2. ABOUT THIS TOOL For more information and program support, contact the National Health Resource Center on Domestic Violence, a project of the Family Violence Prevention Fund: Monday-Friday (9-5 PST) Toll-free (888) Rx-ABUSE (792-2873) TTY: (800) 595-4889 Online: www.endabuse.org/health In addition, this PowerPoint presentation may be downloaded from the Family Violence Prevention Fund's website: www.endabuse.org/health
3. The National Health Resource Center on Domestic Violence The National Health Resource Center on Domestic Violence provides specialized materials and tools including: Consensus Guidelines on Routine Assessment for D.V. Pediatric Guidelines on Routine Assessment for D.V. Business Case for Domestic Violence Multilingual Public Education Materials Training Videos Multi-disciplinary policies and procedures Cultural competency information and materials specific to many communities Online e-Journal: Family Violence Prevention and Health Practice Health Cares About Domestic Violence Day (2nd Wednesday of October annually) Visit www.endabuse.org/health for more information
4. MENU IPV and Sexually Transmitted Infections/HIV SELECT FROM THE TOPICS BELOW IPV and Perinatal Programs Overview IPV, Breastfeeding, and Nutritional Supplement Programs Regional and Local Data Medical Cost Burden and Health Care Utilization for IPV IPV and Child and Adolescent Health The Impact of IPV on Women’s Health ACE Study: Leading Determinants of Health IPV and Behavioral Health IPV and Injury Prevention IPV and Family Planning, Birth Control Sabotage Pregnancy Pressure, and Unintended Pregnancy IPV and Home Visitation
6. HEALTH RESPONSE TO IPV 6 ‘92 ‘91 ‘90 ‘89 ‘88 ‘87 ‘86 ‘85 1985– Surgeon General declares DV a leading public health issue 1989– ACOG Technical Bulletin 1991– ANA Position Statement 1992– AMA Diagnostic Guidelines 1992– APHA Position Paper
7. HEALTH RESPONSE TO IPV 7 ‘02 ‘00 ‘99 ‘98 ‘97 ‘96 ‘95 ‘94 ‘01 1994– AAFP Position Paper 1998– AAP Policy Statement 1999– APA Resolution 2000– AANP Statement and Resolutions 2002– WHO declares violence a worldwide public health issue
8. DEFINING IPV Many different definitions Most definitions include physical abuse, psychological/emotional abuse, and sexual assault Prevalence rates vary significantly between current, recent, and lifetime abuse Earlier studies were often limited to physical abuse 8
16. 10 IPV was a precipitating factor in 52.2% of female homicides { IPV was a precipitating factor in nearly one-third of suicides } CDC, 2009
17. 11 Approximately of all murder-suicides involved an intimate partner three-quarters (73.7%) Violence Policy Center, 2006
18. MAGNITUDE OF THE PROBLEM: GLOBAL Lifetime prevalence of physical and/or sexual IPV among women from 10 different countries ranged from 15% to 71% 12 World Health Organization, 2005
19. MAGNITUDE OF THE PROBLEM: U.S. 24.8% of women 7.6% of men 13 Lifetime prevalence of having been raped and/or physically assaulted by a current or former partner: Tjaden & Thoennes, 2000
20. 24-HOUR NATIONAL CENSUS 60,799 victims served 14 in one day National Network to End Domestic Violence, 2008
21. 15 84% of spouse abuse victims are female Bureau of Justice Statistics, 2005
22. HEALTH DISPARITIES ISSUE African American, Native American, and Hispanic women are at significantly greater risk for IPV 16 Silverman et al, 2006; Field & Caetano, 2005
23. IPV AMONG LATINO WOMEN Prevalence rates of IPV in the past year among women seen at a community health care system: 18.5% disclosed physical violence 14.4% disclosed sexual coercion 72.6% disclosed psychological aggression 17 Hazen & Soriano, 2007
24. HEALTH DISPARITIES ISSUE Couples with IPV are more likely to be economically vulnerable and live in disadvantaged neighborhoods 18 Fox & Benson, 2006
25. IPV AND HOMELESSNESS 60% of homeless young adults disclosed abuse by a current partner 19 Boris et al, 2002
26. SPECIAL POPULATIONS Prevalence among same-sex couples varies by gender of the couple and by the perpetrator’s gender Persons with disabilities are at high risk for IPV 20 Hathaway et al, 2000; McFarlane et al, 2001; Tjaden & Thoennes, 2000
27. 21 400,000 adolescents experience serious physical and/or sexual dating violence Wolitzky-Taylor et al, 2008
28. 22 1 IN 10 to 1 IN 5 high school-aged teens are hit, slapped, or beaten by a dating partner each year Wolfe et al, 2009
29. DATING VIOLENCE & RISK BEHAVIORS Teens experiencing physical dating violence are more likely to engage in: Sexual intercourse Suicide attempts Episodic heavy drinking Physical fighting 23 MMWR, 2006
30. 15.5 MILLION CHILDREN 24 have been exposed to physical IPV in the past year McDonald et al, 2006
31. 25 IPV is associated with 8 of the 10 Leading Health Indicators for Healthy People 2010
34. 28 IPV costs the USA economy $12.6 Billionon an annual basis Waters et al, 2004
35. PUBLIC HEALTH: CALL TO ACTION To integrate culturally relevant prevention, screening, intervention, and referral strategies for IPV into the public health setting 29
36. PUBLIC HEALTH RESPONSE: ESSENTIAL STEPS Develop partnerships with local domestic violence programs Join or create multidisciplinary task forces to promote a coordinated community response to IPV Conduct community needs assessments 30
37. Establish policies to institutionalize routine screening in public health settings Develop, implement, and monitor protocols for IPV in public health agencies Integrate IPV curricula into schools of public health, nursing, and medicine 31 PUBLIC HEALTH RESPONSE: ESSENTIAL STEPS
38. Enhance data collection and dissemination Promote social marketing campaigns and community education Increase funding for science-based, public health approaches Provide technical assistance and evaluation Advocate for local, state, and national policy reform 32 PUBLIC HEALTH RESPONSE: ESSENTIAL STEPS
39. PUBLIC HEALTH RESPONSE: ESSENTIAL STEPS Ongoing training for public health professionals Implement policies to improve the safety of victims and employees in the workplace Ensure that employee assistance programs have protocols 33
44. 35 ASSESSMENTIS THE FIRST STEP OF INTERVENTION Listening and affirmationare invaluable to victims.
45. ASSESSMENT AS INTERVENTION Primary Prevention: For clients who are not experiencing abuse, screening affirms that IPV is an important health care issue and provides an opportunity to talk about healthy relationships and the warning signs of an abusive relationship. 36 PRIMARY PREVENTION
46. ASSESSMENT AS INTERVENTION Secondary Prevention: In the early stages of an abusive relationship, early identification and intervention can prevent serious injuries and chronic illnesses as the violence escalates and the entrapment increases. 37 PRIMARY PREVENTION SECONDARY PREVENTION
47. ASSESSMENT AS INTERVENTION Tertiary Prevention: In relationships with escalating violence, screening provides the opportunity for disclosure in a safe and confidential environment. Even if clients do not feel safe disclosing their abuse, giving supportive messages can end their isolation and let them know that they have options. SECONDARY PREVENTION 38 PRIMARY PREVENTION TERTIARY PREVENTION
48. 39 PROMISING PRACTICES:STATE OF FLORIDA DEPARTMENT OF PUBLIC HEALTH State and local health departments partnered with domestic violence agencies to create screening guidelines Regional train-the-trainers sessions with teams of domestic violence advocates and health department staff Training teams train staff in their counties
