Archived
June, 2007 |
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Highlights in Minority Health
October, 2004
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WHAT IS THE BURDEN
OF INTIMATE PARTNER VIOLENCE IN THE UNITED STATES? |
Intimate partner violence (IPV), also called
domestic violence1 refers to any behavior purposely inflicted
by one person against another within an intimate relationship that
causes physical, psychological or sexual harm. Such behavior
includes acts of physical aggression, psychological or emotional
abuse, as well as forced intercourse and other forms of sexual
coercion.2 Most often, the violent
person is a husband, former husband, boyfriend, or ex-boyfriend, but
sometimes the abuser is female.1 |
Accurate information on the extent of intimate
partner violence is difficult
to obtain because of extensive under-reporting.3 Approximately 1.5
million women and 834,700 men are raped and/or physically assaulted
by an intimate partner each year.4
About 588,490, or 85% of
victimizations by intimate partners in 2001 were against women. IPV made up 20% of all nonfatal violent crime experienced
by women and 3% of the nonfatal violence against men. 1,247 women
and 440 men were killed by an intimate partner in 2000.5 |
The consequences of abuse are profound, extending
beyond the health and happiness of individuals to affect the
well-being of entire communities. Violence has been linked to
a host of different health outcomes, both immediate and long term,
including physical, sexual, reproductive, psychological and
behavioral, and fatal health consequences (see table 1).2
This violence also takes a
devastating toll on children who are exposed to its cruelty.
Approximately 826,000 children are abused by their parents each
year. Children whose mothers are victims of wife
abuse are twice
as likely to be abused themselves as those children whose mothers
are not victims of abuse. When children witness violence in the
home, they have been found to suffer many of the symptoms that are
experienced by children who are directly abused.3 |
Table 1:
Health Consequences of Intimate Partner
Violence |
Physical |
Psychological and
behavioral |
Abdominal / thoracic injuries |
Bruises and welts |
Alcohol and drug abuse |
Depression and anxiety |
Chronic pain syndromes |
Disability |
Eating and sleep disorders |
Feelings of shame and guilt |
Fibromyalgia |
Fractures |
Phobias and panic disorder |
Physical inactivity |
Gastrointestinal disorders |
Irritable bowel syndrome |
Poor self-esteem |
Post-traumatic stress
disorder |
Lacerations and abrasions |
Ocular damage |
Psychosomatic disorders |
Smoking |
Reduced physical functioning |
|
Suicidal behavior and
self-harm |
Unsafe sexual behavior |
Sexual and
Reproductive |
Fatal Health
consequences |
Gynecological disorders |
Infertility |
AIDS-related mortality |
Maternal mortality |
Pelvic inflammatory disease |
Pregnancy complication /
miscarriage |
Homicide |
Suicide |
Sexual dysfunction |
Unwanted pregnancy |
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Unsafe abortion |
Sexually
transmitted diseases, including HIV/AIDS |
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Source:
World Health Organization (WHO), “World Report on Violence and
Health,” 2002, p. 101 |
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EXAMPLES
OF HEALTH DISPARITIES RELATED TO DOMESTIC VIOLENCE |
The prevalence of intimate
partner violence varies among women of diverse racial
backgrounds.
When data on African-American, Asian American and Pacific
Islander (AAPI), American Indian/Alaska Native (AI/AN), and
mixed-race respondents are combined, nonwhite women and men report
significantly more intimate partner violence than do their white
counterparts (Females:
24.8% white; 28.6% non-white.
Males: 7.5% white; 10.0% non-white). These findings
suggest that all racial minorities experience more intimate partner
violence than do whites.
More research is needed to
determine how much of the difference in intimate partner prevalence among women and men of different racial and ethnic backgrounds
can be explained by the respondent's willingness to disclose
intimate partner violence and how much by social, demographic, and
environmental factors.6 |
|
Table 2:
Persons victimized by an intimate
partner in a lifetime, by victim gender, type of victimization, and
victim race |
Victim Gender/
Type of Victimization |
Persons Victimized in Lifetime (%) |
|
White |
African American |
Asian/Pacific Islander (API) |
American Indian / Alaska Native (AI/AN) |
Mixed Race |
Women |
n=6,452 |
n=780 |
n=133 |
n=88 |
n=397 |
Rape |
7.7 |
7.4 |
3.8
b |
15.9 |
8.1 |
Physical
Assault |
21.3 |
26.3 |
12.8 |
30.7 |
27.0 |
Stalking |
4.7 |
4.2 |
-- e |
10.2
b |
6.3 |
Total
Victimized |
24.8 |
29.1 |
15.0 |
37.5 |
30.2 |
Men |
n=6,424 |
n=659 |
n=165 |
n=105 |
n=406 |
Rape |
0.2 |
0.9
b |
-- e |
-- e |
-- e |
Physical
Assault |
7.2 |
10.8 |
-- e |
11.4 |
8.6 |
Stalking |
0.6 |
1.1
b |
-- e |
-- e |
1.2
b |
Total
Victimized |
7.5 |
12.0 |
3.0
b |
12.4 |
9.1 |
|
a
Estimates for American Indian/Alaska Native women are significantly
higher than those for white and African-American women: Tukey’s B, p<
0.05. |
b
Relative standard error exceeds 30 percent; estimates not included
in statistical testing. |
c
Estimates for Asian/Pacific Islander women are significantly lower
than those for African-American, American Indian/Alaska Native, and
mixed-race women: Tukey’s B, p< 0.05. |
d
Estimates for African-American women are significantly higher than
those for white women: Tukey’s B, p< 0.05. |
e
Estimates not calculated on fewer than five victims. |
Source: U.S.
Department of Justice, Extent, Nature, and Consequences of Intimate
Partner Violence: Findings from the National Violence Against Women
Survey, 2000, p. 26 |
|
African Americans |
|
According to the National Violence Against Women Survey (NVAWS),
an estimated 29.1% of African American females and 12.0% of African American
males are victimized by IPV in their lifetime, defined by rape,
physical assault or stalking. This rate is second only to American
Indians and Alaska Natives (AI/ANs) victimized by IPV (AI/AN: 37.5%
females, 12.4% males).6 |
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American Indians/Alaska Natives (AI/ANs) |
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AI/AN women and men report higher rates of intimate partner violence
than do women and men from other minority backgrounds. According to
the NVAWS, 37.5% of AI/AN women and 12.4%
of AI/AN men are victimized by IPV in a
lifetime, defined by rape, physical assault or stalking. These are
the highest rates for any racial or ethnic groups. 10.2 percent of
AI/AN women are stalked in their lifetime, compared to 4.7 percent
of white women, 4.2 percent of African-American women, and 6.3
percent of mixed race women.6
About one in six violent victimizations among
American Indians involved an offender who was an intimate or family
member to the victim. Intimate and family violence each account for
about nine percent of all violence victimizations experienced by
American Indian victims, about the same percentage as found among
all victims of violence.9 |
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Asians/Pacific Islanders (APIs) |
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AAPI women and men tend to report lower rates of intimate partner
violence than do women and men from other minority backgrounds.
According to the NVAWS, 15.0% of Asian Pacific Islander (API) women
and 3.0% of API men report
being victimized by IPV in a lifetime, defined by
rape, physical assault or stalking.6 |
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Because information on violence against
AAPI women and men is limited, it is difficult to explain why they
reported significantly less intimate partner violence than did women
and men of other racial backgrounds. Research is also needed to
determine how prevalence rates vary among women and men of diverse
AAPI groups.6
It has been suggested that |
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Traditional Asian values emphasizing close family ties and harmony
may discourage Asian women from disclosing physical and emotional
abuse by intimates. |
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There may be significant differences in rates of intimate partner
violence between AAPI women that cannot be discerned from the survey
because data on these two groups are combined. |
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There may be significant differences between AAPI women born in this
country and those who immigrated. |
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More research is recommended on violence committed by intimates
against AAPI women.6 |
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Hispanics/Latinos |
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According to the NVAWS, 23.4 percent of Hispanic/Latino females and 7.4
percent of
Hispanic/Latino males are victimized by IPV in a lifetime, defined
by rape, physical assault or stalking. This compares with 25.6
percent of
non-Hispanic females, 24.8 percent of white females, 8.0
percent of non-Hispanic
males, and 7.5 percent of white males.6 |
|
The
NVAWS found little difference in Hispanic and non-Hispanic women's
reports of intimate partner physical assault (Hispanic: 21.2
percent,
non-Hispanic: 22.1 percent) and intimate partner stalking (4.8
percent for both
groups). However, Hispanic women were significantly more likely than
non-Hispanic women to report that they were raped by a current or
former intimate partner at some time in their lifetime (Hispanic:
7.9 percent, non-Hispanic 5.7
percent). These findings are noteworthy because
previously published NVAW Survey findings show that Hispanic women
report significantly less rape victimization than do non-Hispanic
women when all types of perpetrators are considered. Future research
should focus on why Hispanic women are less likely to be raped by a
non intimate but more likely to be raped by an intimate.6 |
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PROMISING INTERVENTION STRATEGIES |
Most intimate partner victimizations are not reported to the police.
Only approximately one-fifth of all rapes, one-quarter of all
physical assaults, and one-half of all
stalkings perpetrated against female respondents by intimates were
reported to the police. Even fewer
rapes, physical assaults, and stalkings perpetrated against male
respondents by intimates were reported. The
majority of victims who did not report their victimization to the
police thought the police would not or could not do anything on
their behalf. These findings suggest
that most victims of intimate partner violence do not consider the
justice system an appropriate vehicle for resolving conflicts with
intimates.6 Increasingly, addressing
IPV in primary care settings is recognized as an important component
of behavioral risk assessment. Although incorporating IPV screening
and intervention into clinical settings can be challenging, these
efforts can be critical in improving the lives of women who
experience violence.10 |
If you or someone you know
has been a victim of intimate partner violence, seek help from other
family members and friends or community organizations. Make sure you
and your children are SAFE. Reach out for support or counseling.
Talk with a health care provider, especially if you have been
physically hurt. Learn more about how to get help for intimate
partner violence. Another important part of getting help
is knowing if you are in an abusive relationship. There are clear
signs to help you know if you are being abused.1 |
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PROGRAMS |
CDC provides leadership in developing IPV prevention programs and
evaluating their effectiveness. CDC’s research on preventing IPV
complements the work of other federal agencies to broaden the
understanding of causes of violence and ways to prevent it. CDC also
funds 10 projects to prevent intimate partner violence and sexual
violence among various racial and ethnic populations, including
African Americans, AI/ANs, Hispanic Americans, and AAPIs. The
projects were selected based on their capacity to identify and
respond to the special needs of the target groups. Project staffs
are developing and evaluating programs for children, victims, and
perpetrators; programs to prevent dating violence among school-age
youth; or programs that link victims with service providers in their
communities.11
CDC research is looking at how other health behaviors and violence
issues, such as substance abuse and dating violence, affect risk
factors for family violence.12 |
In July 1995, in response to new statistics which showed an alarming
rise in sexual and intimate partner violence assaults on America's women,
the U.S. Department of Health and Human Services and the U.S.
Department of Justice announced the creation of the Advisory Council
on Violence Against Women. Consisting of 42 experts from law
enforcement, media, business, sports, health and social services,
and victim advocacy, the Council was formed to bring national
attention to the problem of violence against women and to increase
public awareness of the need for improved strategies to curb these
crimes.13 |
The Office on Violence Against Women was created in 1995 to implement
the 1994 Violence Against Women Act (VAWA) and to lead the national
effort to stop domestic violence, sexual assault, and stalking of
women. The Office on Violence Against Women administers grants to
help states, tribes, and local communities transform the way in
which criminal justice systems respond to violent crimes against
women. |
HHS launched the National Domestic Violence Hotline in 1996, a
24-hour, toll-free service that provides crisis assistance and local
shelter referrals for callers across the country. Since then, the
hotline has responded to more than 500,000 calls, mostly from
individuals who have never before reached out for assistance. HHS
funds the hotline through a grant to the Texas Council on Family
Violence. The hotline number is 1-800-799-SAFE, and the TDD line for
the hearing impaired is 1-800-787-3224.13 |
FOR MORE INFORMATION |
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National Center for Injury Prevention and Control (NCIPC) |
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Intimate Partner Violence: Fact Sheet |
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Costs of Intimate Partner Violence Against Women in the United
States |
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Intimate Partner Violence: Prevention Tips and Resources |
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Preventing Violence Against Women: Program Activities Guide |
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Healthy People 2010 Chapter 15: Injury and Violence Prevention |
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Indian Health Service (IHS) |
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Violence Against Native Women |
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Medline Plus: Domestic Violence |
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National Center for Women’s Health Information |
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Violence and Minority Women |
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Office of the Surgeon General |
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”Family Violence as a Public Health Issue” |
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U.S. Department of Justice |
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Bureau of Justice Statistics |
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American Indians and Crime |
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Crime & Justice Data Online |
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Hispanic Victims of Violent Crime, 1993-2000 |
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Homicide Trends in the U.S.: Intimate Homicide |
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Intimate Partner Violence, 1993-2000 |
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Violent Victimization and Race, 1993-98 |
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Domestic Violence |
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Office on Violence Against Women |
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ORGANIZATIONS |
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An Abuse, Rape, and Domestic Violence Aid and
Resource Collection (AARDVARC) |
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Ethnic/Cultural |
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Asian & Pacific Islander Institute on Domestic Violence |
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Family Violence Prevention Fund |
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National Center on Domestic and Sexual Violence |
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National Domestic Violence Hotline |
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National Latino Alliance for the Elimination of Domestic Violence |
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National Violence Against Women Prevention Research Center |
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Toolkit to End Violence Against Women |
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SOURCES |
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1. |
National Women’s Health Information Center (NWHIC), “Violence
Against Women: Domestic Violence and Intimate Partner Violence,”
2003 |
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2. |
World Health Organization (WHO), “World Report on Violence and
Health,” 2002, p. 89 |
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3. |
Administration for Children and Families (ACF), “Domestic Violence,”
2001 |
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4. |
Centers
for Disease Control and Prevention (CDC), National Center for Injury
Prevention and Control (NCIPC), “Intimate Partner Violence: Fact
Sheet,” 2004 |
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5. |
U.S.
Department of Justice (USDOJ), Office of Justice Programs (OJP),
Bureau of Justice Statistics (BJS), “Crime Data Brief, Intimate
Partner Violence, 1993-2001,” 2003 |
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6. |
USDOJ, OJP,
”Extent, Nature, and Consequences of Intimate Partner Violence:
Findings From the National Violence Against Women Survey”, 2000 |
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7. |
USDOJ, OJP,
BJS, “Victim Characteristics,” 2004 |
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8. |
USDOJ, OJP, BJS, “Trends in Victimization Rates by Race,” 2004 |
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9. |
USDOJ, OJP,
BJS, “American Indians and Crime,” 1999 |
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10. |
CDC, “Addressing Violence Against Women,” 2004 |
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11. |
CDC,
NCIPC, 2004 |
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12. |
Carmona, RH, “Family Violence as a Public Health Issue,” Presented
at Symposium on Family Violence: The Impact of Child, Intimate
Partner, and Elder Abuse, Aug. 6, 2003 |
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13. |
NWHIC,
“Violence Against Women: Legislation and Actions,” 2003 |
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