Chapter 9 Domestic Violence (Supplement)

Statistical Overview

• The National Crime Victimization Survey estimates that in 1999, persons age twelve or older experienced 791,210 violent crimes by current or former spouses, boyfriends, and girlfriends. The majority of the crimes were against women: females within this group experienced 85% of the violent victimizations (BJS October 2001).

• Fourteen percent of female intimate partner victims were raped or sexually assaulted in 1999. Aggravated assault and robbery each accounted for 10% of intimate partner violence against females in 1999 (Ibid.).

• Intimate partner violence varies greatly based on the age of the victim. The overall intimate partner violence in 1999 per capita against women was 5.8 victimizations per 1,000, but among females aged sixteen to twenty-four the rate increased to 15.6 per 1,000 (Ibid.).

• African-American and Caucasian females experienced similar rates of intimate partner violence in 1999 in every age group except for ages twenty to twenty-four. In this age group, there were 29 intimate partner victimizations per 1,000 African-American women, and 20 per 1,000 Caucasian women (Ibid.).

• Intimate partners murdered 1,218 women in 1999. Women ages thirty-five to forty-nine were the most vulnerable to intimate murder (Ibid.).

Stalking and Domestic Violence

• In an analysis of the National Violence Against Women (NVAW) Survey, researchers Tjaden and Thoennes reported that contrary to common belief, only 23% of female victims were stalked by strangers. Thirty-eight percent of female stalking victims were stalked by current or former husbands, 10% by current or former cohabiting partners, and 14% by current or former boyfriends (Tjaden and Thoennes 2000).

• In the same report, 21% of the female victims said that the stalking occurred before the relationship ended; 43% said it occurred after the relationship ended; and 36% said it occurred both before and after the relationship ended (Ibid.).

• The NVAW Survey also demonstrated a strong relationship between stalking and other forms of intimate partner violence. Eighty-one percent of women stalked by current or former husbands, or cohabiting partner, were also physically assaulted by the same partner, and 31% were also sexually assaulted by the same partner. The study concluded that husbands or partners that stalk their partner are four times more likely than husbands and partners in the general population to physically assault their partners and six times more likely to sexually assault their partners (Ibid.).

• Of all pregnant women, 3.9% to 8.3% experience violence. This data suggests that violence may be a more common problem for pregnant women than pre-eclampsia and gestational diabetes, conditions for which pregnant women are routinely screened (Goodwin, et al. 2000).

Legislation

FINANCIAL SERVICES MODERNIZATION ACT OF 1999:
DOMESTIC VIOLENCE DISCRIMINATION PROHIBITION
Title III Section 47 (e), the Domestic Violence Discrimination Prohibition Section of the Financial Services Modernization Act that was enacted on November 12, 1999, amends the Federal Deposit Insurance Act to prohibit banks that sell insurance from denying coverage, terminating coverage, or raising the premiums on coverage of clients who are victims of domestic violence (P.L. 106-102).

Significant Court Ruling

UNITED STATES V. EMERSON
On October 18, 2001, the U.S. Fifth Circuit Court of Appeals upheld an important protection for victims of domestic violence. The court ruled in United States v. Emerson that the protection order gun ban law [18 U.S.C.922 (g) (8)] does not violate Second Amendment constitutional rights. Under the protective order gun ban, people who are subject to qualifying orders of protection are not allowed to purchase or carry guns. Emerson, who had repeatedly threatened to kill his wife and child, was under a protection order when he brandished a loaded pistol at her (270 F. 3d 203).

INTERNAL REVENUE SERVICE (IRS) IMPROVES SAFETY FOR DOMESTIC VIOLENCE VICTIMS
To ensure confidentiality of whereabouts of potential domestic violence victims who apply for "innocent spouse relief," the IRS has launched a new service. Tax law requires that a spouse with tax liability be notified of the request for relief under the innocent spouse relief rule. Until recently, the notification process that was handled by the local tax office of the applicant inadvertently revealed the community in which the victim resided. Applicants fearing retaliation have been unwilling to seek protection from their estranged spouse's tax liability. In consideration of the potential threats to spouses applying for relief, the IRS now requests that all applicants for innocent spouse relief who fear that domestic violence may result from filing should write "potential domestic abuse case" on their application (Form 8877) and should provide a brief explanation. The applications with this information are then forwarded to specially trained IRS employees who process the forms and deliver notification without revealing to the potentially abusive spouse the location of the applicant or the reference to potential abuse (NCADV 2002).

Research

INTIMATE PARTNER HOMICIDE AND PREGNANCY
Several studies in the last decade have examined the role of homicide in maternal mortality. Maternal mortality is defined as death during pregnancy or one year from end of pregnancy that is related to or caused by complications from the pregnancy. It excludes death from "accidental or incidental causes." Various issues with regard to data collection have been addressed by recent research. Many pregnancies ending in homicide go undetected: the victim's condition of pregnancy is not always recorded on the death certificate (only seventeen states currently request pregnancy status on death certificates), and the medical examiner may not detect the condition. Data collection on mortality among pregnant women has also been enhanced to capture more completely causes of death in this population. Studies in Maryland, North Carolina, New York, and Illinois have found that "homicide is the leading cause of death among pregnant or recently pregnant women" (Frye 2001).

For example, a new study published in the Journal of the American Medical Association explores the causes of death of women who died while pregnant or within a year of pregnancy (Horon and Cheng 2001). The study, "Enhanced Surveillance for Pregnancy Associated Mortality, Maryland 1993-1998" found that 20.2 percent of the deceased pregnant women examined were victims of homicide. As a baseline comparison, the study found the homicide rate among not-pregnant women aged fourteen to forty-four was 11.2 percent of the recorded deaths (Ibid.). In addition, a study in New York City that examined maternal deaths due to injury found that homicides made up 25 percent of the deaths among pregnant and recently pregnant women (Frye 2001).

In a JAMA editorial on this subject, Frye emphasizes that whether a women is pregnant or not, homicide is a leading killer of women of child-bearing age (See statistics at beginning of the chapter). "While pregnancy as an independent risk factor for lethal intimate partner violence is currently under investigation, thus far, research indicates that much of the violence that women experience during pregnancy is perpetrated by intimate partners, and that for some, partner violence begins during pregnancy" (Ibid.).

The strong correlation between homicide as a leading killer of women of child-bearing age, the rates of homicide among pregnant and recently pregnant women, and the rates of homicides perpetrated by intimate partners, indicates that those women who are pregnant or have recently reached the end of pregnancy may be at a higher risk for partner violence, which at times will be lethal. Many of the studies suggest that certain population subgroups are at increased risk. All of the studies indicate that efforts to prevent pregnancy-associated mortality should become a focal point among healthcare providers and domestic violence advocates who serve this population (Ibid.).

WELL-DOCUMENTED MEDICAL RECORDS HELP DOMESTIC VIOLENCE VICTIMS IN COURT
A National Institute of Justice study funded by the Violence Against Women Office has determined that healthcare providers can greatly assist victims of domestic violence in court proceedings by improving documentation of medical records. In Documenting Domestic Violence: How Health Care Providers Can Help Victims, researchers Isaac and Enos (September 2001), state that "the importance of documenting abuse is recognized" but "many medical records contain shortcomings that prevent their admissibility as evidence in court and other legal proceedings." There are many issues cited that limit the usefulness of medical records in court: the difficulty of obtaining the records, incomplete records, inaccurate records, and illegible records. Furthermore, healthcare providers are reluctant to testify in court, and while they are well-meaning, they are often confused "about whether and how to record information useful in legal proceedings." Many states allow parts of medical records relating to diagnosis and treatment to be admitted without the testimony of the physician, making it all the more important that documentation be comprehensive, specific, and legible.

The study found that healthcare providers can improve the documentation of factual information in several ways and made the following recommendations (Ibid.):

• Take photographs of the injuries known or believed to have been caused by domestic violence.

• Write clearly.

• Set off the patient's words in quotation marks and use such phrases as "patient states" to indicate the information recorded reflected the patient's words. Describe the offender and the event in the words of the patient, i.e., the patient said, "My husband kicked me in the stomach."

• Avoid such legalistic phrases as "patient claims" or "patient alleges" that cast doubt about the truth of the statements. Avoid terms such as "alleged perpetrator." If the healthcare providers observations differ from the patient's account of the victimization, state the reason for the difference.

• Do not summarize a patient's report in conclusive terms that lack the supporting factual information, i.e., "the patient is a battered woman" because it will render the report inadmissible. In the same theme, do not place the term "domestic violence" in the diagnosis section of the medical record, because it does not convey factual information and is not medical terminology.

• Describe the patient's demeanor, whether she is crying, shaking, angry, calm, laughing, or sad, even if it belies the evidence of abuse.

• Record the time of day of the examination and indicate whenever possible how much time has passed since the abuse.

The American Women's Medical Association (AWMA) has developed an online accredited course, in collaboration with materials developed by the Family Violence Prevention Fund, as part of their continuing education program for physicians, residents, medical students, and other healthcare providers on the nature and dynamics of domestic violence: screening and assessments, planning, referrals, legal aspects of domestic violence, problems associated with children who witness domestic violence, and problems with perpetrators. The AWMA considers the recognition, treatment, and prevention of domestic violence a top priority for the healthcare field.

TOOLKIT TO END VIOLENCE AGAINST WOMEN
The National Advisory Council on Violence Against Women with support from the Department of Justice and the Department of Health and Human Services has launched a Web-based resource to provide concrete guidance to communities to develop more effective programs to address violence against women. Designed in a friendly and accessible format by domestic violence, sexual assault, and stalking experts, the Toolkit offers recommendations for strengthening prevention efforts in communities and for improving services to crime victims. Each of the Toolkit chapters focuses on a specific audience, a specific environment or an aspect of the criminal justice system, community services, and allied professionals who support victims. On each subject, the Toolkit provides a checklist of actions to be taken, followed by a detailed explanation of purpose, guidance on how to accomplish recommended tasks and a list of national resources available for further inquiry. For further information contact Violence Against Women Office's Web site at http://www.justice.gov/ovw.