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"Child Maltreatment Costs of Intervention versus Prevention: How and Where are we Spending our Money in Wisconsin?”
 
Authored by: Adriano Udani and Katie Maguire-Jack 

Overiew
The rationale for child abuse and neglect prevention efforts has been long supported by rigorous cost-benefit evaluations of child welfare programs and services at either the state or national level. However, in this paper, Adriano Udani and Katie Maguire-Jack (2011) argue that minimal attention has been given to whether counties where children are at the most risk of maltreatment are targeted for higher levels of prevention expenditures to reduce costs associated with child abuse and neglect. While prevention leaders and advocates continue to communicate prevention strategies that are informed by cost evaluations, Udani and Maguire-Jack (2011) argue that relying solely on the existing cost-benefit evidence from state-level or national analyses actually weakens a prevention agenda because aggregate state and national estimates mask an unequal distribution of how much counties are spending on prevention commensurate with their needs, particularly in counties where children have a high risk of maltreatment.

Key findings

• We find a general association between increasing Out of Home Care (OOHC) costs and increasing risk levels of child maltreatment. Contrary to our theoretical expectations, however, a large proportion of Wisconsin counties spending relatively higher dollars on prevention still incur large OOHC costs. Among counties in the top quartiles of per child capita prevention spending in Wisconsin during 2007-2008, only 44% are counties in the bottom quartiles of OOHC per child capita costs in 2010.
   
• In contrast, 64 percent of counties in the bottom quartile of prevention spending incur costs in the top OOHC cost quartiles.
   
• Among counties that experience medium-high to very high risk of child maltreatment levels, between 39% and 50% percent allocate money for prevention at levels that are in the bottom two quartiles of prevention spending.

Implications
In current cost/benefit evaluations of child maltreatment prevention, state programmatic costs are typically extracted from the counties in which they are incurred. Our study on county risk levels of maltreatment aims to better estimate the socioeconomic conditions that indirectly generate stressors on families and caretakers. In turn, our analysis can be used to marshal preventive services to families who live in areas with high levels of child maltreatment. Cost evaluations of child maltreatment would improve considerably by understanding the context surrounding counties with high to very high risk levels of maltreatment
 
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