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Alaskan women face a much higher risk of homicide than women nationwide. Non-native Alaskan women are killed 1.5 times more often (6.2 per 100,000) than the national average (4.2 per 100,000) according to the University of Alaska Anchorage’s Institute of Social and Economic Research. Native women are killed 4.5 times more often (19.1 per 100,000). In 1990, 50% of female murder victims in Alaska were killed by their husbands or boyfriends. In 1995, 80% of homicides in Alaska were related to domestic violence. In 1994, 4 of the 16 domestic violence related deaths in Alaska were children. The public health impact of domestic violence is compounded by the fact that the violence escalates in frequency and severity. Three-fourths of the women who are injured once continue to experience ongoing abuse. Without appropriate interventions, these women are at high risk of developing serious, complex medical and psychosocial problems, including suicide attempts. A recent study found that 12% of female emergency department patients with a current male partner were recent victims of domestic violence. Battered women come in contact with other medical settings, including pre-hospital care providers, primary or ambulatory care centers, psychiatric services, and prenatal care. The Pregnancy Risk Assessment Monitoring System (PRAMS) data for 1991 to 1994 revealed that 13% of women, who had recently given birth, had been physically hurt by someone close to them before or during pregnancy. Regardless of the health care setting, the traditional medical response to battered women has been to treat the presenting medical injury or illness without addressing the violence that may be at the root of the problem. The cost of battering to the survivor, her children, the batterer, the health care system, criminal justice system, and society is staggering. Women who are abused have a much higher rate of alcohol and drug abuse, depression, suicide, anxiety, and miscarriage. The cost to children is both immediate and cumulative, from emotional disturbance during childhood to re-enacting the violence during adolescence and adulthood. Finally, the cost to the batterer is also significant, including employment problems, alcohol and drug abuse, homicide, arrests, fines and imprisonment. The cost to the community includes lost wages, sick leave, non-productivity, and absenteeism.
While financial costs may seem calculating, the emotional costs of domestic violence are immeasurable. Communities, like individuals, experience a collective loss of safety when domestic violence occurs and is not addressed. Individuals and communities experiencing and accepting domestic violence as a way of life become increasingly isolated. Domestic violence is not an isolated, individual event, but rather a pattern of batterer behaviors used against a victim. The pattern is typically a variety of abusive acts, occurring more than once over the course of the relationship. The battering episodes can take many forms and last a few minutes to several hours or days. Some batterers will repeat a particular set of abusive acts, while others will use a wide variety with no pattern. Each episode is connected to the others. One battering episode builds on past episodes and sets the stage for future episodes. Some behaviors are crimes in most states (e.g., physical assaults, sexual assault, menacing, arson, kidnapping, harassment) while other behaviors are not illegal (e.g., name calling, interrogating children, denying the victim access to the family car). All parts of the pattern interact with each other and can have profound physical and emotional effects on victims. The battering behaviors take different forms: physical, sexual, psychological, and economic. In the first two behaviors, the batterer has direct contact with victim’s body. The other categories involve tactics where the batterer has no direct contact with the victim’s body although the victim is clearly the target of the abuse.
Physical Assaults
Physical abuse may include spitting, scratching, biting, grabbing, shaking, shoving, pushing, restraining, throwing, twisting, slapping (with open or closed hand), punching, choking, burning, and/or use of weapons (e.g., household objects, knives, guns) against the victim. These assaults may or may not cause injury. Sometimes a seemingly less serious type of physical abuse, such as a shove or push, can result in the most serious injury. The batterer may push the victim against a wall, down a flight of stairs, or out of a moving car, all of which could result in varying degrees of trauma.
Sexual Assaults
Some batterers sexually batter their victims. Sexual assault consists of a wide range of conduct that may include pressured sex when the victim does not want sex, coerced sex by manipulation or threat, physically forced sex, or sexual assault accompanied by violence. Victims may be coerced or forced to perform a kind of sex they do not want (e.g., sex with third parties, physically painful sex, sexual activity they find offensive, verbal degradation during sex, viewing sexually violent material) or at a time when they do not want it (e.g., when exhausted, when ill, in front of children, after a physical attack, when asleep). Some batterers attack their victim’s genitals with blows or weapons. Some deny victims contraception or protection against sexually transmitted diseases. The message to the victims is that they have no say over their own bodies. Some victims will find this difficult to discuss and other victims are unsure whether this sexual behavior is really abuse, while other victims see it as the ultimate betrayal.
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