The cost incurred by victims of bullying from a societal perspective: estimates based on a German online survey of adolescents
Being a victim of bullying is linked to various social, emotional and behavioral problems potentially leading to a reduced quality of life. Furthermore, victims of bullying may cause extensive costs for society, for example by an above-average need for healthcare services. The present study was designed to quantify the costs and the loss of quality of life attributable to bullying by comparing victims with a control group of non-bullied students. A cross-sectional sample of 1293 adolescents (mean age 14.07, SD = 1.36) and their parents reported on bullying victimization, quality of life (adolescents’ self-report), and annual direct (medical and non-medical) as well as indirect costs (parents’ self-report) from a societal perspective (all expressed in €, year 2014 and 2015). For frequent (20.6% of our sample; costs: €8461.80 p.a.) but not occasional (13.3%; costs: €2850.06) bullying, victimization was associated with significantly higher costs compared to non-bullied adolescents (costs: €3138.00; annual difference between frequently bullied students and controls: €5323.01 p.a.; p = 0.008). Cost drivers included increased direct medical costs, but mostly indirect costs caused by productivity losses of the parents. Self-reported quality of life of frequent victims was considerably reduced (T = − 10.96; p < 0.001); also occasional bullying showed significantly reduced values in global quality of life (T = − 5.73; p < 0.001). The present findings demonstrate that frequent bullying is associated with substantial cost to society and reduced quality of life of victims. This observation underscores the need for effective school-based bullying prevention and suggests a high potential of effective programs to be cost effective as well.
KeywordsBullying Victimization Cost of illness Economics Healthcare Prevention
The authors would like to thank all families who took part in the study. Special thanks also go to the Marga und Walter Boll—Stiftung, who financially supported this project. Finally we thank Ramon Schaefer of InnoValHC who assisted in the aggregation of medication resource use and unit cost data.
The study was financially supported by the Marga und Walter Boll—Stiftung.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research involving human participants
The study has been approved by ethics committee of the Medical Faculty of the University of Heidelberg and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
At the beginning of the online questionnaire, parents were informed about protection of data privacy and the anonymity of their answers.
- 1.Olweus D (1994) Annotation: bullying at school: Basic facts and effects of a school based intervention program. Child Psychol Psychiatry Allied Discip 35:1171–1190. https://doi.org/10.1111/j.1469-7610.1994.tb01229.x CrossRefGoogle Scholar
- 8.Jantzer V, Haffner J, Parzer P et al (2015) Does parental monitoring moderate the relationship between bullying and adolescent nonsuicidal self-injury and suicidal behavior? A community-based self-report study of adolescents in Germany. BMC Public Health 15:583. https://doi.org/10.1186/s12889-015-1940-x CrossRefGoogle Scholar
- 16.Gold MR, Siegel JE, Russell LB (1996) Cost-effectiveness in health and medicine. Oxford University Press, New YorkGoogle Scholar
- 18.Fosse GK (2006) Mental health of psychiatric outpatients bullied in childhood. Dissertation, Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, TrondheimGoogle Scholar
- 22.Espelage DL, De La Rue L (2013) School bullying: its nature and ecology. In: Srabstein JC, Merrick J, Srabstein JC, Merrick J (eds) Bullying: a public health concern. Nova Science Publishers, Hauppauge, pp 23–37Google Scholar
- 26.Hummel S, Naylor P, Chilcott J et al (2008) Cost-effectiveness of universal interventions which aim to promote emotional and social wellbeing in secondary schools. Report, School of Health and Related Research (ScHARR), University of Sheffield, SheffieldGoogle Scholar
- 27.Center for Health Promotion and Disease Prevention (2011) The cost benefit of bullying prevention. A first-time analysis of savings. Highmark Foundation, PittsburghGoogle Scholar
- 28.McDaid D, Hopkin G, Knapp M (2017) The economic case for prevention in young people’s mental health: bullying. Report to be published by MQ: Transforming Mental Health, London, EnglandGoogle Scholar
- 32.Bock J-O, Brettschneider C, Seidl H et al (2015) Standardisierte bewertungssätze aus gesellschaftlicher perspektive für die gesundheitsökonomische evaluation, 1st edn. Nomos, Baden-BadenGoogle Scholar
- 33.Drummond MF, Sculpher MJ, Claxton K et al (2015) Methods for the economic evaluation of health care programmes, 4th edn. Oxford University Press, OxfordGoogle Scholar
- 34.Neumann PJ, Sanders GD, Russell LB et al (2017) Cost-effectiveness in health and medicine, 2nd edn. Oxford University Press, New YorkGoogle Scholar
- 35.Statistisches Jahrbuch-Statistisches Jahrbuch (2014) Statistisches bundesamt (Destatis). https://www.destatis.de/DE/Publikationen/StatistischesJahrbuch/StatistischesJahrbuch2014.html. Accessed 9 May 2018
- 36.Online GL (2018) Gelbe Liste Online|Gelbe Liste. https://www.gelbe-liste.de. Accessed 16 May 2018
- 38.The-KIDSCREEN-Group-Europe (2006) Health-related quality of life screening instrument for children and adolescents—deutsche fassungGoogle Scholar
- 42.Brunstein Klomek A, Marrocco F, Kleinman M et al (2007) Bullying, depression, and suicidality in adolescents. J Am Acad Child Adolesc Psychiatry 46:40–49. https://doi.org/10.1097/01.chi.0000242237.84925.18 CrossRefGoogle Scholar
- 50.Olweus D (2013) School bullying: development and some important challenges. Annu Rev Clin Psychol 9:751–780. https://doi.org/10.1146/annurev-clinpsy-050212-185516 CrossRefGoogle Scholar
- 52.Chamberlain T, George N, Golden S et al (2010) Tellus4 national report. https://www.nfer.ac.uk/publications/TEL01. Accessed 11 May 2018
- 53.Radford L, Corral S, Bradley C, Fisher HL (2013) The prevalence and impact of child maltreatment and other types of victimization in the UK: findings from a population survey of caregivers, children and young people and young adults. Child Abuse Negl 37:801–813. https://doi.org/10.1016/j.chiabu.2013.02.004 CrossRefGoogle Scholar