Adding It Up: Hidden Lifetime Costs of Sexual Assault and Misconduct

Victims of sexual assault, violence, and misconduct suffer in multiple ways following the crimes committed against them. Liz Karns, professor from Cornell’s ILR School, has been following the lifetime costs for victims of these sexual crimes. As both a lawyer and an epidemiologist, she is tackling the data from an interesting perspective and sat down with eCornell’s Chris Wofford to discuss the lasting effects for survivors both on campus and in the workplace.

What follows is an abridged version of their conversation.

Wofford: You are an epidemiologist and also a lawyer, so you’re coming at this from two very interesting angles that together make for a really compelling story, so tell me a little bit about when you started looking at this and your experience.

Karns: As an epidemiologist, I started thinking about it just in terms of the types of data we would have, right? But it wasn’t until I went to law school like 13 years after being an epidemiologist that I started applying it to sexual assault, and in that context, I treated, and I continue to treat those cases just as I would any type of medical malpractice case or environmental harm case. They are the exact same set of ways that we assess damage. We need the studies, we need the research, we need the experts, and, it’s been a while coming that we got all of those things together. But at this point, we have so much research, so much information that makes it quite clear that the cost is a lifetime cost, and that currently it is usually the person, the victim, who pays for that – and that’s my interest, is to shift that.

In 2015 we had like a banner year of doing lots of different studies, and these studies were all essentially asking the same, which was ‘Have you been sexually assaulted while in college?’ And, there was some slight difference in terms of the phrasing. This was a study that was done by Kaiser and the Washington Post, and we have 25% of people who were assaulted since starting college, 20% for women, 5% for men. We see pretty similar pattern across all the different places, right? It never varies in a big way. The one that says 27 AAU, this was a study that Cornell was part of. We had 27 different colleges that did the same survey, and it’s important to have this information because it’s consistent across studies. There’s so many people who will say, ‘Oh, but people just make that up or it was dependent on the respondents.’ There’s been a lot of reliability and validity testing on this and this is solid data. The sad thing is that this the exact same data that we had in 1987. The numbers are the same since 1987 – roughly 20% is a consistent thing and it has not changed with anything.

Part of the reason that we add this up is that money matters. Somehow when we start attaching a price tag, people become more accountable, and the different systems that we look at are the legal systems. We’ve got the criminal and the civil system, and the financial obligation that arises out of that. Let’s imagine that a perpetrator is found guilty, and under the criminal system, ordered to pay restitution. That means they have to pay the victim money, and that is a contract now. That cannot be discharged, under a personal bankruptcy, so it is something that will stay with that perpetrator forever until they’ve paid it off.

Wofford: Wow.

Karns: That would change the world.

Wofford: I would imagine.

Karns: This is the standard approach to all injuries. This is exactly what’s used in your car accidents, your slip and falls, medical malpractice, everything else, so it’s interesting that people don’t think of it when it comes to sexual assault. So it’s part of my job, to articulate it, and make people think about that. If we assign dollars, we’ll get societal change. I’m quite sure about this one. The person initially talks to the psychiatrist, and then talks about different situations that this arises in, to figure out how invasive it is in their life. I have had people who could not go to covered parking lots ever again in their lives, and that meant that they would drive 50 miles out of the way to go to a different train station because they didn’t wanna use that one that had the covered parking lot. That meant that she couldn’t take certain jobs, so it’s got this sort of ripple effect.

Wofford: Yes, exactly. So what I’m getting at, or where I was going with that was, linking this particular diagnosis to these behaviors, and I wonder often how that plays out legally.

Karns: Yeah, well, I mean it’s absolutely part of the case because you’ve got, first the initial injury, which is the assault itself, and that doesn’t have a huge amount of value, obviously, like in terms of money, but the ways that it impairs one’s life after that are what get documented. That is the job of the lawyer to go through and describe the day and the life – you bring in different experts to say, this person will have a very predictable set of problems when they have their own children, so that’s a cost that you should be thinking about.

So the expert is who ties this person’s diagnosis and situation and then projects it forward, and when I’ve worked on medical malpractice cases where we had something happening to an infant, we would do the same thing. We’d say this is what their life looks like in the future.

Wofford: Yeah. Okay, behavioral health, again, this is not a big surprise, that they are more likely to be using alcohol or hard drugs, and they’re aware that they need to cut down, so they are aware that they’re using it as a substitute for treatment, if you will. And then this is the one that the insurance company knows is that they continually use more healthcare than non-victims, so whenever somebody discusses, gosh, maybe we should decide this is a preexisting condition, you can see why the insurance company is interested in that ’cause these are very costly, they have higher costs, 20% higher.

Karns: So, when people start acknowledging that the assault occurred, and that’s a process in itself, and realizing that they need counseling, it’s not unusual to have a diagnosis come up from that. They don’t have to go and seek a diagnosis to say, ‘mmm, boom, I have it.’ It’s going to evolve, and you have this statute of limitations, so you have so many years afterwards, that depends on your state, to file this case, and so, you don’t have to seek it right away. If you’re gonna build a case, and you’re talking to your lawyer, right, a lawyer, then they will very much ask you, ‘Are you in counseling? Do you have a diagnosis?’ Most of us have health insurance that would cover some aspect of that so there’s some record of that as well.

Wofford: So you’re recommending that the damages are then directed to the perpetrator, legally. What is the state of the law, what’s happening out there, as far as cases like this? Is this line of thinking adapted?

Karns: Yeah.

Wofford: Okay, so this is nothing new.

Karns: This is not, nothing I’m doing is new. All I’m doing is calling attention to it in a different way, and the way that I check myself, if you will, is that I look at what are called default cases – these are cases where the perpetrator, who then became a defendant in civil court, never showed up and the plaintiff, the person who experienced the assault, has the right to make the argument of, ‘What are the costs?’ And then the judge assesses those costs and decides whether or not they’re warranted.

This is all about true economic loss.

But, compensation funds will actually pay for things like therapy, so you could get that immediate counseling that you need, it’s just onerous to get there. Second one is – I mentioned this before – criminal restitution. This is part of any court process, that the criminal court can order the perpetrator to pay the victim. And then finally, civil damages, and this is the one I think most of us are familiar with, where we undertake legal action. The plaintiff, the person who is the victim, brings the case against that defendant, and everything I’ve talked to today goes into that damages number, and then that number gets used all the way through the civil court process, so demand letter, complaint, arguments.

So shifting the burden is what we need to do. That is absolutely what we’ll have to do. So things we can change. One, sexual assault happens in schools quite a lot, and we need to address the fact that it interrupts their education, and we need to think about a student loan deferral on this. It’s absolutely mandatory. The legal ones, holding the perpetrators responsible. And then finally, support, engaging survivors in discussions about the economic impact.

Want to hear more? Watch an excerpt of the live eCornell WebSeries event, Adding It Up: Hidden Lifetime Costs of Sexual Assault and Misconduct, and subscribe to future events.

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