Brief Report| Volume 47, ISSUE 2, P198-202, August 2014

Incidence and Cost of Sexual Violence in Iowa


      Sexual violence is a serious and costly public health problem. Current research that systematically documents the broad range of economic costs of sexual violence is lacking.


      To estimate the incidence and costs of sexual violence in Iowa in 2009.


      Using data obtained from population surveys, six Iowa government agencies, and other sources, we estimated sexual violence incidence, costs per incident, and total costs in 2009 dollars, by age and sexual violence category, and for various cost elements. We calculated direct costs of medical care, mental health care, property damage, victim services, investigation, adjudication, and sanctioning, as well as indirect costs for lost work and quality of life. We collected data in 2010–2011 and completed analysis in 2013.


      In 2009, an estimated 55,340 individuals experienced sexual violence in Iowa, including 49,510 adults and 5,930 children. Nearly three of every four victims were women. The estimated total cost of sexual violence in 2009 was $4.7 billion, equating to $1,580 per resident. This estimate included $4.44 billion in indirect costs and $265 million in direct costs. In the same year, the government spent an estimated $100.6 million as a result of sexual violence in Iowa, more than half of which ($55.3 million) was spent on perpetrators and little ($0.9 million) on prevention.


      The economic costs of sexual violence are high for individuals and society. Cost information can help identify the burden of sexual violence relative to other social problems in Iowa and prioritize funding for prevention and intervention.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Anda R.F.
        • Fleisher V.I.
        • Felitti V.J.
        • et al.
        Childhood abuse, household dysfunction, and indicators of impaired worker performance in adulthood.
        Perm J. 2004; 8: 30-38
        • Delisi M.
        • Kosloski A.
        • Sween M.
        • Hachmeister E.
        • Moore M.
        • Drury A.
        Murder by numbers: monetary costs imposed by a sample of homicide offenders.
        J Forens Psychiatry Psychol. 2010; 21: 501-513
        • Dolezal T.
        • McCollum D.
        • Callahan M.
        Hidden costs in health care: the economic impact of violence and abuse.
        Academy on Violence and Abuse, Eden Prairie MN2009
        • Lyon E.
        Welfare and domestic violence against women: lessons from research.
        National Resource Center on Domestic Violence, Harrisburg PA2002
        • MacMillan R.
        Adolescent victimization and income deficits in adulthood: rethinking the costs of criminal violence from a life-course perspective.
        Criminology. 2000; 38: 553-588
        • WHO
        The economic dimensions of interpersonal violence.
        WHO, Geneva2004
        • CDC
        Sexual violence prevention: beginning the dialogue.
        CDC, Atlanta GA2004
        • Annan S.L.
        Sexual violence in rural areas: a review of the literature.
        Fam Community Health. 2006; 29: 164-168
        • WHO
        Manual for estimating the economic costs of injuries due to interpersonal and self-directed violence.
        WHO, Geneva2008
        • Miller T.R.
        • Cohen M.A.
        • Wiersema B.
        Victim costs and consequences—a new look.
        National Institute of Justice, Washington DC1996
        • Basile K.C.
        • Saltzman L.E.
        Sexual violence surveillance: uniform definitions and recommended data elements.
        CDC, Atlanta GA2002
      1. Iowa Department of Public Health. Behavioral Risk Factor Surveillance System, 2007.

      2. Iowa Department of Education. Iowa Youth Risk Behavior Survey, 2008.

      3. Iowa Department of Public Safety. Iowa Uniform Crime Reports, 2009.

        • Finkelhor D.
        • Turner H.A.
        • Ormrod R.K.
        • Hamby S.L.
        Violence, abuse, and crime exposure in a national sample of children and youth.
        Pediatrics. 2009; 124: 1-14
        • Beck A.J.
        • Harrison P.M.
        • Berzofsky M.
        • Caspar R.
        • Krebs C.
        Sexual victimization in prisons and jails reported by inmates, 2008–09.
        Bureau of Justice Statistics, Washington DC2010 (
        • Beck A.J.
        • Harrison P.M.
        • Guerino P.
        Sexual victimization in juvenile facilities reported by youth, 2008–09.
        Bureau of Justice Statistics, Washington DC2010
        • Harrison P.M.
        • Beck A.J.
        Prison and jail inmates at midyear, 2005.
        Bureau of Justice Statistics, Washington DC2006
        • Sickmund M.
        Juveniles in residential placement, 1997–2008.
        Office of Juvenile Justice and Delinquency Prevention, Washington DC2010
        • West H.C.
        Prison inmates at midyear 2009—statistical tables.
        Bureau of Justice Statistics, Washington DC2010
      4. U.S. Department of Justice. Uniformed Crime Reporting Statistics, 2009.

        • Miller T.R.
        • Taylor D.M.
        • Sheppard M.A.
        Costs of sexual violence in Minnesota: detailed methods supplement.
        PIRE, Calverton MD2007
      5. Iowa Department of Public Health. Costs of sexual violence in Iowa, 2009. Des Moines IA: Iowa Department of Public Health, 2012.

        • Miller T.R.
        The social costs of problem behavior.
        in: Biglan A. Brennan P.A. Foster S.L. Helping adolescents at risk: prevention of multiple problem behaviors. 1st ed. Guilford Press, New York2004
        • Corso P.
        • Mercy J.
        • Simon T.
        • Finkelstein E.
        • Miller T.R.
        Medical costs and productivity losses due to interpersonal and self-directed violence in the U.S.
        Am J Prev Med. 2007; 32: 474-482
        • Miller T.R.
        • Levy D.T.
        • Spicer R.S.
        • Taylor D.M.
        Societal costs of underage drinking.
        J Stud Alcohol. 2006; 67: 519-528
        • Holmes M.M.
        • Resnick H.S.
        • Kilpatrick D.G.
        • Best C.L.
        Rape-related pregnancy: estimates and descriptive characteristics from a national sample of women.
        Am J Obstet Gynecol. 1996; 175: 320-324
        • Kendler K.S.
        • Bulik C.M.
        • Silberg J.
        • Hettema J.M.
        • Myers J.
        • Prescott C.A.
        Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis.
        Arch Gen Psychiatry. 2000; 57: 953-959
        • Nelson E.C.
        • Heath A.C.
        • Madden P.A.
        • et al.
        Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study.
        Arch Gen Psychiatry. 2002; 59: 139-145
        • Miller T.R.
        • Hendrie D.
        Cost and benefit analysis of substance abuse prevention interventions.
        PIRE, Calverton MD2006
        • Fellows J.L.
        • Trosclair A.
        • Adams E.K.
        • Rivera C.C.
        Annual smoking-attributable mortality, years of potential life lost, and economic costs—U.S., 1995–1999.
        MMWR Morb Mortal Wkly Rep. 2002; 51: 300-303
        • Miller T.R.
        • Finkelstein A.E.
        • Zaloshnja E.
        • Hendrie D.
        The cost of child and adolescent injuries and the savings from prevention.
        in: Liller K. Injury prevention for children and adolescents: research, practice, and advocacy. 2nd ed. APHA Press, Washington DC2005
        • Machlin S.R.
        • Rohde F.
        Health care expenses for uncomplicated pregnancies. Research findings no. 27.
        Agency for Healthcare Research and Quality, Rockville MD2007
        • Eaton D.K.
        • Kann L.
        • Kinchen S.
        • et al.
        CDC. Youth Risk Behavior Surveillance—U.S., 2009.
        MMWR Surveill Summ. 2010; 59: 1-142
        • Potter S.J.
        • Laflamme D.J.
        An assessment of state level sexual assault prevalence estimates.
        Matern Child Health J. 2011; 15: 77-86
        • Breiding M.J.
        • Black M.C.
        • Ryan G.W.
        Prevalence and risk factors of intimate partner violence in eighteen U.S. states/territories, 2005.
        Am J Prev Med. 2008; 34: 112-118
        • Breiding M.J.
        • Ziembroski J.S.
        • Black M.C.
        Prevalence of rural intimate partner violence in 16 U.S. states, 2005.
        J Rural Health. 2009; 25: 240-246
        • Black M.C.
        • Basile K.C.
        • Breiding M.J.
        • et al.
        The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report.
        CDC, Atlanta GA2011
        • U.S. Department of Justice
        Breaking the cycle of violence: recommendations to improve the criminal justice system response to child victims and witnesses.
        U.S. Department of Justice, Washington DC1999
        • DeGue S.
        • Holt M.K.
        • Massetti G.M.
        • Matjasko J.L.
        • Tharp A.T.
        • Valle L.A.
        Looking ahead toward community-level strategies to prevent sexual violence.
        J Womens Health (Larchmt). 2012; 21: 1-3