Childhood abuse is a serious social and economic problem. In Australia, there are 17,000 substantiated cases of physical and sexual child abuse each year. We model the relationship between childhood abuse and long‐term health, health care costs and well being using data from the 2007 National Survey of Mental Health and Wellbeing. We find that adults with a history of childhood abuse suffer from significantly more health conditions, incur higher annual health care costs and are more likely to harm themselves. Our results suggest that child abuse has long‐lasting economic and welfare costs. The costs are greatest for those who experienced both physical and sexual abuse.