Intimate partner violence is not just a criminal justice issue. It is also a public health issue. Panelists on “Domestic Violence as a Public Health Issue and Social Determinants of Health” discussed how the United States health care system can do a better job of helping survivors physically and emotionally.
A distinction of importance for journalists was made at the very beginning of the session. Domestic violence refers to any violence in the home. Intimate partner violence is violence especially between spouses and other intimate partners. The panel focused on intimate partner violence, and moderator Joan Kenen told audience members that any journalist in any market could write about it because “it’s everywhere.”
Kenen, a reporter for Politico Magazine and at the Johns Hopkins Bloomberg School of Public Health, wrote a 2022 article about the movement to improve how health care providers identify and treat survivors of intimate partner violence. Panelists were among the experts and survivors featured in her story.
The CDC collects the best data on the prevalence of intimate partner violence through its National Intimate Partner and Sexual Violence Survey (NISVS), said panelist Jacqueline Campbell, a professor at the Johns Hopkins University School of Nursing. This is an ongoing, nationally representative survey that collects national and state-level data on adult female and male victimization of sexual violence, stalking, and intimate partner violence.
Survey data show that nearly equal percentages of men and women report experiencing intimate partner violence. But a deeper look into the data shows that women report surviving intimate partner violence at far higher rates than men, Campbell said.
Investigator Anita Ravi, a family medicine physician who specializes in the health of survivors of gender-based violence, says she sees intimate partner violence as an infection that can affect everyone in a household over generations. Ravi is the CEO and co-founder of the PurpLE Health Foundation, a New York-based nonprofit that addresses the holistic health of survivors of gender-based violence, including children who have witnessed parental abuse.
Melissa Beal, a registered nurse and survivor of intimate partner violence, also highlighted the effects of such abuse on children at home. Her five-year-old child, who witnessed her ex-husband’s abuse, has been diagnosed with PTSD and is about to undergo a specialized counseling program.
Bill is the co-founder of Surviving to Thriving, a nonprofit organization in Michigan that connects survivors to services. She talked about how as a nurse she knows how to take care of herself and that she has the resources to hire an attorney. However, many survivors of intimate partner violence don’t have those resources, Beal said. Intimate partner violence can happen to anyone, “but poor women are more vulnerable,” Kenen said.
The US Preventive Services Task Force recommends that health care providers screen women of reproductive age for intimate partner violence and provide or refer women who test positive to support services. But Kenen and Campbell noted that the show isn’t always done. “A lot of health workers worry that if the woman says ‘yes’, what do they do next?” Campbell, who added that 47 percent of women killed by their intimate partners, according to his research, had been in the health care system in some way in the previous year.
Bill discussed the need for more trauma-trained paramedics, law enforcement officers and judges. For example, not all states require training of judges. Kennen suggested it might make a good story for local reporters to investigate. When it comes to training new doctors, “medical education is failing us miserably in terms of intimate partner violence,” Ravi said.
Several participants talked about how domestic violence can start gradually, often as emotional abuse, and escalate over time. “Abusers are often charismatic, and they find people who are vulnerable,” Bill said. “Abuse doesn’t start right away and it always gets worse.”
But some abusers can change if they get early intervention through an evidence-based program, Campbell said. So far, only one offender intervention program, the Veterans Administration’s Force at Home, has been tested in randomized controlled trials and shown to be effective, Campbell said. The program is being piloted for civilians in Rhode Island.
Panelists emphasized that journalists writing stories about intimate partner violence should include the voices of survivors.