Closest community background reading: http://www.givewell.org/labs/causes/criminal-justice-reform

Scale

prevalence

Back of the envelope estimate of the number of abused excluding those who are emotionaly abused and neglected (because those stats aren’t on the wikipedia page for child abuse):

>Despite these limitations, international studies show that a quarter of all adults report experiencing physical abuse as children, and that and 1 in 5 women and 1 in 13 men report experiencing childhood sexual abuse. Emotional abuse and neglect are also common childhood experiences ("Child maltreatment: Fact sheet No. 150". World Health Organization. December 2014)

If all those physically abused are the same as those sexually abused (most conservative estimate) then 0.2 of all people are abused as children. If they are completely seperate populations then ((1/5 + 1/13)/2) + (1/4) = 0.39 (~0.4) of all people are abused as children. So, 0.2-0.4 of all people are abused.

>A long-term study of adults retrospectively reporting adverse childhood experiences including verbal, physical and sexual abuse, as well as other forms of childhood trauma found 25.9% of adults reported verbal abuse as children, 14.8% reported physical abuse, and 12.2% reported sexual abuse

More likely ¼ of all people are abused as children in some way or another

Harm (qualitatively)

>reduction in lifespan of 7 to 15 years (Kolassa, Iris – Tatjana. "Biological memory of childhood maltreatment – current knowledge and recommendations for future research" (PDF). Ulmer Volltextserver – Institutional Repository der Universität Ulm. Retrieved 30 March 2014.)

 

>more likely to suffer from physical ailments such as allergies, arthritis, asthma, bronchitis, high blood pressure, and ulcers (Dolezal, T.; McCollum, D.; Callahan, M. (2009). Hidden Costs in Health Care: The Economic Impact of Violence and Abuse. Academy on Violence and Abuse.)

 

>emotional abuse has been linked to increased depression, anxiety, and difficulties in interpersonal relationships ("Reactive attachment disorder")

 

>One long-term study found that up to 80% of abused people had at least one psychiatric disorder at age 21, with problems including depression, anxiety, eating disorders, and suicide attempts.[95] One Canadian hospital found that between 36% and 76% of women mental health outpatients had been abused, as had 58% of women and 23% of men schizophrenic inpatients.[96] A recent study has discovered that a crucial structure in the brain's brain's reward circuits is compromised by childhood abuse and neglect, and predicts Depressive Symptoms later in life.[9]

Exponential growth, externalities or diminishment of the problem

>90 percent of maltreating adults were maltreated as children (Starr RH, Wolfe DA (1991). The Effects of Child Abuse and Neglect (pp. 1–33). New York: The Guilford Press. ISBN 978-0-89862-759-6)

 

>children who experience child abuse and/or neglect are 59% more likely to be arrested as juveniles, 28% more likely to be arrested as adults, and 30% more likely to commit violent crime ("Child Abuse Statistics". Childhelp. Retrieved 5 March 2015.)

 

> A study by Dante Cicchetti found that 80% of abused and maltreated infants exhibited symptoms of disorganized attachment. When some of these children become parents, especially if they suffer from posttraumatic stress disorder (PTSD), dissociative symptoms, and other sequelae of child

Shut up, stop dumping qutes and give me the QALY’s

>The combined strata-level effects of maltreatment on Short Form–6D utility was a reduction of 0.028 per year (95% confidence interval=0.022, 0.034; P<.001). (www.ncbi.nlm.nih.gov/pmc/articles/PMC2377283/)

0.028per year * world population * 0.25 = 51800000 QALY’s per year

Neglectedness

>In the U.S. in 2013, of the 294,000 reported child abuse cases only 81,124 received any sort of counseling or therapy. ("National Statistics on Child Abuse". National Children's Alliance. Archived from the original on 2 May 2014.)

It's likely to be more neglected in low and middle income countries.

Tractability

>Most acts of physical violence against children are undertaken with the intent to punish.[106] In the United States, interviews with parents reveal that as many as two thirds of documented instances of physical abuse begin as acts of corporal punishment meant to correct a child's behavior, while a large-scale Canadian study found that three quarters of substantiated cases of physical abuse of children have occurred within the context of physical punishment.[107] Other studies have shown that children and infants who are spanked by parents are several times more likely to be severely assaulted by their parents or suffer an injury requiring medical attention. Studies indicate that such abusive treatment often involves parents attributing conflict to their child's willfulness or rejection, as well as "coercive family dynamics and conditioned emotional responses".[16] Factors involved in the escalation of ordinary physical punishment by parents into confirmed child abuse may be the punishing parent's inability to control their anger or judge their own strength, and the parent being unaware of the child's physical vulnerabilities.[15]

 

>Some professionals argue that cultural norms that sanction physical punishment are one of the causes of child abuse, and have undertaken campaigns to redefine such norms.[108][109][110]

 

>Into the 21st century many countries have taken steps to eradicate domestic violence, such as criminalization of violence against women and other abuses. Organizations have been formed which provide assistance and protection of domestic abuse victims, laws and criminal remedies, and domestic violence courts (https://en.wikipedia.org/wiki/Management_of_domestic_violence)

What can we do about it?

Given that ‘’three quarters of substantiated cases of physical abuse of children have occurred within the context of physical punishment’’, (see tractability section) assuming that a ban on corporal punishment towards children could be enforced with just 10% compliance worldwide, we could save a minimum of 10% * ¾ * 51800000 QALY’s per year = 3885000 QALY’s per year.

Now how cost effective would it be? What could we use as a reference class for how much resources would need to be invested to outlaw and enforce bans on corporal punishment of children? I don’t have the subject matter experience to say, so if anybody can help me out here please do. If you can also estimate how much money would be saved from everything from healthcare costs to criminal justice aversion costs, please chime in.

Instead, let’s compare with one Open Philanthropy Project funded area [clearing the organ donation waitlist](http://www.givewell.org/labs/causes/organ-transplantation). They’ve simply funded trying to figure out the solution, whereas some steps are more obvious for child abuse. They decide to go ahead on that based on estimates for merely thousands of QALY’s. It should be overwhelmingly evident that averting child abuse probably dominates the organ donation waitlist problem.

Faced with such aberrant findings, I think it’s appropriate to hand this over to the community for input before collaboratively investigating this area. Could averting child abuse be the most important cause? If it is at least an important cause, what does it’s neglectedness from the cause prioritisation community thus far say about the methods by which potential important causes are identified?