title: The burden of child maltreatment in the East Asia and Pacific region.
abstract: This study estimated the health and economic burden of child maltreatment in the East Asia and Pacific region, addressing a significant gap in the current evidence base. Systematic reviews and meta-analyses were conducted to estimate the prevalence of child physical abuse, sexual abuse, emotional abuse, neglect, and witnessing parental violence. Population Attributable Fractions were calculated and Disability-Adjusted Life Years (DALYs) lost from physical and mental health outcomes and health risk behaviors attributable to child maltreatment were estimated using the most recent comparable Global Burden of Disease data. DALY losses were converted into monetary value by assuming that one DALY is equal to the sub-region's per capita GDP. The estimated economic value of DALYs lost to violence against children as a percentage of GDP ranged from 1.24% to 3.46% across sub-regions defined by the World Health Organization. The estimated economic value of DALYs (in constant 2000 US$) lost to child maltreatment in the EAP region totaled US $151 billion, accounting for 1.88% of the region's GDP. Updated to 2012 dollars, the estimated economic burden totaled US $194 billion. In sensitivity analysis, the aggregate costs as a percentage of GDP range from 1.36% to 2.52%. The economic burden of child maltreatment in the East Asia and Pacific region is substantial, indicating the importance of preventing and responding to child maltreatment in this region. More comprehensive research into the impact of multiple types of childhood adversity on a wider range of putative health outcomes is needed to guide policy and programs for child protection in the region, and globally.
authors.affiliation: International Center for Applied Economics and Policy, College of Economics and Management, China Agricultural University, Haidian District, Beijing, China.
authors.forename: Xiangming
authors.initials: X
authors.lastname: Fang
authors.affiliation: Moray House School of Education, University of Edinburgh, Scotland, UK.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Fry
authors.affiliation: Brown School, Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Derek S
authors.initials: DS
authors.lastname: Brown
authors.affiliation: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Mercy
authors.affiliation: The Children and Youth Research Centre, School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, Australia.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Dunne
authors.affiliation: Department of Violence and Injury Prevention and Disability, Noncommunicable Diseases and Mental Health, World Health Organization, Geneva, Switzerland.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Butchart
authors.affiliation: Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA.
authors.forename: Phaedra S
authors.initials: PS
authors.lastname: Corso
authors.affiliation: FISCO ID LLC, Ukraine.
authors.forename: Kateryna
authors.initials: K
authors.lastname: Maynzyuk
authors.affiliation: FISCO ID LLC, Ukraine.
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Dzhygyr
authors.affiliation: International Center for Applied Economics and Policy, College of Economics and Management, China Agricultural University, Haidian District, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: UNICEF East Asia and Pacific Regional Office, Bangkok, Thailand.
authors.forename: Amalee
authors.initials: A
authors.lastname: McCoy
authors.affiliation: UNICEF East Asia and Pacific Regional Office, Bangkok, Thailand.
authors.forename: Diane M
authors.initials: DM
authors.lastname: Swales
mesh_terms: D000293:Adolescent; D001208:Asia / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000191:economics* / Q000706:statistics & numerical data; D002675:Child, Preschool; D017281:Cost of Illness; D004644:Emotions; D000069581:Exposure to Violence / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010139:Pacific Islands / Q000453:epidemiology; D015995:Prevalence; D019057:Quality-Adjusted Life Years
keywords: Child maltreatment; Disability-Adjusted Life Years; East Asia and Pacific region; Economic burden; Lifelong consequences