An Ounce of Prevention for Sexual Violence
April is Sexual Assault Awareness Month, a time to recognize and address the public health consequences of sexual violence on individuals and communities. Responding to sexual violence and lessening its impact on communities often requires the coordination and collaboration of state agencies. To facilitate these collaborative efforts, Minnesota recently created a position to coordinate sexual violence activities across state agencies and make “recommendations for changes to laws relating to domestic violence and sexual assault prevention.” In addition, several states, including Alaska, Kentucky, Michigan, New Jersey, and Oregon, established legislative or executive advisory councils to develop legislative recommendations to combat sexual violence. The members of the advisory councils often represent multiple branches of government, as well as the public. Leadership from public health, social services, public safety, the attorney general, and corrections departments often represent the executive branch. Legislative members often serve on the committees that authorize the programs or appropriate funds to prevent sexual violence. The judicial system is typically represented by judges, prosecutors, and victim-witness advocates. The public is represented by state advocacy organizations, survivors of violence, and academics or practitioners who have expertise in violence prevention.
It is estimated that approximately 19.3 percent of women and 1.7 percent of men are raped during their lifetime, and the negative impact of sexual violence on the health and well-being of individuals, families, and communities is even more extensive when taking into account costs to the criminal justice and healthcare systems, workplace absenteeism, and the heighted risk for further victimization. The root causes of sexual violence are multi-faceted and include unsupportive family and community environments, ready access to drugs and alcohol, and social norms that disempower women and girls. Public health solutions must be responsive to that complexity. While providing support and services to those impacted by sexual violence remains a priority, effective primary prevention interventions should focus on preventing sexual violence from happening at all.
Critical to primary prevention strategies for sexual violence is strengthening protective factors and reducing risk factors at the societal, community, and individual levels. Protective factors, such as coordination of resources across community and social services programs, as well as strong community connectedness, make it less likely that an individual will experience violence and increase resilience in the face of violence. Risk factors, such as substance abuse and a history of family conflict, make it more likely that an individual will experience or perpetuate violent acts. CDC released a report, “Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence,” which identifies shared risk and protective factors to help health departments, advocates, and policymakers develop coordinated and integrated responses to multiple forms of violence across the lifespan. Some state health departments, such as the Minnesota Department of Health, are already leveraging the shared risk framework to identify new partners and advocate for cross-cutting programs, funding, and policy changes across government agencies to elevate sexual violence prevention. Addressing sexual violence through this lens is beneficial, in that many of the factors cut across violence prevention initiatives, including child and elder abuse, bullying, inter-personal violence, and suicide.
Risk and protective factors are broad concepts, ranging from cultural norms that support aggression and commitment to education, making it a challenge to translate them into specific policies and interventions. CDC recently released a report, entitled “Stop SV: A Technical Package to Prevent Sexual Violence,” which helps fill the gap by identifying actionable strategies with evidence to support their effectiveness. The strategies spell out STOP SV (i.e., sexual violence):
- S: Promote social norms that protect against violence
- T: Teach skills to prevent sexual violence
- O: Provide opportunities to empower and support girls and women
- P: create protective environments
- SV: Support victims/survivors to lessen harms
For each strategy, Stop SV includes several approaches, such as training bystanders, improving educational curriculums and employment opportunities, as well as addressing community-level risks through environmental approaches. A key thread running through all of the strategies is the need to engage across sectors and governmental agencies, as well as prioritize approaches that work for a given state and population. In addition, CDC released a tool, Applying Science. Advancing Practice (ASAP), which uses rapid synthesis and translation processes to bring together violence prevention practitioners and researchers. This six-step process structures systematic communication between researchers and practitioners through all phases of the research process. By fostering this collaboration from the beginning of the research process, ASAP products and tools bring the most recent evidence to practitioners, include those at state health departments, in ways they can immediately apply to their work.
States can also learn sexual violence prevention strategies from each other. ASTHO’s updated guide, “Preventing Injuries and Violence,” provides state health agencies with data and examples of innovative programs to reduce the burden of sexual violence. In addition, ASTHO is providing targeted technical assistance and capacity building to six states to strengthen public health leadership and infrastructure to elevate sexual violence prevention as a public health issue. As part of this project, the Safe States Alliance produced stories from the field highlighting the work and progress of 20 states in preventing sexual violence. This year’s theme for Sexual Assault Awareness Month is Engaging New Voices, and while not a new voice, state and territorial health departments certainly provide essential leadership when it comes to developing and implementing interventions to prevent sexual violence, as well as aligning the efforts of vital partners, including public safety, education, housing, faith-based leaders, businesses, non-profits, and other advocates, to help accomplish this important work.