CDC: National Intimate Partner and Sexual Violence Survey

CDC’s National Intimate Partner and Sexual Violence Survey (NISVS) is an ongoing, nationally-representative telephone survey that collects detailed information on sexual violence, stalking, and intimate partner violence victimization of adult women and men in the United States. The survey collects data on past-year experiences of violence as well as lifetime experiences of violence. The 2010 survey is the first year of the survey and provides baseline data that will be used to track trends in sexual violence, stalking and intimate partner violence. CDC developed NISVS to better describe and monitor the magnitude of these forms of violence in the United States.

Highlights of 2010 Findings

Sexual violence, stalking, and intimate partner violence are widespread in the United States. The findings in this report underscore the heavy toll of this violence, the immediate impacts of victimization, and the lifelong health consequences.

Women are disproportionally affected by sexual violence, intimate partner violence and stalking.

• 1.3 million women were raped during the year preceding the survey.
• Nearly 1 in 5 women have been raped in their lifetime while 1 in 71 men have been raped in their lifetime.
• 1 in 6 women have been stalked during their lifetime. 1 in 19 men have experienced stalking in their lifetime.
• 1 in 4 women have been the victim of severe physical violence by an intimate partner while 1 in 7 men experienced severe physical violence by an intimate partner.
• 81% of women who experienced rape, stalking or physical violence by an intimate partner reported significant short or long term impacts related to the violence experienced in this relationship such as Post-Traumatic Stress Disorder (PTSD) symptoms and injury while 35% of men report such impacts of their experiences.
• Women who had experienced rape or stalking by any perpetrator or physical violence by an intimate partner in their lifetime were more likely than women who did not experience these forms of violence to report having asthma, diabetes, and irritable bowel syndrome.
• Men and women who experienced these forms of violence were more likely to report frequent headaches, chronic pain, difficulty with sleeping, activity limitations, poor physical health and poor mental health than men and women who did not experience these forms of violence.

Female victims of intimate partner violence experienced different patterns of violence than male victims.

• Female victims experienced multiple forms of these types of violence; male victims most often experienced physical violence.

The majority of this victimization starts early in life.

• Approximately 80% of female victims experienced their first rape before the age of 25 and almost half experienced the first rape before age 18 (30% between 11-17 years old and 12% at or before the age of 10).
• About 35% of women who were raped as minors were also raped as adults compared to 14% of women without an early rape history.
• 28% of male victims of rape were first raped when they were 10 years old or younger.
  

 Summary
Overall, lifetime and one year estimates for sexual violence, stalking and intimate partner violence were alarmingly high for adult Americans; with IPV alone affecting more than 12 million people each year. Women
are disproportionately impacted. They experienced high rates of severe intimate partner violence, rape and
stalking, and long-term chronic disease and other health impacts such as PTSD symptoms. NISVS also shows that most rape and IPV is first experienced before age 24, highlighting the importance of preventing this violence before it occurs to ensure that all people can live life to their fullest potential.

CDC: Child abuse and neglect cost the United States $124 billion

For Immediate Release: February 1, 2012
Contact :CDC Division of News and Electronic Media
(404) 639-3286

Rivals cost of other high profile public health problems

The total lifetime estimated financial costs associated with just one year of confirmed cases of child maltreatment (physical abuse, sexual abuse, psychological abuse and neglect) is approximately $124 billion, according to a report released by the Centers for Disease Control and Prevention, published in Child Abuse and Neglect, The International Journal.

This study looked at confirmed child maltreatment cases, 1,740 fatal and 579,000 non–fatal, for a 12–month period. The lifetime cost for each victim of child maltreatment who lived was $210,012, which is comparable to other costly health conditions, such as stroke with a lifetime cost per person estimated at $159,846 or type 2 diabetes, which is estimated between $181,000 and $253,000.  The costs of each death due to child maltreatment are even higher.

“No child should ever be the victim of abuse or neglect – nor do they have to be.  The human and financial costs can be prevented through prevention of child maltreatment,” said Linda C. Degutis, Dr.P.H., M.S.N., director of CDC′s National Center for Injury Prevention and Control.

Child maltreatment has been shown to have many negative effects on survivors, including poorer health, social and emotional difficulties, and decreased economic productivity.  This CDC study found these negative effects over a survivor′s lifetime generate many costs that impact the nation′s health care, education, criminal justice and welfare systems. 
Key findings:

• The estimated average lifetime cost per victim of nonfatal child maltreatment includes:
• $32,648 in childhood health care costs
• $10,530 in adult medical costs
• $144,360 in productivity losses
• $7,728 in child welfare costs
• $6,747 in criminal justice costs
• $7,999 in special education costs

• The estimated average lifetime cost per death includes:
• $14,100 in medical costs
• $1,258,800 in productivity losses

Child maltreatment can also be linked to many emotional, behavioral, and physical health problems. Associated emotional and behavioral problems include aggression, conduct disorder, delinquency, antisocial behavior, substance abuse, intimate partner violence, teenage pregnancy, anxiety, depression, and suicide.
Past research suggests that child maltreatment is a complicated problem, and so its solutions cannot be simple. An individual parent or caregiver′s behavior is influenced by a range inter–related factors such as how they were raised, their parenting skills, the level of stress in their life, and the living conditions in their community.  Because of this complexity, it is critical to invest in effective strategies that touch on all sectors of society. 

“Federal, state, and local public health agencies as well as policymakers must advance the awareness of the lifetime economic impact of child maltreatment and take immediate action with the same momentum and intensity dedicated to other high profile public health problems –in order to save lives, protect the public′s health, and save money,” said Dr. Degutis.

Several programs have demonstrated reductions in child maltreatment and have great potential to reduce the human and economic toll on our society.  Several examples of effective programs include:

• Nurse–Family Partnership, an evidence–based community health program. Partners a registered nurse with a first–time mother during pregnancy and continues through the child′s second birthday.   http://www.nursefamilypartnership.org/
• Early Start, provides coordinated, family–centered system of services:  http://www.dds.ca.gov/earlystart/ California′s response to federal legislation providing early intervention services to infant and toddlers with disabilities and their families.
• Triple P, a multilevel parenting and family support system: http://www.triplep–america.com/ Aims to prevent severe emotional and behavioral disturbances in children by promoting positive and nurturing relationships between parent and child.

The article, "The economic burden of child maltreatment in the United States and implications for prevention," is available at http://www.sciencedirect.com/science/journal/aip/01452134.

CDC′s Injury Center works to prevent injuries and violence and their adverse health consequences.  For more information on public health child maltreatment prevention activities and research, please visit http://www.cdc.gov/ViolencePrevention/childmaltreatment.

If you know or suspect a child is being abused, contact the National Child Abuse Hotline at 1–800–4–A–CHILD or visit the Childhelp website.

CDC Awards $7M to Prevent Teen Dating Violence

Did you know? 
In a nationwide survey of students in grades 9-12, nearly one in 10 students reported being hit or physically hurt on purpose by a boyfriend or girlfriend at least once in the past 12 months. 
 
What is CDC doing to prevent teen dating violence?
On September 13th, Vice President Biden announced the Centers for Disease Control and Prevention (CDC) awarded grants for its new teen dating violence prevention initiative, Dating Matters™: Strategies to Promote Healthy Teen Relationships. The funding will aid local health departments in leading their communities in developing, implementing, and evaluating a comprehensive approach to prevent teen dating violence before it starts. The grant is expected to cover five years of teen dating violence prevention program activities in the following cities:

• Baltimore, Maryland
• Ft. Lauderdale, Florida
• Chicago, Illinois
• Oakland/Hayward, California

CDC developed the initiative to respond to the serious public health issue of teen dating violence. The roll-out of the initiative will help CDC examine the cost, feasibility, sustainability, and effectiveness of a comprehensive approach to prevent teen dating violence in four high-risk urban communities. 
 
Learn More

• Learn more about CDC’s Dating Matters Initiative
• Visit CDC's Violence Prevention web site.
• Learn about Vice President’s Biden Efforts to End Violence Against Women.
• Contact DatingMatters@cdc.gov for more information. 

Centers for Disease Control and Prevention (CDC) Releases Latest Data on Deaths

“Surveillance for Violent Deaths — National Violent Death Reporting System, 16 States, 2008,” appears in the August 26, 2011 online edition of Morbidity and Mortality Weekly Report Surveillance Summaries (MMWR). 

 

Report Highlights:

The new report compiled data on 16,138 deaths in 2008 from 16 NVDRS states. A majority of these deaths were:

• Suicides (58.7%)
• Homicide/legal intervention deaths (26.4%)
• Deaths of undetermined intent (14.5%)

NVDRS provides a comprehensive picture by combining once fragmented pieces of information from:

• Death certificates
• Coroner/medical examiner reports
• Toxicology results
• Law enforcement reports
• And other reports related to each death

Data are used to inform prevention efforts by providing a more complete understanding of the circumstances preceding deaths in these 16 states.

To Learn More:

• View an electronic copy of this document.
• Data from the NVDRS states is available online through WISQARS™ (Web-based Injury Statistics Query and Reporting System)
• About CDC’s violence prevention efforts: www.cdc.gov/violenceprevention
• Follow the CDC on Facebook: www.facebook.com/vetoviolence

ABSTRACT

HOMICIDE PATTERNS

"Escalated interpersonal conflicts with an intimate partner, a friend, or another acquaintance remained the primary preceding circumstances for homicide. These circumstances were vastly more common than random acts of violence, hate crimes, or drive by shootings. For incidents with male victims, arguments with an acquaintance other than an intimate partner most often preceded homicide. Homicides with female victims were most often a result of intimate partner violence. Similar findings were provided in previous reports and studies (7--9,21). These findings provide more evidence that homicides are most commonly perpetrated by someone known to the victim, and strategies designed to reduce interpersonal and relationship conflicts might be valuable for prevention efforts.

Homicide-followed-by-suicide (i.e., homicide-suicide) incidents continued to be rare in 2008. However, they did account for the greatest proportion of violent incidents that involved multiple deaths. Similar to other reports and previous data years, perpetrators of homicide-suicide incidents were mostly white males of mid-late adulthood (i.e., aged 35--54 years) and victims were mostly females who were either current of former intimate partners of the perpetrator (21,23,24). As expected, intimate partner problems were among the most common circumstances preceding these incidents (7--9,21); however, job/financial problems and mental health problems were two to three times more common among perpetrators in 2008 versus those in 2007.  

PREVENTION OPPORTUNITIES

NVDRS continues to show that interpersonal conflicts and relationship problems, particularly with an intimate partner, are common circumstances preceding a violent event.

 In addition to demonstrating the need to address the situational stressors highlighted in this report, prevention strategies also need to focus on community level factors. For example, changing cultural and social norms (e.g., attitudes condoning the use of violence as a means of resolving conflict) and addressing the social and economic conditions within communities that often give rise to violence (e.g., inequities with regard to the distribution of and access to resources and opportunities, social isolation and lack of connectedness among persons, families, and communities) might further help prevent violence.

CONCLUSION

Accurate, timely, and comprehensive surveillance data can be used to monitor the occurrence of violence-related fatal injuries and assist public health and other authorities in the development, implementation, and evaluation of programs and policies that reduce and prevent violent deaths and injuries at the national, state, and local levels (36,37). Continued development and expansion of NVDRS is critical to the public health and criminal justice communities at the federal, state, and local levels that work to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states participating in NVDRS, with the ultimate goal of full national representation, including all 50 states, the District of Columbia, and U.S. territories. 

CIRCUMSTANCES - Circumstances preceding fatal injury, by manner of death --- National Violent Death Reporting System, 16 states, 2008 (ABSTRACTED)

SUICIDE/UNDETERMINED

• Intimate partner problem: problems with a current or former intimate partner that appear to have contributed to the suicide.
• Other legal problem: decedent was facing civil legal problems (e.g., a child custody or civil lawsuit).
• Perpetrator of interpersonal violence in previous month: decedent perpetrated interpersonal violence (e.g., being sought by police for assault or having been issued a restraining order resulting from recent violence) during the previous month.
• Victim of interpersonal violence in previous month: decedent was the target of interpersonal violence in the past month.

 HOMICIDE

• Other argument, abuse, conflict: conflict between decedent and suspect was over something other than money, property, or drugs.
• Jealousy ("lovers' triangle"): jealousy or distress over an intimate partner's relationship or suspected relationship with another person led to the homicide.
• Intimate-partner violence--related: homicide is related to conflict between current or former intimate partners; includes the death of actual intimate partners and nonintimate partner decedents killed to cause pain to an intimate partner (e.g., child or parent).

Key STATS - Suicides

30.9% - Intimate Partner Problem - 32.2% of Males and 25.9% Females who commit suicide.

27.9% - Crisis in past or impending 2 weeks - 29% Males and 24% Females

74.6% - Depression - 74.2% Males and 75.4 Females

9.3% - Anxiety - 8.4% Males and 11.4% Female

1.6% - PTSD

KEY STATS - Homicides

22.9% Married

10.2% Spouse/Intimate partner (current or former)

.8% Other intimate partner involvement

18.1% Females Age 35-44

18.7% Males Age 20-24

53.5% Black, Non-hispanic Males

50.7% White Females

52.2% Mudered at home

18.4% Intimate partner-violence-related - 7.6% Males and 51.6% Females

24.3% Assault/Homicide

KEY STATS - Undetermined Death

11.1% Intimate partner problem 

14.7% Crisis in past or impending 2 weeks

To see entire report, please visit the CDC's website.

CDC: Majority of U.S. adults had troubled childhoods

USA TODAY
Updated 12/17/2010 8:18 PM

By Steven Reinberg HealthDay

 

Almost 60% of American adults say they had difficult childhoods featuring abusive or troubled family members or parents who were absent due to separation or divorce, federal health officials report.

 

In fact, nearly 9% said that while growing up they underwent five or more "adverse childhood experiences" ranging from verbal, physical or sexual abuse to family dysfunction such as domestic violence, drug or alcohol abuse, or the absence of a parent, according to the U.S. Centers for Disease Control and Prevention (CDC).

"Adverse childhood experiences are common," said study coauthor Valerie J. Edwards, team lead for the Adverse Childhood Experiences Team at CDC's National Center for Chronic Disease Prevention and Health Promotion. "We need to do a lot more to protect children and help families," she said.

About a quarter of the more than 26,000 adults surveyed reported experiencing verbal abuse as children, nearly 15% had been physical abused, and more than 12% — more than one in 10 — had been sexually abused as a child.

Since the data are self-reported, Edwards believes that the real extent of child abuse may be still greater. "There is a tendency to under-report rather than over-report," she said.

The findings are published in the Dec. 17 issue of the CDC's journal Morbidity and Mortality Weekly Report.

For the report, researchers used data from the Behavioral Risk Factor Surveillance System, which surveyed 26,229 adults in Arkansas, Louisiana, New Mexico, Tennessee and Washington. Edwards is cautious about extrapolating these results, but based on other data they probably are about the same in other states, she said.

While there were few racial or ethnic differences in reports of abuse, the report confirmed that women were more likely than men to have been sexually abused as children. In addition, people 55 and older were less likely to report being abused as a child compared to younger adults.

One theory why older people did not report as much childhood abuse is that since these takes a toll on health in adulthood, many of these older abuse victims may have died early, Edwards said. The CDC report, for example, notes that adverse childhood experiences are associated with a higher risk of depression, heart disease, diabetes, cancer, substance abuse and premature death. "So (childhood abuse) may be associated with years of life lost," she said.

There was no difference in the number of people reporting childhood abuse in any other age group, Edwards added.

Adverse childhood experiences included in the report included verbal abuse, physical abuse, sexual abuse, incarceration of a family member, family mental illness, family substance abuse, domestic violence and divorce.

According to the report, about 7.2% had had a family member in prison during their childhood and 16.3% had witnessed domestic violence in the family home. In addition, about 29% grew up in a home where someone abused alcohol or drugs. "These cases occur across all racial groups and ethnicities," Edwards noted.

Almost one in five respondents (19.4 percent) had lived as a child with someone who was depressed, mentally ill or suicidal, the report noted.

Although the volume of abuse and dysfunction is significant, such traumatic experiences cannot be used to describe a person or determine what that person will be, the researchers cautioned. Instead, they said, keeping track of these abusive experiences is important to gain a better understanding of them and their effect on society.

In addition, it's crucial to work harder to prevent abuse and household stress as well as finding better ways to identify and treat children at risk, they said.

"For adults who have had these experiences and feel they are still causing them problems, they are not alone and there is help available," Edwards said.

Dr. Lee M. Sanders, an associate professor of pediatrics at the University of Miami Miller School of Medicine said that "one of the things we don't realize when we look around at our neighborhoods and communities is that these problems are so common."

"That's something to be concerned about. That's something to take communal action on," he added.

Identifying and treating abuse early can prevent many serious health consequences later in life. Programs that provide quality care for children, as well as home visitation programs in early infancy and parenting programs, are part of the solution to this problem, Sanders said.

"These interventions are important not just because abuse is so common, but because of the lifelong health implications," Sanders said. "There is a connection of these events to lifelong implications, not just for mental health for adults, but also for physical health."

For example, a person who has several of these events is more likely to get cancer and heart disease, Edwards said. "This is serious and it's not just a quirk of statistics. It's a real relationship."

CDC Report: Adverse Childhood Experiences Reported by Adults

Adverse childhood experiences (ACEs) include verbal, physical, or sexual abuse as well as family dysfunction (an incarcerated, mentally ill, or substance-abusing family member, domestic violence, and absence of a parent due to divorce or separation).

Adverse Childhood Experiences (ACEs) have been linked to a wide range of health outcomes in adulthood including substance abuse, depression, cardiovascular disease, diabetes, cancer, and premature mortality.


Using the 2009 ACE module of the Behavioral Risk Factor Surveillance System (BRFSS) to examine whether a history of ACEs was common, 26,229 adults were interviewed in 5 states- Arkansas, Louisiana, New Mexico, Tennessee, and Washington. The MMWR report on ACEs among U.S. adults summarizes the results of that analysis. The module consisted of 11 questions that yielded 8 categories of ACEs (verbal abuse, physical abuse, sexual abuse, household mental illness, household substance abuse, domestic violence, parental separation/divorce and incarcerated family members). Respondents were asked to refer to the time period before they were 18 years of age when answering questions.


Overall, 59.4% of respondents reported having had at least one ACE while 8.7% reported five or more ACEs. Given the high prevalence of ACEs, additional efforts are needed at the state and local level to reduce and prevent childhood maltreatment and associated family dysfunction in the US, and further the development and dissemination of trauma-focused services to treat stress-related health outcomes associated with ACEs.
The most common ACEs were:

• Separated or divorced parents
• Verbal abuse
• Family member with depression or mental illness
• Witness of domestic violence
• Physical abuse
• Sexual abuse

Differences by gender

Men and women reported similar prevalence for having grown up with a mentally ill household member (22.0% for women, 16.7% for men) and growing up with a substance-abusing family member (30.6% for women, 27.5% for men). A difference between men and women was observed in the ACE category of sexual abuse, where women reported more than twice as many experiences as men (17.2% for women, 6.7% for men).

Differences by race/ethnicity

Black, non-Hispanic respondents had the lowest prevalence of each ACE category among all racial-ethnic groups. However, compared to all racial-ethnic groups Black non-Hispanics reported higher prevalence of having had an incarcerated family member (12.9%) and experiencing parental divorce (37.9%). Compared to Whites, Hispanics more frequently reported physical abuse (14.6% for Whites, 19.8% for Hispanics), witnessing domestic violence (15.1% for Whites, 21.7% for Hispanics), and having an incarcerated family member (6.2% for Whites, 9.5% for Hispanics).


These findings reinforce that adverse childhood experiences are common across racial/ethnic groups and states, further reinforcing the need to expand evidence-based child abuse prevention programs such as home visiting and parent education.

Data Source

CDC. Adverse Childhood Experiences Reported by Adults — Five States, 2009. MMWR 59(49);1609-1613.

More Information

• Academy on Violence and Abuse
• Adverse Childhood Experiences Study
• American Professional Society on the Abuse of Children
• American Psychological Association Trauma Psychology Division
• Childhood Maltreatment Prevention
• Legacy for Children™
• National Clearinghouse on Child Abuse and Neglect Information
• Preventing Child Maltreatment: Program Activities Guide

STRYVE to Prevent Youth Violence

From:  CDC's National Center for Injury Prevention and Control.   

Youth violence is preventable. Learn how STRYVE helps communities build comprehensive strategies that are based on the best available evidence and implemented through multisector action.  

STRYVE, or Striving To Reduce Youth Violence Everywhere, is a national initiative led by the Centers for Disease Control and Prevention (CDC) to prevent youth violence before it starts. 

STRYVE provides community tools through mechanisms such as STRYVE Online. STRYVE Online offers community leaders and others working to prevent youth violence

• Effective strategies based upon the best available evidence;
• Training and technical assistance;
• Online community workspaces; and
• Connections to other communities.

More Information

• STRYVE to Prevent Youth Violence
• STRYVE Online
• Violence Prevention

Cost of Injury and Violence in the United States

from CDC's National Center for Injury Prevention and Control. 

 CDC's Injury Center is pleased to announce the release of the new WISQARS^TM (Web-based Injury Statistics Query and Reporting System) Cost of Injury Reports.* 
 

WISQARS™ data can be used to learn more about the public health and economic burden associated with unintentional injury and violence-related injury in the United States.
 
The Cost of Injury Reports module provides cost estimates for injury deaths, hospitalizations, and emergency department visits where the patient was treated and released. 
 
The new module allows users to create reports of: medical costs (e.g., treatment and rehabilitation), work loss costs (e.g., lost wages, fringe benefits, and self-reported household services), and combined costs (medical plus work loss) based on a number of variables including: intent and mechanism (cause) of injury, body region and diagnosis of injury, geographic location (for deaths only), sex, and age.

 
Learn More

• Cost of Injury Reports Module
• About Cost of Injury Reports
• WISQARS^TM

* WISQARS^TM Cost of Injury Reports are based on lifetime medical and lifetime work loss costs in 2005. This was the most recent year of unit cost data available at the time the module was developed. NCIPC plans to update these estimates to more recent years in the future.

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