Violence Against Women: A Multi-level Analysis, Part 1
A new report released by the World Health Organization (WHO, 2013) provides sobering statistics on the prevalence of physical and sexual violence against women in countries worldwide. The report estimates that globally, 1 out of every 3 women (35%) will experience sexual and/or physical abuse in her lifetime, and 30% will experience violence at the hands of an intimate partner.
“This new data shows that violence against women is extremely common. We urgently need to invest in prevention to address the underlying causes of this global women’s health problem.” said Professor Charlotte Watts, from the London School of Hygiene & Tropical Medicine.
The recent report from the WHO, as well as my current research in the area of intimate partner violence prevention, will serve as the foundation and motivation for my first series of blog posts, entitled Violence Against Women: A Multi-Level Analysis. This series will feature 3 parts: Part 1- History, Social Movements, and Policy; Part 2- Defining a Public Health Approach to Violence Prevention; and Part 3- Current events and trends, successful and promising innovations, and future challenges and opportunities.
Part 1: History, Social Movements, and Policy
Addressing a global epidemic such as violence against women presents a significant challenge for the public health community, but recent and historical achievements demonstrate that preventing/reducing violence against women (VAW) is a realizable goal. However, it also necessary to acknowledge that many of the major achievements in the movement to prevent VAW have been met by social and political resistance… more on this in a moment. First, let’s take a look at some of the significant accomplishments and major milestones that have important implications for our future efforts.
Historical Milestones and Social Movements
The 1970’s mark the beginning of widespread public awareness of domestic/intimate partner violence. The first “Take Back the Night” (TBTN) event was held in PA in 1975, followed by the first international TBTN in 1976, when over 2,000 women from more than 40 countries gathered in Belgium to take a stand against sexual and physical violence, harassment, and other violence against women. Two years later, in 1978, the National Coalition against Domestic Violence (NCADV) was organized by a group of less than 100 female activists; since then, the group has grown into one of the largest and most influential violence prevention organizations. NCADV were involved in the initial passing of the Violence Against Women Act (VAWA, 1994) and the Family Violence Prevention and Services Act (FVPSA), and in October 1987 NCADV organized and promoted the very first Domestic Violence Awareness Month. Also in the 1980’s (1983), the CDC established their first Violence Epidemiology Branch to address the need for systematic violence prevention efforts; later (in 1993), the CDC established the National Center for Injury Prevention and Control, which includes the Division of Violence Prevention, an organization devoted to developing primary prevention strategies (i.e. stopping violence before it happens), conducting research on violence-related trends and statistics, identifying risk factors for violence, and establishing the effectiveness of violence prevention programs. Since then, the CDC has adopted a public health approach to violence prevention using the Social-Ecological Model as a framework for prevention. This represented a significant paradigm shift in violence prevention efforts: previously, violence against women- especially domestic violence- was viewed as a private matter to be dealt with by the people directly involved in the incident (e.g. the victim and the perpetrator). The public health approach to violence prevention challenges the notion that domestic violence is an individual problem by identifying, emphasizing, and explaining the sociocultural context in which violence occurs. From this perspective, successful violence prevention involves a systematic, multilevel approach focusing on individual factors, interpersonal and social factors, community and environmental determinants, and public policy and societal influences. The public health approach to violence prevention emphasizes the importance of contextual factors, recognizing that the incidence of violence is situated in a broader societal context.
“If the numbers we see in domestic violence were applied to terrorism or gang violence, the entire country would be up in arms, and it would be the lead story on the news every night.”
–Rep. Mark Green, Wisconsin
Major Policy Developments
The 1994 passing of the Violence Against Women Act was a landmark piece of legislation and a major milestone in the history of violence prevention efforts. The 1994 version of VAWA fostered the development of new, systematic responses to various forms of VAW (e.g. dating violence, intimate partner violence, stalking) by bringing together multiple agencies including the criminal justice system, the social services system, medical care providers, and local, state, federal, and non-profit agencies providing crisis counseling and intervention, shelters, hotlines, and other services for victims. The 1994 act also enforced stricter punishment guidelines, provided better access to protection orders for victims, and gave special attention to protecting immigrants and other underserved populations including Native Americans and Alaska Natives.
In 2000, Congress reauthorized the VAWA, with some improvements: most notably, the recognition of dating violence and stalking as forms of domestic violence, and the creation of a program providing legal assistance to victims of domestic violence and sexual assault. The 2005 reauthorization promoted a community-based response to domestic violence, emphasizing primary prevention strategies aimed at stopping violence before it starts. In the most recent reauthorization (Feb. 2013), VAWA expanded the scope of previous versions to ensure that vulnerable and/or underserved populations (e.g. Native American/Alaska Native; LGBT; youth; immigrants) have access to necessary services and fair protection under the law. The 2013 reauthorization also maintained and extended existing VAWA grant programs (e.g. safe housing; civil and legal protective services; emergency/crisis intervention programs), with a special emphasis on developing culturally relevant prevention strategies and promoting collaboration among multiple agencies to coordinate community-based approaches to violence response and prevention.
The success of VAWA is demonstrated in a variety of ways. Since VAWA was first enacted, states across the country have passed almost 700 laws aimed at reducing and preventing domestic violence, sexual assault, stalking, and other forms of VAW. The passing of VAWA also resulted in hundreds of companies (including Polaroid, Liz Claiborne, The Body Shop, Aetna, and Dupont) adopting specific employee-assistance programs to help victims of domestic violence and sexual assault. Notably, since the first VAWA was enacted in 1994, the rate of IPV victimization has declined by over 60% for both males and females in the U.S (Catalano, 2012).
Challenges and Political Opposition
In 2000 and 2005, VAWA was reauthorized with overwhelming bipartisan support and little to no resistance; in 2005, there were only 4 “no” votes. However, at the end of 2012, the Republican-controlled House of Representatives failed to reauthorize the now 18-year-old VAWA, and it took nearly a year of partisan (not evidence-based) debates before VAWA was reauthorized. When the House of Representatives finally passed the new VAWA, the final vote was 286 (yes) to 138 (no), with Republicans claiming all 138 “no” votes. (As a side note, many potential and/or definite 2014 Senate Republican candidates voted against VAWA, including: Reps. Tom Cotton (Ark.), Steve King (Iowa), Bill Cassidy (La.), John Fleming (La.), Justin Amash (Mich.), Kristi Noem (S.D.), Paul Broun (Ga.), Tom Price (Ga.), Phil Gingrey (Ga.), Jack Kingston (Ga.), Austin Scott (Ga.) and Tim Graves (Ga.) (see the official final vote and breakdown)). The rationale behind the opposition to VAWA was not based on solid ideological grounds or practical concerns, and was certainly not grounded in evidence- as mentioned previously, the passing of VAWA was followed by a significant decrease in rates of IPV, as well as a significant increase in reporting behaviors of victims (CDC, 2003). VAWA has also helped save countless lives: in the first decade after VAWA passed, the number of IPV-related homicides decreased by 34% for women and 57% for men (U.S. Dept. of Justice, 2007). The economic impact of VAWA has also been undeniably positive: within the first 6 years of implementation, VAWA saved approximately $12.6 billion in domestic violence-associated costs (Archer et al., 2002), in addition to establishing funding streams to support the work of rape crisis centers and other victim support services.
Using Evidence to Overcome Opposition
With these statistics, it is difficult to argue against the effectiveness of VAWA-affiliated programs; however, the opposition is out there, and their efforts to impede legislation like VAWA are still ongoing. Foundations such as ‘Heritage Action’ and ‘FreedomWorks’ (both well-funded conservative activist groups) claim that the evidence does not support the effectiveness of VAWA and claim that the cost of the legislation ($660 million) outweighs any potential benefits. As we saw in the official VAWA program evaluation reports, this is simply not true, and these statements directly contradict all available evidence. This is exactly why it is so important for the public health community to continue to monitor the progress of such programs and continuously disseminate evidence to support the efficacy our violence prevention efforts and encourage the adoption of new policies aimed at reducing violence against women. With recent cuts to domestic violence funding as a result of sequestration, coupled with increasing demand for domestic violence services, we can see the ongoing impact of political partisanship on the health and wellbeing of women in our country. As a direct result of sequestration-related budget cuts, it is estimated that as many as 955,843 fewer victims of domestic violence will receive the services they so desperately need. The effects of such cuts extend far beyond the victims; as discussed throughout this post, violence is not an isolated problem, and the consequences of underfunding and unmet service needs will radiate throughout the community.
“In rural areas of America, there is a growing increase in poverty, homelessness and hunger. You cannot separate these factors from domestic violence ‑- a mother with three kids and no financial security is going to stiffen her lip and take the abuse, because not only does she have nowhere else to go, she has three children depending on her for survival.”
–Sen. Blanche Lincoln, Arkansa
In the next post, I will discuss and describe a Public Health Approach to Violence Prevention, including the role of political activism and the need for bipartisan efforts to develop successful programs. I will also discuss the sociopolitical, cultural, and environmental factors that contribute to and maintain societal tolerance of violence against women. Finally, I will also discuss the impact of seemingly isolated incidents of violence on the overall health of our neighborhoods and communities in the U.S. Violence against women is not a problem that affects a certain type of person or only occurs in a certain type of community; it is a pervasive public health problem that threatens the health and wellbeing of all. It is up to us, as a public health community, to demonstrate the permeating effects of violence in our country; to show that violence is not their problem, his problem, her problem, or my problem, but our problem to deal with.
“Violence against women is an everyday reality, act now, always, and forever before it it too late.” -Unknown
Archer et al. (2002). Intimate Partner Violence in the U.S. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, Institute for Law and Justice, National Evaluation of the Grants to Encourage Arrest Policies Program.
CDC (2003). Costs of Intimate Partner Violence Against Women in the United States. Atlanta, GA: Centers for Disease Control and Prevention, National Centers for Injury Prevention and Control.
Catalano, S.M. (2012). The latest information from the Bureau of Justice Statistics (BJS) on Intimate Partner Violence, 1993-2010. NCJ # 239203. U.S. Dept. of Justice, Bureau of Justice Statistics. Available from: http://www.bjs.gov/index.cfm?ty=pbdetail&iid=4536.
Uniform Crime report (UCR) Supplementary Homicide Reports (SHR), Federal Bureau of Investigation, 1993-1997.