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April 2018Vol. 19, No. 3Cost-Benefit Analysis of Two Primary Prevention Programs

A recent study in Prevention Science assessed the state-level budget and societal costs, as well as the long-term benefits, of nationally implementing two child abuse and neglect primary prevention programs: Child-Parent Centers (CPC), an early education intervention used in Chicago public schools that provides services for low-income families with children aged 3-9, and Nurse-Family Partnership (NFP), a home visitation program provided by registered nurses to first-time mothers until their child's second birthday.

The study focused on two main outcome measures: (1) the net value (i.e., benefits minus costs) for states when implementing these programs and (2) the net value of these programs in terms of societal perspective (i.e., economic impact) outside of the state government budget. Economic impact could include the costs associated with parents' time to participate in program sessions, lifetime work productivity gains from reduced abuse and neglect among participating children, and other factors.

The researchers developed a set of estimates for a hypothetical implementation of each program in all states. According to the study, the following were the estimated lifetime costs associated with abuse and neglect:

  • The average amount spent per incident of abuse and neglect by state governments was $62,781 (ranging from $47,120 in Louisiana to $76,352 in New York).
  • The average amount spent on per incident of abuse and neglect based on economic impact was $222,800 (ranging from $179,179 in Louisiana to $261,536 in North Dakota).

The average cost per child to participate in the CPC program was $8,512 for children who participated during their preschool years only and $12,719 for children who participated during preschool and while school age. The average cost per child to participate in the NFP program was $8,046, ranging from $6,750 in Mississippi to $9,498 in California.

The study results indicated that the CPC and NFP programs have the potential to avert abuse and neglect for participating children and thereby save state governments and society on associated costs. The following are the estimated results of these programs if they were to be implemented on a national level:

  • CPC during the preschool years only: 110,457 children avoiding maltreatment annually for a combined lifetime savings of  $10.4 billion from the societal cost perspective
  • CPC during the preschool and school-age years: 171,208 children avoiding maltreatment annually for a combined lifetime savings of $16.9 billion from the societal cost perspective
  • NFP: 85,149 children avoiding maltreatment annually for a combined lifetime savings of $16.0 billion from the societal cost perspective

These results suggest that the benefits of the CPC and NFP programs outweigh the costs from a societal perspective. Likewise, states may see the cost of implementing these programs offset by reductions in direct spending on health care, child welfare, criminal justice, and special education associated with child maltreatment.

"Cost-Benefit Analysis of Two Child Abuse and Neglect Primary Prevention Programs for U.S. States," by Cora Peterson, Curtis Florence, Robert Thomas, and Joanne Klevens (Prevention Science, 2017), is available at https://link.springer.com/article/10.1007/s11121-017-0819-8.