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Abstract
Child maltreatment—encompassing neglect and physical, sexual, and emotional abuse of children—is associated with myriad negative physical, mental, and social outcomes. Childhood maltreatment is associated with significantly higher rates of mortality,1-3 obesity,1,4-7 and human immunodeficiency virus infection.1,8 Children who experience maltreatment also have significantly more mental health problems1,9-14 and are as much as 5 times more likely to attempt suicide.1,15 Maltreated children are also more likely to engage in criminal behavior than other children1,16,17 and are more than 50% more likely to have a juvenile record than other children.17 Child maltreatment also has substantial social costs. Estimates suggest that child maltreatment costs the United States $124 billion annually, with per-person lifetime costs higher than or comparable to those of diseases such as a stroke or type 2 diabetes mellitus.18 Childhood maltreatment has thus been referred to as “a human rights violation and a global public health problem [that] incurs huge costs for both individuals and society.”19(p332)

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