Unit 2: Prevalence and Differential Impact of DV/SV

DPH Training Unit 2: Prevalence and Differential Impact of DV/SV

Unit 2 Introduction

As mentioned in the Introduction Unit, adopting a lens of intersectionality is essential for understanding and addressing domestic and sexual violence (DV/SV). There is a common expression that these types of violence “can happen to anyone,” and – although that is correct – the prevalence, dynamics, and impact of DV and SV differ substantially based on a person’s social location (i.e., the constellation of privilege and oppression that correspond with a person’s different identities).

In this section we highlight the important role of social location by examining domestic and sexual violence according to race and ethnicity, gender identity, sexual identity, age, immigration status, socioeconomic status, (dis)ability, geographic location, and military involvement. We recognize that this list is neither exhaustive, nor does it get at the minutia of identities and experiences within any one identity category. Moreover, the very nature of intersectionality means that people are comprised of multiple identities; thus, there is a compounded effect for people who face multiple sources of oppression (e.g., an undocumented, low-income woman). This unit is merely a foundation for continual learning about these complex issues. Please note, for information on the intersection of DV/SV and behavioral health please see Unit 1.

Learning Objectives

  • Gain an increased awareness of the prevalence of DV/SV

  • Articulate which populations are most at risk for DV/SV victimization and why

  • Understand the ways in which structural and other forms of oppression create differences in the experiences and impact of DV/SV

Race & Ethnicity

Prevalence

In the U.S., people of color generally experience increased rates of lifetime DV and SV compared to White counterparts.1

Sexual Violence

Homicide by Intimate Partner

Domestic Violence

  • 4 in 10 non-Hispanic Black, American Indian, or Alaska Native and 1 in 2 multiracial non-Hispanic women report experiencing rape, physical violence, and/or stalking by an intimate partner.1

  • About 1 in 2 American Indian or Alaska Native and 4 in 10 Black and multiracial men report experiencing rape, physical violence, and/or stalking by an intimate partner.1

    • Rates of IPV homicide are substantially higher among Non-Hispanic Black and American Indian/Alaska Native compared to other racial ethnic groups. Specifically, the rate (per 100,000) was 4.4 for Non-Hispanic Black women, 4.3 for American Indian/Alaska Native women, and 1 to 2 for all other racial ethnic groups.2

    • Among women, 1 in 3 multiracial non-Hispanic, 1 in 4 American Indian and Alaska Native identifying, 1 in 5 Black and White non-Hispanic, and 1 in 7 Hispanic, report experiencing rape.3

    • Among men, 1 in 3 multiracial non-Hispanic, 1 in 4 Hispanic, and 1 in 59 White non-Hispanic men report experiencing rape.3

Differential Impact Considerations

  • Differences between DV/SV survivors of color and White survivors stem largely from racism, discrimination, and the enduring legacies of slavery and colonization.

  • As a result, people of color – particularly African Americans and Native populations – have higher rates of DV/SV, are at heightened risk for other forms of violence (e.g., police violence) and oppression (e.g., inadequate schools, racial wealth gap),6 and generally have access to fewer resources and help-seeking options.7,8

  • Click here for a graphic from the SASHA Center that depicts how multiple layers of oppression create unique risk and vulnerability for Black SV survivors.

Gender Identity

Prevalence

In the U.S. transgender individuals have higher rates of DV/SV compared to women and men9, and women have higher rates of SV and DV (specifically sexual violence, severe physical injury, and homicide) compared to men.1

Differential Impact Considerations

Differences regarding DV/SV among gender identity groups stem largely from sexism, transphobia and toxic (or hyper) masculinity. 13-15

Transgender

Men

Women

  • Entrenched sexist attitudes about women's roles and rights contribute to their higher rates of DV (fatal and nonfatal) and SV.16,17

  • Structural forces such as the feminization of poverty leave women with fewer resources to draw upon when seeking safety.18

  • Toxic or hyper-masculinity are the negative mental health effects on men who live in a society of strict masculine gender norms regarding role and behavior.19

  • Although hyper-masculinity is associated with men's use of SV/DV perpetration, it also negatively impacts men who experience DV/SV (e.g., leads to feelings of shame and underreporting, victim blaming, disbelief when men disclose).14,20-22

  • Trans individuals experience discrimination and bias-based violence in all facets of their life, including intimate relationships, putting them at risk for complex trauma.11

  • Barriers to seeking help for DV/SV include limited understanding of trans IPV, stigma, and systemic inequalities.23

  • Abusive partners often use transphobia against them (e.g., blaming the abuse on them being trans) or deny that it exists.24

  • Many trans individuals, especially those of color, receive substantially less support from their family and other people,11 a problem given that social support is a primary buffer against the negative effects of DV/SV.25

Sexual Identity

Prevalence

In the U.S., bisexual women are the sexual minority group at highest risk of experiencing DV/SV. Rates of DV/SV for bisexual men, lesbian women, and gay men, however, are also quite high.26

Differential Impact Considerations

  • The primary drivers of differences across sexual identities are heterosexism and homophobia.

  • LGB people continue to face stigma, marginalization, and - as a result - internalized homophobia, all of which contribute to unique aspects of DV/SV in the LGB community (e.g. outing) and also present unique barriers to accessing services (e.g. fear of homophobia in providers, the small size of LGBTQ communities).28-30

  • Although bisexual women's significantly higher rates of DV/SV compared to lesbian and heterosexual women is largely understudied, research suggests several possible contributing factors: hypersexualization and cultural misunderstandings of bisexual women; lack of support and discrimination from heterosexual, gay, and lesbian communities; and higher risk for increased substance abuse.31,32

  • For more on best practices for working with LGBTQ IPV survivors, see here.

Age: Adolescents & Young Adults

Prevalence

Adolescents and young adults are at highest risk for DV/SV victimization; yet, they face substantial help-seeking barriers. Below are a few important statistics:

Domestic Violence

Sexual Assault

    • Among women with lifetime experience of DV, 22.4% were 11-17 years old and 47.1% were 18-24 years old when they first experienced it.1

    • Among men with lifetime experience of DV, 15% were 11-17 years old and 38.6% were 18-24 years old when they first experienced it.1

    • One meta-analysis found that 20% of teens reported physical violence and 9% of teens reported sexual violence in dating relationships.33

    • Nearly 10% of all 18-24 year old women report experiencing physical or sexual violence by an intimate partner (down from 33.9% in 1994).34

    • A review of 1,039 intimate partner homicides from 2003-2016 found that the victim in 150 of those homicides were people aged 11-18 – 80% of whom were female.35

  • Over 1 in 14 women (7%) in the U.S. reported first experiencing completed rape before the age of 18.3

  • Among female victims of completed rape, the vast majority are younger than 25 years of age when the incident occurred: 37.4% were 18-24 years old, 30.1% were 11-17 years old, and 11.2% were 10 years old or younger.3

  • We could not find statistics on rape by age group for men; the BJS estimates that the rate for all men is 0.3 per 1000.36

Differential Impact Considerations

  • Adolescents and even young adults often do not recognize that they are being abused (e.g., confuse jealousy and control with love), or they think it is a normal part of adult relationships.37

  • Most adolescents and young adults do not disclose their experiences or access services, for fear of not being believed or getting in trouble (especially if alcohol and drugs are involved).38

  • Most DV shelters accept adult survivors only, and some community programs require parental consent.39

  • Most parents do not talk to their kids about DV and/or falsely assume that they would know if their child was experiencing DV.40

  • Some providers often do not consider DV to be a serious concern for adolescents and young adults.41,42

Age: Older Adults (65+)

Prevalence

Although the prevalence of DV and SV is lower among older adults (65+) compared to younger age groups, it still occurs. Pervasive misperceptions that older adults are somehow immune to DV/SV is a primary barrier to intervention and help-seeking for this population.43

Domestic Violence

Sexual Violence

Elder Abuse

    • Estimates from the Bureau of Justice Statistics indicate that the rate of IPV among people 50 and older ranges from 0.7 and 1.3 per 1000 people.34

    • A literature review found that between 0.2%-17% of older adults experience sexual violence, and that the overwhelming majority of victims are women.43 This variation in rates stems from methodological differences across studies.

    • In 2008, approximately 1 in 10 elders reported experiencing a form of abuse (i.e., physical or sexual) or potential neglect.44

Note: For each of these three types of abuse against older adults, the most common assailants are family members.

Differential Impact Considerations

  • Ageism plays an important role in the differential experiences and impact of DV/SV among older adults.46

  • The notion that older adults are not sexually active or romantically involved can render DV/SV invisible and result in misdiagnosis and hinder proper care.46

  • DV/SV services, especially shelters, are often not designed to meet the needs of older survivors, leaving them with fewer options for safety and healing.39,45,46

  • The aging population is growing rapidly, meaning that many more older adults – some of whom are DV/SV survivors – will need services from healthcare providers.46

Immigration Status

Prevalence

Not surprisingly, it is extremely difficult to obtain DV/SV prevalence estimates for immigrants, especially those who are undocumented.47,48 Here, we present statistics from studies with nonprobability samples.

  • It is estimated that at least 40-50% of immigrant women have experienced some form of IPV.47

  • A study using data from the MA Youth Risk Behavior Survey found that the rate of sexual assault was double that for immigrant female students compared to their nonimmigrant peers.49

  • Between 2002-2013, 65.9% of all homicides involving an immigrant female victim and 65.1% of homicides involving a non-immigrant female victim were committed by a male intimate partner.50

Differential Impact Considerations

Several factors make immigrant survivors especially vulnerable to DV/SV victimization:

  • They are more likely to be socially isolated, financially impoverished, and economically dependent upon abusive partners due to language barriers and other challenges.7,47

  • Fear of deportation, experiences of discrimination, feelings of shame, and lack of health insurance and knowledge of systems prevent disclosure.47,51,52

  • Several immigration-related abuse tactics include controlling the survivor’s ability to attain a legal immigration status, hiding or destroying documents needed for the citizenship application process, and claiming that the survivor will be deported if they call the police for help.53

  • Immigrant women are at heightened risk for sex trafficking and sexual exploitation, either once they arrive in the U.S. or because they were brought here by human traffickers.52,54

Socioeconomic Status (SES)

Prevalence

DV/SV is more prevalent among people who are financially impoverished compared to more well-resourced people.55 This relationship is due in part to its cyclical nature and the traumatic impact of poverty on people’s coping strategies and help-seeking options.

  • Between 2008-2012, the rate of sexual violence (rape and sexual assault) among people living in households at or below the Federal Poverty Level was nearly two times higher than those in middle-income households and more than two times higher than those in high-income households.56

  • Between 2008-2012, the rate of DV among people living in households at or below the Federal Poverty Level was almost four times the rate for middle- and high-income persons.56

  • People (especially women and undocumented people) in low-wage jobs such as those in the restaurant industry, agriculture, home care and domestic work are at particularly high risk for experiencing sexual violence and harassment due to their very vulnerable status (e.g., societal invisibility and lack of protections or recourse).57

Differential Impact Considerations

  • Survivors who are caught at the intersection of IPV and poverty are often trapped and have to make costly tradeoffs to survive (i.e., “survival- focused coping”).18 This means having to make tradeoffs related to their safety in order to protect important aspects of their lives that are too costly to risk losing (e.g., children, housing).

  • There is a powerful cyclical relationship between DV/SV and SES, especially for women. That is, poverty increases risk for DV/SV, and DV/SV increases risk for unemployment and reduced income (by causing survivors to have to take time off, interfering with their ability to concentrate, reducing effectiveness, and even triggering them.59,60

  • SES can dramatically impact survivors’ help-seeking behaviors. For example, although higher income survivors are as likely to use hotline services as lower-income survivors, they are far less likely to consider using a shelter.58 This difference is often due to the fact that lower-income survivors have fewer housing-related resources at their disposal, leaving them no choice but to use a shelter.

Homelessness & Housing Instability

Prevalence

Prevalence estimates regarding the overlap between DV and homelessness depends on sample, data source, how DV is defined, survivor willingness to disclose, and whether the study focuses on DV as a primary risk factor for homelessness (vs. general exposure).

  • With these limitations in mind, it is estimated that between 15% to 50% of people who are homeless have experienced DV victimization.61-64

  • One study found that women who experienced past-year IPV were nearly four times more likely to experience housing instability than those without IPV.63

  • In a study of 737 homeless women and 91 homeless men, lifetime rape victimization was 53.9% among women and 14.3% among men.65

Differential Impact Considerations

  • DV/SV can lead directly to housing instability and homelessness (i.e., fleeing due to fear for safety) and indirectly lead to it (i.e., DV/SV erodes the personal and financial resources necessary to maintain stable housing).66,67

  • For low-income survivors, having to choose between safety or housing is often a no-win situation with costly tradeoffs for them and their children.67,68

  • Being homeless can increase one’s risk for sexual violence and having to engage in sex work and survival sex.65

(Dis)ability Status

Prevalence

People with disabilities are at increased risk for all forms of DV and SV; yet, they face considerable barriers to help-seeking than their non-disabled peers.69-71 We use the definition of disability put forth by the Americans with Disabilities Act of 1990: “a physical or mental impairment that substantially limits one or more of the major life activities of such individual.”

Violence Generally

Sexual Violence

Domestic Violence

  • Depending on the type of DV, women with disabilities are anywhere from 1.8 times (psychological abuse) to 4.5 times (rape) more likely to experience DV than women without disabilities. Men with disabilities are between 1.2 times (reproductive coercion) and 4.9 times (stalking) more likely to experience DV than men without disabilities.70

  • Between 2011 and 2015, people with disabilities reported experiencing SV at a rate of 3.5 times higher than people without disabilities.72

  • Between 2011 and 2015, the rate of violent victimization for people with disabilities was 2.5 times higher than people without disabilities (except those aged 65+).72 People with cognitive disabilities experience the highest rates of violence, and people with multiple disabilities experience higher rates of violence than those with one disability.72

Differential Impact Considerations

  • Ableism plays an important role in the experiences and impact of DV/SV among people with physical and cognitive disabilities.

  • People with disabilities are often dependent on others for financial support and help with activities of daily living, making them especially vulnerable to DV/SV.69

  • DV/SV can cause physical and cognitive disabilities, which creates barriers to help-seeking and increases risk for continued DV/SV (including disability specific tactics) as well as other forms of victimization. 73,74

  • DV/SV services, especially shelters, are not designed to meet the needs of survivors with disabilities, leaving them with fewer options for safety and healing.74

Geographic Location: Rural

Prevalence

Historically, DV/SV in rural communities has not been given the same attention as DV/SV in urban communities. Below are a few important statistics:

Sexual Violence

Domestic Violence

  • National estimates suggest that the prevalence of DV is similar across rural, urban, suburban areas; however, substantial differences exist according to forms of DV.75

  • One study found that the severity of violence was significantly higher among rural women than urban women.76

  • In another study, women in rural areas who were separated or divorced were at much higher risk for rape and sexual assault by a former partner (3.1/10000) as compared to their counterparts in urban (1.4/1000) and suburban areas (1.7/1000).77

  • Between 2005-2010, the rate of sexual violence for women ages 12+ in rural areas was 3.0 per 1,000 compared to 2.2 per 1,000 in urban areas and 1.8 per 1,000 in suburban areas.78

Differential Impact Considerations

  • Several unique factors of rural locales contribute to the higher prevalence and more severe impact of DV/SV in rural locales: geographic & social isolation, scarcity of services, lack of anonymity due to small communities, increased level of collective efficacy (group influence over people’s behavior), and attitudes against involving systems.75,76

  • People in rural areas have the highest rate of violence by other family members, suggesting less social support and multiple sources of trauma.79

Military Involvement

Prevalence

Military-involved individuals, especially women, are at heightened risk for DV/SV. Below are a few important statistics:

Sexual Violence

Domestic Violence

  • 31.5% of active duty women and 29.5% of wives of active duty men reported experiencing physical violence, rape, or stalking by an intimate partner.80

  • 53.7% of active duty women and 48.6% of wives of active duty men reported experiencing psychological aggression by an intimate partner.80

  • 9.5% of 4,729 male veterans across 8 U.S., states reported lifetime IPV (physical and sexual).81

  • Military Sexual Trauma (MST) can be defined as sexual assault and sexual harassment that occurs during military service.82

  • A meta-analysis found that 38.4% of female and 3.9% of male military personnel & veterans reported experiencing MST. Focusing on sexual assault only, percentages were as follows: 23.6% of women and 1.9% of men reported sexual assault.83

  • One study found that female veterans with documented prior DV victimization were 2.5 times more likely than those without DV to report experiencing MST.84

  • Finally, 36.3% of active duty women and 32.8% of wives of active duty men reported experiencing lifetime contact SV.80

Differential Impact Considerations

  • Women often enter the military already having experienced some form of DV and/or SV, which is compounded by combat trauma and active duty DV/SV victimization.85

  • Survivors in active duty face many barriers to reporting DV/SV. Most notably, they report to their chain of command – not the police, as civilians do.86

  • Other barriers include rigid hierarchy and expectations to “be tough” and “suck it up” (i.e., “warrior identity”).86

  • A positive: Veterans have access to occupational resources that civilians do not including integrated healthcare services through the Veterans Health Administration (VHA).

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