USA TODAY US Edition

‘Code of silence’ stifles abuse victims

Domestic violence shows no sign of slowing down

- Lewter and Lozano are fellows in the Urban Health Media Project, which O’Donnell co-founded. Contributi­ng: UHMP intern Katherine Gilyard Jayne O’Donnell, Sierra Lewter and Karla Lozano

WASHINGTON – L.Y. Marlow remembers the night two years ago like it was last night.

Her daughter called screaming that her boyfriend was “busting her head against the bathtub,” said Marlow. “‘Mom, he’s going to kill me!’ ” And then, the phone went dead.”

Her daughter lived, but it was only the latest violent assault the five generation­s of women in Marlow’s family had endured.

The recent domestic violence news involving now-former White House aides thrust abuse back into the spotlight. This time, however, Marlow is determined it won’t fade away as it has in the decade since she founded the nonprofit Saving Promise.

1 in 3 women will be a victim

One in three women experience domestic or dating violence in their lifetimes, according to the Centers for Disease Control and Prevention, and the vast majority of the victims are women harmed by men.

The numbers show no sign of abating despite advances including the domestic violence screenings required covered under the Affordable Care Act (ACA) along with considerab­le research on the effect exposure to domestic violence has on children’s overall health and how it increases the chance they will become victims or perpetrato­rs.

In 2013, about a quarter of women ages 18-44 said a doctor or other health care provider had talked to them about domestic violence in the previous three years, according to a Kaiser Family Foundation (KFF) survey. A preliminar­y analysis of the 2017 Kaiser Women’s Health survey shows the numbers have barely budged since 2013, which means rates “fall far short” of recommende­d screening levels for women of reproducti­ve age, said Alina Salganicof­f, KFF’s vice president for women’s health policy.

Kaiser Permanente, which is unaffiliat­ed with KFF, has been screening for intimate partner violence, providing mental health counseling and safety planning, and linking victims to services for almost 20 years.

Marlow recently partnered with Harvard University’s T.H. Chan School of Public Health on a research project called the “Learning Laboratory” to develop strategies and policies to prevent domestic violence, such as how to get men and boys involved in the solutions.

“It is the very definition of a public health problem,” Michelle Williams, dean of Harvard’s school of public health, said of domestic violence.

Screening efforts have stalled, she said, because doctors and hospitals “weren’t given the tools and training to do something,” said Williams. She hopes the new Harvard Learning Lab will be able to create the tools doctors need to make a difference.

It’s critical that physicians recognize the effect of such trauma, one of the 10 adverse childhood experience­s (ACEs) in children’s lives that are closely linked to poor health, said Surgeon General Jerome Adams. “It’s about asking, ‘ What happened to you?’ Instead of asking: ‘What’s wrong with you?’ ” he said.

If children watch their parents be abused while growing up, Adams said, “it instills in you the idea that it’s OK, that this is a proper way to interact.”

“We have to get almost indignant about violence in the family and not justify it in any way,” said Rep. Ted Poe, a Texas Republican who worked on domestic violence as a prosecutor and criminal court judge in Houston before joining Congress.

Some of the needed changes will be around changing cultural norms, said Sarah DeGue, a clinical psychologi­st at the CDC. Parents, peers and mass media can all reinforce good or bad views of violence in relationsh­ips. In homes where violence is common, children might be- lieve “it can be productive and help them control their partner,” said DeGue.

Children exposed to domestic violence are more likely to suffer from problems including anxiety, depression, physical aggression and sleep issues, according to Erica Weiler-Timmins, a psychologi­st at the Milton Hershey School in Hershey, Pa. About a third of the students, who are all from low-income families, have been exposed to domestic violence.

Effect on black women

Domestic violence occurs more often in minority communitie­s, according to a CDC study. Forty-five percent of black women have been physically or sexually abused by intimate partners, compared to 37% of white women and 34% of Hispanic or Latina women, the CDC said. One in eight black women are abused by a family member, the CDC said.

A “code of silence” in the African-American community keeps many girls and women from reporting physical or sexual abuse, Marlow said. Families of- ten close ranks to protect the family’s income, she said, and believe that’s “just the way it is.”

Some of the silence links back to slavery and is worsened by lingering distrust of the medical community, said Octavia Sykes, an adolescent therapist at the Body Image Therapy Center in Baltimore.

This leads to feelings of guilt and unhealthy coping mechanisms such as drugs or alcohol abuse.

The wave of sexual-harassment allegation­s in the media and entertainm­ent world has focused almost exclusivel­y on white women, which has the potential to diminish the black voice on sexual violence even more because black women may feel like their tragedies don’t matter, Sykes said.

The machismo factor

The Hispanic community has its own challenges, buffeted by the tradition of “machismo” among Hispanic men, which can lead to aggression and abusive behavior toward the women in their lives, experts say. A “macho” male feels entitled to obedience from the men and women around him.

“Latino men believe you are the ‘king of your castle,’ and think, ‘I have the right to anything I see,’ including the women,” said Kristiana Huitròn, a sexual abuse survivor who is a project coordinato­r for the National Latina Network (NLN), which advocates against domestic violence.

Women who have been physically, emotionall­y or sexually abused may stay in a toxic environmen­t for economic stability, said Melanie Greenberg, a clinical psychologi­st based in Marin County, Calif.

“They’re afraid that the man of the house who provides for them will leave, and they won’t have any support,” she said.

Many Latinas “have grown up to always value family and to make sure it’s kept together,” Greenberg said.

“(Domestic violence) is the very definition of a public health problem.” Michelle Williams Dean of Harvard’s school of public health

 ??  ?? Michelle Williams
Michelle Williams
 ??  ?? Rep. Ted Poe, R-Texas USA TODAY
Rep. Ted Poe, R-Texas USA TODAY

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