Using Benefit-Cost Analysis to Assess Child Abuse Prevention and Intervention Programs

Article excerpt

Benefits and costs are discussed when child abuse prevention and intervention programs are proposed and evaluated, but systemic benefit-cost analysis as developed by economists has not been applied to such programs. This article presents the case for using benefitcost analysis to structure evaluations of child abuse prevention and intervention programs. It presents the basic concept of benefit-cost analysis, its application in the context of assessing these types of child welfare programs, and limitations on its application to social service programs.

Benefit-cost analysis has become a widely applied, but often controversial and misunderstood, tool of program evaluation. Initially used to assess the economic soundness of infrastructure projects such as dams and highways, it is now routinely applied in evaluations of a broad range of public policies, including environmental and occupational safety and health regulations [Cropper & Oates 1992], health and mental health interventions [Ginsberg & Shouval 1992; Keeler & Cretin 1987; Weisbrod 1981], and a variety of human resources programs, such as early education [Schweinhart et al. 1993], family planning services [Levey et al. 1988], job training [Kemper et al.1983; Long et al.1981; Orr et al.1996], alcohol and drug abuse [Rundell et al.1991; Hubbard & French 1991; Plotnick et al. in press], vocational rehabilitation [Lewis et al.1992], HIV testing [Gelles 1993], and welfare-to-work programs [Gueron & Pauly 1991].

When child abuse prevention and intervention programs are proposed and evaluated, their costs and the various benefits they may produce are discussed [Daro 1988; Panel on Research on Child Abuse and Neglect 1993]. Systematic benefit-cost analysis, however, has not been applied in assessing such programs. A survey of the child welfare literature covering 1990-1995 uncovered no benefit-cost analyses of child abuse prevention or intervention programs. One comprehensive study [Daro 1988], drawing on research from the 1970s and 1980s, briefly critiques benefit-cost methods and summarizes potential benefits of effective interventions, but does not cite any actual benefit-cost analyses of specific interventions produced during these years. The comprehensive National Research Council report, Understanding Child Abuse and Neglect [Panel on Research on Child Abuse and Neglect 1993] does not mention the term, though it does include a short discussion of some of the economic benefits of reducing child maltreatment [pp. 39-40]. The report, as well work by Daro [1988] and Vondra [1993], also points out the contributions to improving interventions that can be made by cost-effectiveness studies, which are closely related to benefit-cost studies, and Daro [1988] discusses two major cost-effectiveness studies from the 1970s and 1980s.

This article argues that benefit-cost analysis can and should be used to help structure evaluations of the impact of child abuse prevention and intervention programs, and, in general, any program aimed at promoting child welfare. It presents the basic ideas of benefit-cost analysis and of cost-effectiveness analysis, a closely related tool. These include the concepts of economic benefits and costs; the identification, measurement, projection, and discounting of benefits and costs likely to arise in child abuse prevention and intervention programs; the incorporation of equity effects; and how costs and benefits differ depending on whether they are assessed by participants, nonparticipants, or society as a whole. For expositional simplicity, the article discusses the issues in terms of child abuse, although the analysis and arguments also apply to programs to treat or prevent child neglect.1

Applications of benefit-cost analysis to human services programs generally analyze efforts to remedy problems after they have appeared, not efforts to prevent them. Benefit-cost analysis applies equally well, however, to both prevention and intervention programs. …