theft. They cover few of the tangible expenses of
other crimes.

Victims pay about $44 billion of the $57 billion
in tangible nonservice expenses for traditional
crimes of violence--murder, rape, robbery,
assault, and abuse and neglect. Employers pay
almost $5 billion because of these crimes,
primarily in their health insurance bills. (This
estimate excludes sick leave and disability
insurance costs other than workers' compensation.)
Government bears the remaining costs through lost
tax revenues and Medicare and Medicaid payments.
Crime victim compensation accounts for 38 percent
of homeowners' insurance payments and 29 percent
of auto insurance payments.

Uncertainty of the estimates and sensitivity
analysis

This section explores the uncertainty in the
study's estimates but cannot provide confidence
intervals. Since this study relies on a wide range
of disparate sources of data, the data are not in
a format that would support a systematic study of
the confidence interval around the estimates.
Although the researchers attempted to be
conservative, the estimates have a high degree of
uncertainty. Some of the key problems are
discussed below.

Number of victimizations

o Confidence intervals for NCVS. The NCVS is based
on a complex sampling design. Although this
research team does not have adequate information
to be able to compute standard errors for all its
derived estimates, the NCVS series=1 victimization
estimates can be examined over the 4-year period
(for which this study took the average). These
standard errors are relatively small, implying
that the NCVS estimates are generally within 5-10
percent of the true population. Although standard
errors are low, NCVS estimates are only as good as
the survey design and respondents' ability to
recall and be truthful. For example, these
confidence intervals tell nothing about the true
underlying population of rape victims if women are
reluctant to volunteer information about rape
incidents. Moreover, these confidence intervals
apply only to the aggregate victimization count
estimates, not for the various breakouts used in
this research. For example, although there is a
high degree of confidence about the number of
robbery victims reported in NCVS, there can be
less confidence in the estimated proportion of
robbery victims who were hospitalized for broken
bones.

o Series victimization. Few researchers have used
the series victimization counts in the NCVS. This
study's team carefully analyzed the raw sample
data and checked the series victims for outliers
and reasonableness. Although a few of the outliers
were obvious miscodings (and thrown out of the
sample for purposes of analysis), this study found
that   these observations generally were quite
plausible. Ultimately, when presenting national
cost estimates, the researchers decided to
truncate the few remaining possible outliers at 10
victimizations in a 6-month period. 

However, since this approach is novel, a
sensitivity analysis on the aggregate national
crime victimization costs was conducted. Weighting
the data with series victimizations without
imposing the maximum of 10 victimizations in 6
months would raise the estimated tangible crime
costs by 7.5 percent, quality of life costs by 12
percent, and total costs by 11 percent. Weighting
the data with the most recent victimization in a
series counted as the only victimization would
lower tangible costs by 4 percent, quality of life
costs by 8 percent, and total costs by 7 percent.
Thus, aggregate cost estimates are not overly
sensitive to decisions about how to handle series
victimizations.

The costs per rape are quite sensitive to choice
of weighting for series victimizations since the
quality of life losses for rape are computed per
victim, then allocated across victimizations. The
cost of a rape victimization is estimated to be
$87,000, while the cost of being a rape victim is
$110,000. The latter figure is probably a more
useful estimate, since the quality of life losses
(the largest component of rape costs) are
estimated from jury awards to victims (not
victimizations). Conversely, because of this
study's methodology using jury awards for victims,
the national quality of life losses due to rape
are unaffected by the decision about how to weight
series crimes.

Monetary valuation of intangible losses

o Quality of life losses for fatal crimes. The
largest cost element for all violent crimes is
lost quality of life and related fear, pain, and
suffering. It may also be the cost item with the
highest degree of uncertainty. For fatalities, the
study estimated lost quality of life using a $2.7
million value of saving an anonymous life derived
from a synthesis of almost 50 published values
(Miller, 1990), adjusted for the difference in
expected lifespan of crime victims (by crime type)
versus the average injury fatality. Miller (1990)
finds the standard deviation of the quality of
life values across studies is 30 percent of the
mean value for a statistical life. Although one
cannot use this information directly to estimate
the standard errors of the composite samples, if
one assumes that each of the 50 studies used to
generate the $2.7 million estimate were actual
samples from the population of values, it would
imply a 95 percent confidence interval of + $1.3
million. 

Viscusi (1993) reviews the same literature but
does not adjust the values for obvious sources of
variation (e.g., differences in the discount rates
used in calculations). He favors a larger value of
$3 million to $7 million. Using a $5 million value
would raise the estimated quality of life lost due
to fatalities and the estimated total cost of
fatal crime by $93 billion (to $184 billion).

Alternatively, one could argue that the typical
crime victim is not the same as the typical
individual used to generate the lost quality of
life estimate for fatal injuries. Although
estimates are generally based on nationally
representative samples of workers or consumers, it
is known that murder victims are
disproportionately young, nonwhite, and in the
lowest income classes (National Research Council,
1993). They may also be more likely to display
high tolerance for risk taking (which might reduce
their implied valuation of future quality of
life), as demonstrated by higher rates of
alcoholism, drug abuse, drug trafficking, and
other forms of criminal behavior. On the other
hand, more than half of all murders are domestic
or involve children; society also might decide for
equity reasons that differences in value of life
estimates across individuals should not be used
for policy analysis. Regardless of which lost
quality of life value is determined to be
appropriate, a sensitivity analysis can be
conducted to determine the effect of varying this
parameter. For example, if one values lost quality
of life at the lower bound of the 95 percent
confidence interval (about $500,000 instead of
$1.9 million), the estimated total cost of fatal
crime would fall from $91 billion to $54 billion.

o Quality of life losses for nonfatal crimes. The
nonfatal quality of life estimates come from
regression analysis of jury verdicts. For nonfatal
injuries, the standard error range around the
log-linear regression estimates is +39 percent 
for assault and +29 percent for rape. Translating
back to linear estimates of the quality of life
yields extremely large confidence intervals.

As an alternative method of checking this study's
quality of life estimates, they were compared to a
completely different methodology described in
Miller, Pindus et al. (1995). This alternative
method is based on physician ratings of the loss
of functioning that typically results from
different injuries and surveys that reveal how
people rate different functional losses relative
to death. These ratings are then applied to the
same $2.7 million statistical value of life used
above to arrive at a monetary equivalent for the
nonfatal injury. Using the values derived from
physician judgments would lower the estimated
quality of life losses by just 6 percent. This
close match masks substantial disagreement over
the losses by treatment status, with the jury
verdict estimates lower than the physician
judgment estimates for hospitalized cases and
higher for other medically treated cases.

The concern that the fatal victim population might
not have the same risk tolerance or income as the
U.S. population as a whole is not as relevant for
nonfatal injuries. This study used estimates of
wage rates directly from NCVS, and there is less
reason to believe that victims who sue for damages
are different from the population of victims in
general.

Until there is a larger data base on jury awards
or more confidence in alternative methodologies,
this is the best this study is able to do. Based
on the size and uncertainty of the estimates,
further research on the lost quality of life due
to crime victimization appears to be a priority.

o Lifestyle changes due to victimization. The
psychological effects of victimization may result
in lifestyle changes such as moving to a new
neighborhood, switching jobs or occupations,
buying more protective devices, changing daily
routines, and simply enjoying life less. In some
instances, victims may subsequently attempt
suicide. Since this study already estimated pain,
suffering, and lost quality of life,  many of
these lifestyle effects were incorporated into the
estimates. Juries presumably take such effects
into account when awarding damages for pain,
suffering, and lost quality of life; and
individuals also take them into account in making
decisions on which risk-reducing actions to take. 

Of course, it is impossible to know empirically
whether or not juries take all of these costs into
account. One sensitivity analysis was conducted to
look at the maximum medical costs associated with
suicide attempts precipitated by criminal
victimization. The order-of-magnitude of these
losses can be bounded for sexual assaults using
excess suicide attempt rates from Golding and
George (1993) and Kilpatrick et al. (1992) and for
other child abuse using rates from the literature
review in Daro (1988). With the costs per suicide
and per hospitalization for suicide attempts from
Miller, Pindus et al. (1995), suicide-related
medical costs would be $107 per rape and $165 per
child abuse case. Although this equates to $300
million annually, it is a very small percentage of
estimated costs. Because the associations between
crime and suicide are uncertain and these costs
might already be implicitly taken into account in
this study's quality of life costs, they are
excluded from the estimates in this 
document.

Comparison with prior estimates 

Estimates of the cost of crime have a long
history, dating back as early as the 1931
Wickersham Commission. A review of some of these
studies is contained in Gray (1979). These earlier
studies tended to report broad aggregates and
focus on direct costs such as victims'
out-of-pocket costs, the criminal justice system,
the cost of private security, and the value of
illegal wagers. Most of the earlier studies did
not go beyond tangible costs. Beginning with
Thaler (1978), there have been several attempts to
include indirect costs. Thaler (1978) and
subsequent studies estimated the difference in
housing prices that can be attributed to
differential crime rates, thus inferring
homeowners' willingness to pay for reduced crime.
Although in theory these approaches can yield
estimates of the cost of different types of crime,
the data requirements for such a project appear to
be too onerous, and the property value studies to
date have only estimated the cost of a generic
"index crime" (rape, robbery, assault, motor
vehicle theft, burglary, and larceny). Phillips
and Votey (1981) took a different approach by
combining estimates of the value of a statistical
life with crime seriousness rankings from the
public surveys of Sellin and Wolfgang (1964).
Their approach was the first that attempted to
account for the intangible costs of individual
crimes, but it still was not able to account for
many of those intangible costs. 

Cohen (1988) was the first study to explicitly
attempt to place monetary values on pain,
suffering, and lost quality of life to victims of
different crimes. Although that study had numerous
data limitations (including using short-term
losses in the absence of long-term data and
relying primarily on NCVS incidence estimates), it
used a similar methodology to that used in this
study by combining jury awards and the statistical
value of life to estimate intangible losses. Cohen
(1990) compared these estimates to the earlier
property value studies and found that the two
different approaches yielded very similar
estimates of the cost of an "index crime." Several
followup studies have updated these estimates by
adding more comprehensive information, including
Cohen, Miller, and Rossman (1994); and Miller,
Cohen, and Rossman (1993). 

For individual crimes, this study has estimated
significantly higher costs for rape than previous
studies. For example, the average cost of a rape
(including attempts) is estimated to be $87,000,
whereas previous estimates ranged from $55,000 to
$70,000. This difference is primarily due to the
fact that jury awards in rape cases were analyzed
to determine estimates of pain, suffering, and
lost quality of life, whereas earlier studies
employed even more indirect methods of estimation
(such as jury awards in more generic cases of
emotional distress). Further, earlier studies did
not make clear distinctions between victims and
victimizations. They often used victim counts even
though they estimated costs on the basis of
victimizations. This study's estimate of the cost
per rape victim is $110,000.

This study's estimates are substantially higher
than Government estimates published from the NCVS.
For example, the medical, mental health care,
public services, and productivity costs are more
than 10 times the short-term loss components
captured in the NCVS for rape and assault and 5
times the costs captured for robbery. This is
primarily because this study's methodology
included long-term medical and wage costs, mental
health care, valuation of lost household and
school hours, and the administrative (insurance
and Government) costs of reimbursement for many of
these losses. Nor did the researchers follow the
extremely conservative approach of ignoring costs
acknowledged to be real though not directly
supplied by NCVS survey respondents. For example,
some NCVS survey respondents reported that they
did incur costs (medical, property loss, etc.) but
were unsure of the dollar amount. Klaus (1994)
treats these responses as a zero-cost, whereas
this study assigned these cases the mean cost
among similar cases with known costs. 

The quality of life and mental health care costs
are lower than in earlier studies. Both the
quality of life costs and mental health care costs
in the earlier studies were based on jury awards
for auto crashes and tort cases; but data on jury
awards for pain and suffering in criminal
victimization cases are now available. For mental
health care costs, survey data on victim use from
mental health care providers are now also
available. 

Aggregate cost estimates have also increased
significantly for some crimes. The largest
increase is for rape, since the cost per incident
is higher and this study's estimate of the number
of rapes has increased tenfold. For example,
Cohen, Miller, and Rossman (1994) estimated the
aggregate cost to be $10 billion (in 1993
dollars), based on 147,000 NCVS rape victims
(excluding series victims) and $68,800 per victim.
This figure was subsequently updated to include
series victimizations (with series=1), reported in
Miller, Cohen, and Rossman (1993). The latter
estimate resulted in aggregate costs of $16
billion (in 1993 dollars), based on 229,000 rape
victims and $68,800 per victim. This study
estimates the aggregate cost of a rape to be $127
billion, based on 1,467,000 victimizations and a
cost per victimization of $87,000. 

Future Research

No single research project can hope to fill all of
the gaps in our knowledge of the incidence,
consequences, and costs of crime. This research
has taken a comprehensive look at both incidence
and victim costs, summarized the best estimates
currently available, and, in some instances,
provided new estimates where major gaps existed.
Along the way, this project identified a host of
future research issues. These fall into three
general categories: improving estimated incidence,
improving cost estimates, and applying the costs
in benefit-cost and demographic analyses.

Improving incidence estimates. For many Americans,
crime is a secret. Consequently, crime statistics
are prone to undercounting. That is especially
true of rape and domestic violence. Recent surveys
show that Americans are increasingly willing to
talk about these problems. Partly from a lack of
data, various researchers and organizations have
undertaken surveys to estimate the incidence of
crimes such as rape, domestic violence, and child
abuse. Unfortunately, these surveys suffer from
lack of consistent definitions and often are
discredited for including incidents that are not
criminal or not deemed criminal in the minds of
the victims. It is particularly difficult to
compare various estimates because of
methodological differences. For example, one
survey might ask for all victimizations that
occurred during the past year, while another asks
for the "most serious" that occurred during the
past 6 months. Even if they had consistent
victimization definitions, these two surveys would
differ due to response error (e.g., "telescoping"
the timeframe so that an event that happened 7
months ago is included in a study measuring the
crime over a 6-month period). They would also
differ because of victims' subjective answers to
the "most serious" question. A new version of the
NCVS incorporates a more probing approach to these
issues and begins to address this undercounting
problem in a systematic way that can be analyzed
over time.

We still know very little about the true extent
and consequences of violence, abuse, and neglect
of children. This study's preliminary estimates of
nondomestic assaults against children under age
12, for example, indicate that more than 500,000
children under age 12 may be assaulted or raped
annually. Although these estimates are based on
reasonable and conservative assumptions, they are
not based on direct survey or other direct
measurement techniques. We know even less about
the severity of injury for these child victims and
about social service utilization. Thus, further
research in this area should be a priority.

Improving cost estimates. A particular research
priority seems to be the long-term impact on
earnings potential for victims of domestic
violence and child maltreatment. The frequency of
physical injury due to different types of child
maltreatment, as well as recent data on
social/victim service intensity and cost, also is
lacking.

The cost estimates for domestic assault and
especially for child abuse and neglect are
probably incomplete. They do not fully capture the
effects of these crimes. Repeated victimization
can shatter lives, reducing the earning capacity
of victims who lack the self-confidence to pursue
educational opportunities they might have in the
absence of the abuse. Child abuse may also lead to
intergenerational violent abuse. For example,
Widom (1992) finds abused and neglected children
are 1.38 times as likely as other children to
commit violent acts. Using this number, the
study's estimated rate of child maltreatment would
imply that 13 percent of all violence can be
linked to earlier child maltreatment. In theory,
the costs of these induced crimes, including the
incarceration costs, could properly be added to
costs of the original crime. Doing so would
substantially raise the costs per maltreated
child. In practice, however, adequate data on the
causal connection between child abuse and
subsequent violence is not yet available. 

A serious gap in this research effort stemmed from
the lack of nationally representative contextual
and demographic data about murder victims. For
example, lack of data about income levels of
murder victims forced this study to use national
average earnings by age and sex to estimate
earnings lost to murder. The first fledgling
attempt to fill the murder data gap was the 1986
National Mortality Follow-Back study. That study
covered all deaths. A more focused study is needed
that captures NCVS-like data for murder victims.

This study's work on mental health care costs is
preliminary in nature and merits followup with a
larger sample and more extensive pretesting. A
victim service agency survey should be coordinated
with this survey. Challenges in that related
survey will be to avoid double counting with the
provider survey, to count volunteer time, and to
track compensation for victimization (which
affects who pays rather than the total cost)
separately from resource costs.

Most wage losses due to crime result from the
occasional injury that causes permanent
disability. The NCVS questions the same respondent
in six time periods. Since permanent disability is
rare, the NCVS might collect these rare but
important costs for crimes described in prior
surveys. NCVS estimates also probably would
improve if respondents reported medical and mental
health care costs, rather than just medical costs
(which some respondents may interpret as including
psychiatric care).

This study dealt only peripherally with costs to
third-party victims (e.g., fear of crime among the
general population or crime victims' families,
post-traumatic stress disorders of emergency
service personnel). These costs merit focused
study. This study also barely touched on
crime-induced suicide, crime-induced criminality,
or AIDS transmission through rape. These events
could potentially be large contributors to
victimization costs. Conversely, explicit suicide
costs easily could double count since both pain
and suffering and mental health treatment already
are incorporated in this study's framework.

Lost quality of life is the largest cost
component. It also is the least easily measured.
Research should continue on measurement methods. A
National Highway Traffic Safety Administration
project (MacKenzie et al., 1994) has produced new
physician estimates of impairment following injury
that will improve the willingness-to-pay approach.
A regression analysis of published values of
statistical life estimates could better separate
out modeling effects, potentially yielding more
credible fatal risk reduction values.

In a rapidly growing number of States, cause-coded
hospital discharge data represent a rich source
for data on the most serious injuries resulting
from crime. In the States analyzed for this study,
the health care system appeared to capture data on
many more victimizations than the NCVS. These data
lack details about crime context, but that
information might be added by linking them with
police crime reports. A demonstration is needed to
assess the value of linked data and the
difficulty/cost of linkage.

Applying the cost estimates. Criminologists and
public policy researchers are beginning to use
crime cost estimates in many new ways to help shed
light on the desirability of various policy
options. A next step would be to compute cost
estimates for defined populations--the elderly,
youthful offenders, women, low-income people,
minorities, and police-reported victimizations.
Although these breakouts might prove useful, care
must be taken in deriving them from existing data
sets. For example, although it might be reasonable
to estimate the percentage of victims who are
Hispanic and their age distribution, at some point
the sample cells become too low to make meaningful
estimates. It might not be reasonable to estimate
the number of Hispanic females from the ages of 18
to 24 who suffer from broken bones due to physical
nondomestic assaults, for example. 

Costs per police-reported crime are higher than
costs of the average crime. These costs can be
derived with this study's costing system and data.
For analyses of police resource allocation, they
would be more appropriate than this study's cost
estimates. Conversely, the costs here are most
appropriate to use in assessing the wisdom of
early offender release and diversion programs. 

The recent health care reform debate emphasized
proven interventions, ones that had benefits
exceeding their costs. Data on proven violence
prevention approaches were notably lacking in the
debate. These costs provide a basis for such
analyses.

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