COE 1999 : SEMINAR Men and Violence
Male violence: the economic costs
EuroPROFEM - The European Men Profeminist Network http://www.europrofem.org
European Council of Europen - Human Rights
Section Equality between women and men
Seminar : Men and Violence Against Women
Strasbourg, 8 October 1999 - Palais de l'Europe - France
Male violence: the economic costs
Alberto GODENZI and Carrie YODANIS
University of Fribourg (Switzerland)
During the second wave of the women’s movement, attention was drawn to male violence against women through presentation of the brutality, the loss of life and freedom, and the fear that many women experience in their lives (Brownmiller, 1975; Pizzey, 1977; Russell, 1982). Based on these profoundly negative consequences, advocates argued that something must be done to assist battered women.
Arguments in the fight against male violence against women have come from a variety of perspectives. The most common argument defines violence against women as a legal rights issue. This argument has taken different forms. Some argue that victims of male violence have a right to equal protection from the criminal justice system. Therefore, laws need to be in place to ensure that violence against women is defined as a crime and that perpetrators are arrested, tried, and punished (Stanko, 1985). Others argue that women have a civil right to be protected from violent men through government funded counselling and refuge (Dobash & Dobash, 1992). Still others, most notably at the United Nations’ 4th World Conference for Women in Beijing, call for an end to violence against women throughout the world in all its diverse forms, because violence is a violation of women’s human rights. Therefore, male violence must be condemned and stopped regardless of cultural traditions and beliefs.
A different perspective views violence against women as a health issue. In 1994, the World Bank published a report, “Violence Against Women: The Hidden Health Burden”, which examined how male violence contributes to poor health and early death for women throughout the world (Heise, 1994). Such evidence has been used to strengthen laws and policies protecting victims. For example, the concept of the battered woman syndrome, based on the argument that abuse results in psychological trauma and dysfunction, was used to fight for a legal defence for women who kill their abusive partners (Walker, 1984; Dobash & Dobash, 1992).
During the late 1980s and 1990’s, another perspective on violence against women emerged. This perspective views violence against women as an economic issue. This perspective does not disagree with earlier perspectives. Rather, it provides another, quite powerful, angle from which to view the legal, health, and other consequences resulting from male violence and to argue for social policies to improve the services and protection for victims of male violence. In another paper co-authored with Elizabeth Stanko, we evaluate the benefits of an economic argument and consider the potential for this perspective to affect policy (Yodanis, Godenzi, & Stanko, forthcoming). In this paper, we review cost of violence studies and discuss their common methodological approaches. We consider both the weaknesses associated with this methodology, and how these studies are important for improving the availability of data on violence against women – a step which is vital for increasing assistance to women.
STUDIES OF THE ECONOMIC COSTS OF MALE VIOLENCE
In 1986, Straus sought to measure the costs of medical care relating to intrafamily assault and homicide. By compiling statistics about the prevalence of injuries and medical attention resulting from spouse and child assaults, he estimated that homicide within families may account for roughly 24% (or about $1.73 billion) of the total costs of homicide as estimated by the Joint Economic Committee of Congress in 1976. Yet, he also stressed that this figure omits many of the medical costs that are incurred prior to death. He outlines the types and frequencies of possible costs which need to be included if we think of homicide as the final outcome of the disease of violence, but he leaves the “translation of the injury and medical care dollar costs to those more familiar with medical economics” (p. 557). The next year, Straus and Gelles (1987) in “The Costs of Family Violence” used data from a nationally representative study to expand on this idea and outline the prevalence of additional costly outcomes of violence in the family, including drug and alcohol use, crime and vandalism, missed work and daily activities, and psychological distress. While they list the numerous possible sources of costs, they do not estimate cost figures. That same year, Friedman and Couper (1987) published the report, The costs of domestic violence: A preliminary investigation of the financial costs of domestic violence.
During the 1990’s, costs studies and estimates became even more ambitious. Researchers began to combine prevalence rates of violence and various outcomes of violence with estimates of related costs in order to develop a total figure which measures the costs of male violence against women. Such studies have been completed in Canada (Day, 1995; Greaves et al., 1995), the Netherlands (Korf et al., 1997), New South Wales (NSW Women’s Coordination Unit, 1991), New Zealand (Snively, 1994), Northern Territory (Office of Women’s Policy, 1996), Queensland (Blumel et al., 1993), Switzerland (Godenzi & Yodanis, 1998), and the United Kingdom (Stanko et al., 1998). Key information about each study is summarised in Table 1.
Throughout this paper, we will use our study as an example. Our study builds on and adapts the methods used in the previous cost studies. It focuses on the costs of male violence against women in Switzerland and is being conducted in three phases. In 1998 (German version) and 1999 (English version), we published the results from the first phase of our project, which focused on state-related costs resulting from male violence against women. By compiling data from representative surveys, government publications and reports, social service agency records and other sources, we estimated an annual state cost of $290 million. We discuss our calculations in greater detail throughout this paper. For the second phase of the project, we are currently studying the costs of male violence to business. And in the third phase, we will focus on the costs to individuals, including victims, family, friends, volunteers and service providers, and tax payers.
THE METHODOLOGY OF COST STUDIES
In their US report, Laurence and Spalter-Roth (1996) offer a basic equation for determining the costs of domestic violence as follows,
“We need to know how many people are affected, how many are using services as a result of domestic violence, how much of these services they are using, and the costs of these services” (p. 14).
Although applying the above seems straightforward, accurately computing it is not. In nearly all countries, we do not know how many women are affected by male violence, and we do not know how many and how often women use various services as a result of violence. For years, advocates, activists, and others have argued that most violence against women remains hidden from official view. Indeed, crime surveys, when compared to surveys of women, show that most violence never becomes part of the official statistics. This is true not only in criminal justice institutions but also in health care and social service institutions and work places. Accurate information on the prevalence and impact of male violence is lacking in all parts of society. On one hand, this limits the possibility of cost studies to provide accurate cost estimates and useful information to service providers and policy makers. On the other hand, cost studies bring to light and can reduce this lack of knowledge in parts of society where individuals usually do not consider themselves impacted by violence.
Conducting cost studies with missing data
The majority of cost of violence studies rely predominantly on existing data previously gathered by government agencies or research institutes. For example, Greaves et al. (1995) compiled their estimate for Canada based on information from approximately 30 surveys, reports, and studies, including the Statistics Canada Survey on Violence Against Women. Laurence and Spalter-Roth’s (1996) review of US material provides an extensive list of empirical studies, organisations, and government offices, which can provide information relating to various dimensions of the costs of violence against women. This data can be an important starting point for estimating the costs of violence. Yet, relying too heavily on the existing data creates problems, not due to inadequate researchers, but because of inadequate data. Since the existing data is always incomplete, the cost estimates based on this data, likewise, suffer from shortcomings, which limit their usefulness. As a result of using existing data, cost estimates are weakened by methodological problems related to operationalisation and measurement of economic costs, units of analysis, time frames, and population inferences.
Operationalisation and measurement
When measuring a concept, it is necessary to first have a clear definition. Then, one needs to outline the various dimensions, or facets, of the concept. Finally, data is gathered on particular indicators which measure the various dimensions of the concept. When using existing data, however, it is not always possible to include the full range of dimensions or indicators required for adequate measurement of a desired concept. Often the data simply are not available. This is a consistent problem in cost of violence studies. Concepts are often operationalized according to the availability of information rather than the requirements for valid and reliable measurement. As Snively (1994) explains, “The results of New Zealand Economic Costs of Family Violence depend considerably on the availability of data consistent with the definition of family violence pursued for estimation purposes” (p. 6). This is true for our study as well. Most obviously, while we plan to include additional phases in our study, we first selected state-related costs, because the most information was available about these costs.
The limitations of existing data result in a number of measurement problems. First, there is often inconsistency between conceptualisation and operationalisation in studies. For example, in our study, we define violence as “physical, sexual, and psychological abuse which is perpetrated by men on women or girls as a result of their gender“. Yet, when we calculate the costs, we are often not able to include the costs associated with these various forms of violence. For example, in our estimate of health costs, we do not include information on women under 20 years of age, because that information is not available.
Similarly, the measures often do not include dimensions and indicators which other studies have shown to be likely costs of violence. There is substantial evidence to show that women who experience abuse, including women in Switzerland, are more likely to engage in self-destructive behaviour, such as alcohol and drug abuse, and report worse mental health (Stark & Flitcraft, 1996; Gilloz et al., 1997, Kavemann, 1997). Nevertheless, we are unable to include abuse-related costs for drug and alcohol treatment or other psychiatric treatment in our cost figure, because information on the rate of these services sought by women as a result of violence is not available in Switzerland.
Third, weaknesses in measurement occur, because due to the lack of data, informed assumptions have to be made. From the national study of violence against women in Switzerland, we know that approximately 10,000 women a year sought help from a social worker as a result of experiencing violence. Yet, we do not know the reasons behind their help seeking. Backed with additional information regarding the financial stresses of women leaving abusive relationships, we make the assumption that about half of these women sought some form of financial assistance.
In other cases, data that is available are used as merely proxies for missing information. For example, there is no data recorded on the number of court cases which are related to crimes of male physical violence against women in Switzerland. However, we do have information from a national study on the number of women who contacted lawyers and sought divorces, separations, or protection orders as a result of violence from partners. We use these figures, adjusted to account for the often high percent of the women who will drop charges before trial, to estimate the number of court cases each year which occur as a result of physical violence against women.
These problems of operationalisation, omitted dimensions and indicators, assumptions and estimates, which are found in most cost studies, weaken the validity and reliability of measures of the cost of violence against women. One can not be sure if the studies are accurately measuring the economic costs and if that same figure would be reproduced if recalculated at a later point in time. However, it would be extremely difficult, if not impossible, to calculate the precise costs of violence against women. Cost figures must be, to some extent, merely estimations. Given this, the problems of operationalisation and measurement may at first appear to be an insignificant problem. If additional costs indicators or more precise data were added to the estimates, the total figures would only be higher. Therefore, omission of additional costs seems to ensure that the estimates are more conservative and less refutable.
These problems of measurement, however, extend beyond the ability to compile an accepted figure of the costs of violence. When researchers omit some costs completely or include guesses and proxies rather than empirical data, the study does not provide solid, practically applicable information about the problem of violence against women. Yet, the very fact that data is not available indicates the lack of information available to individuals, who are in key positions to support and assist women if they realise the need.
Unit of analysis
Other methodological problems facing cost estimate studies are related to the units of analysis. The unit of analysis in cost estimate studies is usually women. Equations are based on the prevalence of service usage as reported by a sample of women. Cost figures are then applied to this prevalence rate to calculate an estimate for the costs of male violence. Relying on women as the unit of analysis is very important for establishing differences between abused and non abused women in costly conditions such as physical and mental health status (Stark & Flitcraft, 1996; Gillioz et al., 1997), alcohol use and illegal drug use (Kavemann, 1997), work income and job turnover (Hyman, 1993; Lloyd, 1997), and welfare usage (Allard et al., 1997; Raphael & Tolman, 1997).
Yet, weaknesses result when individuals are the unit of analysis in costs of violence studies. Under these circumstances, estimates are not based on data from particular agencies, organisations, or businesses. Rather, they are calculated based on women’s use of unspecified service agencies and experiences in unspecified work places. For example, we estimate from the national study of violence against women that approximately 4,000 women require hospital care as a result of experiencing violence. We also know that the average hospital stay for a patient in a Swiss hospital costs approximately Sfr. 10,000 and that the federal, state, and local governments are responsible for paying 75 percent of the expenses. We compute a fairly convincing cost estimate based on these figures.
Nevertheless, the resulting estimate will likely have limited meaning for and effect on doctors, nurses, and other service providers in individual Swiss hospitals. Such figures may not be viewed as applicable to their organisation and can not provide advice for how to alter daily operations and services to better meet the needs of women experiencing violence.
A problem related to the unit of analysis is the issue of time frames. Researchers primarily aim to estimate the annual cost of violence. Ideally, costs could be calculated for every year and changes could be observed over time. However when using infrequently and sporadically gathered data, researchers must compromise by gathering data from the various years in which figures are available and computing a cost estimate for an “average” year. For example, within our study, some cost figures are based on 1993 data while others are based on 1996. In another example, when calculating the cost of research, we knew the amount of research grants that were awarded in 1996 by the largest national granting agency to study violence against women. The funding amounts were unusually large for that year as a result of a one- time research program on violence against women. Few grants to study violence against women have been awarded before or after this program. In order to estimate the expenditures on research over time, we assumed that grants of this amount would be given every 20 years and divided the total amount of research funding by twenty to get an annual cost.
While the best given the circumstances, this solution is not optimal. Not only is it impossible to observe changes in costs across years, but it also omits many costs. The U.S. National Institute of Justice measures costs as “the total losses imposed by crimes that occur in a given year - regardless of when the losses actually occur” (Travis, 1996). Laurence and Spalter-Roth (1996) explain the need for a prevalence-based approach measuring all service usage, both new and recurring, which occur in a given time period. In their outline of an ideal study, they suggest a five year period. Both of these specified time frames are able to capture the full extent of costs occurring from violence. Yet, most current cost estimates are unable to use these defined time frames and thus, can not know the long term costs of violence. Recurring use of services as a result of violence are likely to be the most expensive costs. Knowing how long and how many times women use particular services is also essential for understanding the role of the services in assisting victims and evaluating the cost effectiveness of a program.
A final methodological problem in cost of violence studies is the inability to make accurate inferences to the desired study population. Often, data is available from only one organisation or region and does not allow accurate extrapolation to a whole country or state. For example, we use figures on the costs of public assistance from one state to estimate a national figure in this area. When researchers use the available data to make inferences to the entire country, estimates gain substantially more error.
In sum, use of existing data to calculate cost estimates is not optimal. Yet, cost studies, relying on existing data, can be and often are used to highlight and correct this lack of information. Bringing this lack of information to light is one of the primary benefits of cost of violence studies.
Increasing awareness and data with cost studies
All researchers using existing data in cost studies, including us, recognise the problem of unavailable and partial data and have stressed the need for better systems of gathering data on the effects of violence on the workplace, service agencies, and organisations. In their estimates of the economic costs of violence against women in Canada, Greaves et al. (1995) write, “The main difficulties in establishing full cost estimates of violence against women in Canada are the lack of data and inconsistent data collection systems particularly at the federal and provincial levels” (p.1). After their review of the existing data in the United States, Laurence and Spalter-Roth (1996) conclude, “We found considerable gaps in the research literature in all of the areas studied, suggesting that considerable research is needed before reliable cost figures can be determined” (p. 4).
Fortunately, cost of male violence studies can be designed to improve the very problems from which they suffer. They can increase the availability of data in two ways. First, cost studies, by their very design, suggest the many areas within a society which are impacted by male violence against women. As Stanko (1999) states, “The lessons of the costs study point to the multiple intervention sites where it is possible to disrupt the serial patterns of domestic violence.” They can capture the attention and increase the awareness of police officers, judges, lawyers, social workers, employers, doctors, nurses, and political leaders – individuals and organisations who previously did not consider themselves affected by violence against women. As a result, violence will no longer be an unknown cause of health, financial, and workplace problems, and victims will no longer remain “hidden” in the social institutions.
In addition to creating awareness, cost studies can also be designed to increase data and thus, knowledge about the extent and effects of violence within these social institutions. Some researchers have taken steps in this direction. Blumel et al. (1993) and the Office of Women’s Policy (1996) conducted interviews with abuse survivors and asked for detailed information regarding their service use. Stanko (1997) gathered data about experiences with abuse from patients in a medical office waiting room. We compiled and recorded data about violence against women from hundreds of separate files in a victims’ assistance service department. In the future, researchers can continue to play an important role by working with police departments, courts, prison systems, public assistance offices, hospitals, and physician offices to develop accurate and on-going systems of gathering data on experiences of abuse among their clients.
In the second phase of our costs of violence against women study, we are working with researchers at the International Labour Organisation (ILO) to conduct a study of the costs of violence to business. The workplace is possibly the setting in which male violence is most hidden. Afraid of losing their jobs, women hide bruises, call in sick, and sit in fear instead of doing work all without the knowledge of co-workers and managers.
Yet, there is some evidence that many companies may be willing to assist women who experience violence if they are aware of the need. As was posted on the list-serve for the European Network on Conflict, Gender, and Violence, on October 1, 1998, the Family Violence Prevention Fund sponsored the third annual Work to End Domestic Violence Day in which hundreds of American businesses, public agencies, and organisations participated. On this day, Bell Atlantic Mobile introduced a toll-free link to the National Domestic Violence Hotline. They also continue to provide awareness cards to employees and customers and work with police and social service agencies to provide wireless phone and voicemail boxes to victims of domestic violence. At the Limited, Inc., human resource and security managers have attended domestic violence education and response training courses lead by a women’s shelter director. In addition, associates receive information on violence against women and have access to an internal company domestic violence hotline number. Numerous other companies, including Liz Claiborne, Inc., Levi Strauss, Blue Shield of California, Gap Foundation, Marshalls, Wells Fargo, Polaroid, and Time Warner, sponsored the program, have taken measures to educate managers about violence against women, and provide support for employees who experience abuse. By aiming to continue or expand such efforts, economic cost of violence studies are likely to contribute to creating policies in the workplace which will support rather than punish women who experience violence (NOW Legal Defense and Education Fund, 1996).
Therefore, we are conducting a study that will both generate information regarding the impact of male violence on the workplace and estimate a cost figure, which is useful for convincing businesses to implement helpful policies. The study will focus on violence against women which occurs outside of the workplace, including physical, sexual, and psychological violence in and outside of intimate relationships, as well as, violence which occurs in the workplace, such as sexual harassment. We seek to estimate lost employee days, productivity, profits, and additional expenses resulting from the actions of perpetrators and needs of victims. Examples include a male employee missing work as a result of court appearances related to an arrest for assaulting a female partner and a female employee missing work as a result of abuse-related injuries. Data for the study will be gathered through the distribution of a survey to women and men in a sample of work settings. Key managers will also be interviewed to determine the measures which are taken to create a safe work environment and the costs of such measures and their knowledge of the effects of male violence on business.
Yet data gathering can and ideally should not be a one time occurrence. Rather, on-going data gathering systems can be institutionalised to become part of the daily operations of the organisation. These systems do not need to be time consuming or cumbersome. Often the information is currently being collected from clients but is recorded in separate files and on inconsistent forms rather than in ways that make it readily accessible and analysable. Many organisations merely need assistance in order to make the relatively minor adjustments needed to establish ongoing data collection systems.
There are examples of such successful efforts. In the London Borough of Hackney, the Metropolitan Police have established a Crime Report Information System (CRIS). As described by Stanko et al. (1997), this system records all incidents reported to the police and highlights any incident or crime which is domestic in nature. These would include offences of violence, sexual offences, offences against property, public order offences, breach of an injunction where there is a power of arrest, and incidents which are not later recorded as crime but where the police have been contacted.
As in the Hackney examples, we also believe that studies should begin to consider a new unit of analysis, the organisation, in order to improve estimates, as well as, the usefulness of the data to service providers and employers. Collecting data at the institutional level will improve estimates of the costs of violence. By gathering data from all individuals who seek services from a particular organisation, it is possible to have accurate knowledge of the portion of service usage which occurs as a result of violence against women. By knowing which services were used, more exact cost figures can be used in the calculations. For example, when data is gathered from a hospital emergency room, we will know the number of cases which were related to domestic violence, the medical treatment that was given, and have a better estimate of the cost of the services.
Following from that, we believe that less attention can be spent on trying to compute precise national figures. By focusing instead on gathering data at the institutional level, organisations, agencies, and businesses will have access to data on an ongoing basis to observe changes over time in the relationship between violence and service needs. The need for additional support services, the quality, and cost effectiveness of existing programs can be evaluated. In the end, the cost estimate will not just be a large number, but directly meaningful for developing effective services to assist victims and reducing all costs of violence – monetary and non-monetary.
In this paper, we present studies on the economic costs of male violence against women and discuss their methodological approaches and weaknesses. But why study costs? In this paper, we present one benefit of these studies – cost of violence studies can solve the very problems they suffer from. By raising questions regarding where the costs fall, the studies bring to light the many diverse social institutions and organisations which are impacted by male violence against women. With adjustments in methodological approach, cost studies can be used to increase the availability of data and knowledge regarding the pervasiveness of male violence throughout societies. The elimination of ignorance and blinders is the essential first step in reducing male violence.
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A review and agenda for studies on the economic costs of violence against women.
Summary of Economic Cost of Violence Against Women Studies, 1991-98.
Total Cost Estimate (USD)
Type of Violence
Types of Costs included in Estimate
New South Wales,
NSW Women’s Co-ordination Unit
Domestic violence of women at various stages.
Individual, Government, Employer and Third Party – Health care, Legal, Criminal justice, Social welfare, Employment, Child care, and Housing Queensland, Australia
Sunshine Coast Interagency Research Group
Physical abuse, psychological abuse, rape, sexual assault of women
Victims, Public/community, and Other individuals – Housing and Refuge, Social Security, Health care, and Criminal justice New Zealand
$625,000,000 – 2,500,000,000
(NZ$ 1.2 - 5.3 bn - 9 figures given)
Family violence, including threats of violence, on women and children
Individual, Government, Third party, and Employer – Medical care, Social welfare and assistance, Legal and Criminal Justice, and Employment Canada
Physical and sexual abuse of women
Health costs – Medical, Dental, and Psychiatric care, Paid and Unpaid Work loss, Housing and refuge, Long term costs Canada
O. Hankivsky, &
Physical violence, Sexual assault, rape, incest, child sexual abuse
Individual, Government, and Third party - Social services & education, Criminal justice, Labor & work, Health & medical
Office of Women’s Policy $6,500,000
Physical, sexual, and psychological domestic violence – effects on women and children Individual, community and other costs – Crisis support, Police, Housing, Financial, Medical, Child care, Legal services, Employment Netherlands
D. J. Korf, H. Meulenbeek, E. Mot, & T. van den Brandt
Physical and sexual domestic violence against women
Police and justice, Medical, Psychosocial care, Labor and social security
E. A. Stanko, D. Crisp, C. Hale, & H. Lucraft
Physical and sexual abuse of women and children
Police, Civil justice, Housing, Refuge, Social services, and Health care
A. Godenzi &
Physical, sexual, and psychologicalabuse of women and girls