By IHPL - April 1, 2019

In light of National Public Health week, I decided to focus on a topic that has received limited attention as a health issue. Domestic violence is a serious public health concern and it deserves to be discussed. We join together with the American Public Health Association in creating a healthier community and healthier nation.

The Dangers of Domestic Violence and the Importance of Prevention

Violence or abuse in any form has serious health consequences for the victim. It can lead to negative health outcomes such as chronic pain, increased risk of stroke, heart disease, lung disease, diabetes, cancer, or gynecological problems.1,2 There are also behavioral health concerns like depression, alcohol and substance abuse, and high-risk sexual behaviors.2 Additionally, domestic violence is linked to absenteeism and poor performance in the workplace, which may result in social isolation, housing and financial concerns, and further health risks for the victims and their families.2

The Centers for Disease Control and Prevention (CDC) states that one in four women and one in nine men experience a form of domestic violence.3 Children witness more than half of domestic assaults and have a 45 to 60 percent chance of experiencing child abuse if their parent is being assaulted.4

WHAT IS DOMESTIC VIOLENCE AND WHY DOES IT HAPPEN?

Domestic violence is a form of abuse used to harm or control others. Different forms of abuse include: physical, emotional, sexual, reproductive, financial, or digital.5 Although victims of domestic abuse can be of any gender, race, age, or sexual orientation, violence is most common in women ages 18 to 34 and among women and men of color.6 In addition, the chances of experiencing abuse almost doubles for bisexual, gay, and lesbian adults in California.6

Abuse occurs when a domestic partner wants to control, physically harm, or have power over their partner.7 In addition to a desire for control, abusive behavior can also result from exposure to being abused themselves, history of witnessing domestic violence, social and emotional isolation, absence of healthy role models and relationships, and a lack of emotional and nonviolent social skills.6

PREVENTION STRATEGIES

Preventing violent behavior can often seem impossible, but there are many approaches that have proven to be effective.

The CDC developed a social-ecological model that shows the intersection of four factors that influence domestic abuse: individual, relationship, community, and societal.8

  1. Individual factors include age, education, income, substance abuse, or history of abuse.
  2. Relationship factors include peers in a social group, domestic partners, and family members.
  3. Community factors include schools, workplaces, and neighborhoods.
  4. Societal factors include health, economic, educational, and social policies that create social inequity in society.

This framework suggests making changes to each factor separately and together through education, life skills training, prevention programs, and policy change to prevent domestic violence. For example, changes in individual factors will result in better attitudes, beliefs, and behaviors, which can prevent domestic violence. Attending parent or family-focused prevention programs can help strengthen relationships and reduce conflict that may spark violent behavior. Changes to policy and processes in social settings can strengthen community relationships and minimize violence. Similarly, changes in health, economic, educational, and social policy lead to equity amongst society and can contribute to lower violence rates.8

The CDC also developed six strategies to prevent intimate partner violence:3

  • Teach safe and healthy relationship skills;
  • Engage influential adults and peers;
  • Disrupt developmental pathways toward partner violence;
  • Create protective environments;
  • Strengthen economic supports for families; and
  • Support survivors to increase safety and lessen harms

The Prevention Institute (PI) recommends yet another approach to prevent domestic violence by focusing on creating health equity and improving the community environment that fosters safe relationships.6 Health equity affirms that everyone deserves to be safe in their relationship. PI suggests that improving health equity and community environment is a group effort that requires advocacy, increased access to affordable housing, community support, delivery of healthcare and social services; for example, providing emergency food, child care and safe shelter, and prevention programs.6

POLICY MAKES A DIFFERENCE

As mentioned above, group advocacy can have a large impact on preventing domestic violence and creating safer relationships. Advocating concerns to policymakers can lead to positive change and ensuring the safety of many domestic violence victims and their families. Below are a few examples of policy that are making a difference in millions of lives.

The Violence Against Women Reauthorization Act of 2013 is a federal law that provides protections for victims of domestic violence, sexual assault crimes, date violence, and stalking. This law offers free rape exams, housing protections, and programs especially for immigrant women, women with disabilities, and children/teens.9

The Family Violence Prevention and Services Act (FVPSA) offers resources and shelter to families experiencing domestic violence.9 This Act expired in 2015, but has been reintroduced to extend through 2023. The FVPSA was approved by the House and it still awaiting action from the Senate.

The Violence Against Women Health Act of 2019 (H.R. 973) is a federal bill that has been introduced to the House of Representatives to provide additional grant-funded programs for domestic violence, dating violence, sexual assault, and stalking.10 This pending bill builds off of Health Resources & Services Administration’s (HRSA) strategy to address intimate partner violence. HRSA’s key priorities include training the public health workforce, developing partnerships for intimate partner violence awareness, increased access to health care for domestic violence services, and increased knowledge for risks, impacts, and interventions of abuse.10

One last important resource to note is the National Domestic Violence Hotline, funded by the Violence Against Women Act. This hotline offers free 24/7 support, information, resources, and answers questions for domestic violence victims or those who feel they may be in an unsafe relationship.11 Everyone deserves to be in a safe and healthy relationship and the various resources available today make that possible.


Author bio:

Kaitlin Brehaut, MPH

Kaitlin Brehaut, MPH, CHES

Kaitlin Brehaut serves as IHPL’s Health Policy Assistant, providing administrative, programmatic and research support to the Institute team. Ms. Brehaut completed her undergraduate education in Health Science with a concentration in Health Care Management at California State University, San Bernardino (CSUSB). She then received her Master of Public Health degree at CSUSB. She is also certified as a Health Education Specialist.

For more information, contact Kaitlin at: kbrehaut@llu.edu.


References:

  1. https://www.cdc.gov/violenceprevention/publichealthissue/strategicvision.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Foverview%2Fstrategicvision.html
  2. https://www.hrsa.gov/sites/default/files/hrsa/HRSA-strategy-intimate-partner-violence.pdf
  3. https://www.cdc.gov/violenceprevention/pub/technical-packages/infographic/ipv.html
  4. https://www.psychologytoday.com/us/blog/progress-notes/201902/alarming-effects-childrens-exposure-domestic-violence
  5. https://www.thehotline.org/is-this-abuse/abuse-defined/
  6. https://www.preventioninstitute.org/publications/health-equity-and-multisector-approach-preventing-domestic-violence
  7. https://www.psychologytoday.com/us/basics/domestic-violence
  8. https://www.cdc.gov/violenceprevention/publichealthissue/social-ecologicalmodel.html
  9. https://www.womenshealth.gov/relationships-and-safety/get-help/laws-violence-against-women
  10. https://www.congress.gov/bill/116th-congress/house-bill/973/text?q=%7B%22search%22%3A%5B%22domestic+violence%22%5D%7D&r=6&s=3
  11. https://www.thehotline.org/

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