Intimate partner violence is not simply a criminal justice issue. It’s also a public health problem. Speakers at the panel, “Domestic violence as a public health problem and social determinant of health,” discussed how the health care system in the United States could do a better job of helping survivors physically and emotionally.
A distinction of importance to reporters was made right at the beginning of the session: Domestic violence refers to any violence in the home; intimate partner violence is violence specifically between spouses and other intimate partners. The panel focused on intimate partner violence, and moderator Joanne Kenen told audience members that any reporter in any size market can write about it because “it is everywhere.”
Kenen, a contributing writer to Politico Magazine and the Journalist-in-Residence at the Johns Hopkins Bloomberg School of Public Health, wrote an article in 2022 about the movement to improve how health care providers flag and treat survivors of intimate partner violence. The 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 Jacquelyn Campbell, a professor at Johns Hopkins University School of Nursing. It is an ongoing, nationally representative survey that gathers national and state-level data on sexual violence, stalking and intimate partner violence victimization from adult women and men.
Survey data show that almost an equal percentage of men and women report experiencing intimate partner violence. But a deeper dive into the data reveals that women report surviving serious intimate partner violence in far greater numbers than men, said Campbell.
Panelist Anita Ravi, a family medicine physician who specializes in the health of gender-based violence survivors, said she thinks of intimate partner violence as an infection that can affect everyone in the home, across generations. Ravi is the CEO and co-founder of PurpLE Health Foundation, a non-profit organization in New York City that addresses the comprehensive health of survivors of gender-based violence, including children who have witnessed violence against a parent.
Melissa Beal, a registered nurse and a survivor of intimate partner violence, also stressed the impact of such violence on children in the home. Her five-year-old, who witnessed her ex-husband’s violence against her, has been diagnosed with PTSD and about to enter a specialized counseling program.
Beal is the co-founder of the non-profit Surviving to Thriving in Michigan that connects survivors to services. She talked about how as a nurse she knew how to take care of herself and that she had the resources to hire a lawyer. However, many survivors of intimate partner violence do not have these resources, Beal said. Intimate partner violence can happen to anyone, “but poor women are more vulnerable,” Kenen said.
The U.S. Preventive Services Task Force recommends that health care providers screen women of reproductive age for intimate partner violence and provide or refer women who screen positive to support services. But Kenen and Campbell pointed out that screening is not always done. “Many health care providers worry that if a woman says, ‘Yes,’ what do they do next?” said Campbell, who added that 47 percent of women murdered by their intimate partners were in the health care system in some way in the prior year, according to her research.
Beal discussed the need for more trauma-trained health care providers, law enforcement officers and judges. For example, not all states require training for judges; Kenen suggested that might make a good story for local reporters to investigate. As far as training of new physicians, “medical education woefully fails us in terms of intimate partner violence,” said Ravi.
Several panelists talked about how abuse in the home can start out gradually, often as emotional abuse, and escalate over time. “Abusers are often charismatic, and they find people who are vulnerable,” said Beal. “The abuse does not start right away, and it always gets worse.”
But some abusers can change if they receive early intervention through an evidence-based program, said Campbell. So far, only one offender intervention program, the Veterans Administration’s Strength At Home, has been tested in randomized controlled trials and been shown to work, said Campbell. The program is being piloted for civilians in Rhode Island.
Panelists stressed that reporters writing stories about intimate partner violence should include the voices of survivors.