The Effect of child abuse on long-term health and wellbeing: evidence from Australia

Our paper examines the relationship between physical and sexual abuse of children and adult physical and mental health conditions and health care costs in Australia. In addition, we investigate the associations between child abuse and self harm, including drug and alcohol problems and suicide attempts. The analyses utilise confidentialised unit record file data from the National Survey of Mental Health and Wellbeing 2007, which includes 8841 persons aged from 16 to 85. We employ strategies to minimise the possibility of spurious associations between childhood abuse and adult health outcomes. The results indicate that Australians with a history of childhood abuse suffer from significantly more physical and mental health conditions as adults and incur higher annual health care costs. We show that the impact of child abuse on health care costs occurs both indirectly, via the number of health conditions, and directly. Victims of child abuse are also significantly more likely to have drug and alcohol problems as adults and increased likelihood of attempting suicide. We also find that the longer term impacts vary significantly depending on the type of abuse suffered in childhood. We conclude that child abuse has long run health and wellbeing consequences for the victims and impacts more broadly through greater social and health care costs. The persistent effects of child abuse beyond childhood should be taken into consideration when evaluating the costs and benefits of interventions targeting prevention of abuse. Top down estimation methods and failure to disaggregate costs by the type of abuse are expected to produce biased estimates.