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Can we stop domestic violence? 

Advocates for battered women are going proactive by reframing family violence as a preventable public health problem. But for this hidden epidemic to be viewed the way we now view smoking or drunken driving, more money, research and attention are needed

Maj. Gary Blankenship doesn't fit the typical profile of a domestic violence survivor. For one thing, he's a man. For another, he's in law enforcement as Operations Commander for the Chatham County Sheriff's Department.

With his military bearing and close-cropped hair, Blankenship is the picture of brisk professionalism and control. Yet, here he is, at a panel discussion at a recent "Strong Men are Gentle Men" conference in Siler City, telling a story that's a world away from all of that.

It's a story that even few of Blankenship's colleagues have heard before, about a violent, alcoholic father who frequently beat his wife (she had broken fingers and toes from where he stomped on them) and years later, ended up dying a violent death himself. It's about a mother who, when her husband began to turn on her eldest son, decided to gather up her five kids and leave for good.

"I don't have very many fond memories of being a child," Blankenship says, leveling his gaze at the 30 other men in the audience while the hum of Spanish translation goes on in the background. "I just don't remember very many happy times. When we're exposed to violence like that, we think it's the norm. As a 6-year-old child, I didn't know any different from a father who would come home and beat my mother."

"So how did you avoid following your father's example?" the moderator asks.

"If it wasn't for my mother leaving and getting away, we could have grown up very different," says Blankenship, who wears a beribboned photograph of his mom on his lapel. "It took her nine years to get to that point. At a time in your life when you know right from wrong no matter what you're exposed to, I decided I did not want to be violent."

Like the moderator's query, the focus of the Siler City gathering this month was on prevention. A new community group, Men for Family Peace, organized the half-day conference as a way to encourage more men to start examining the causes of violence--and ways it can be stopped before it starts.

The local event fits into a larger patchwork-quilt of efforts to recast family violence as a public health problem that can be eliminated, not just "band-aided," as one agency director put it. North Carolina and the Triangle are leaders in this growing push, home to nationally recognized pilot programs and training centers.

Many battered women's advocates, who've spent years fighting for services for victims--as well as adequate punishments for abusers--are eager to shift into preventive gear because it holds out the promise of getting to a solution faster.

"This gives us a chance to be proactive instead of reactive," says Jo Ann Harris, coordinated community response specialist for the N.C. Coalition Against Domestic Violence, whose job is to spread the prevention message statewide. "And it allows us to reach out to a broader audience with our trainings, not just preaching to the choir."

The public health approach moves the beam of attention from individual victims and batterers to the larger community, Harris says. It focuses on educating people about beliefs and behaviors that lead to family violence--as well as those that keep it from happening. (Imagine public service ads on the sides of city buses touting healthy relationships, or parenting classes that discuss the effects of violent video games.)

"It means working with populations and teaching children at an early age," Harris says. "It means tracing things back to find out where people learn violent behavior and why it is that some people grow up in violent homes but don't choose violence."

The new approach uses science to target groups and settings where anti-violence strategies can be most effective. Pilot projects funded by the federal Centers for Disease Control and Prevention, for example, are aimed at children, men, adolescents and communities of color because research shows they are most at risk.

While still in the early stages, North Carolina's pilot programs follow along those lines. A major facet of Men for Family Peace's work has been reaching out to the Latino community. In Wilmington, Domestic Violence Shelter and Services has been conducting a survey of public attitudes toward gender roles and violence in the wake of some high-profile stalking and murder cases of local female college students.

In recent years, a combination of federal funding, advanced research, more media attention--and, in North Carolina, landmark legislation that mandates more anti-violence education in public schools--has helped move prevention to the front burner. Even state Attorney General Roy Cooper has called family violence an "epidemic that requires extraordinary remedies."

Perhaps even more important is the conviction that, despite important progress, existing remedies in criminal justice and social services haven't made enough of a dent.

"We're working so hard in crisis mode serving victims and it's not working in the bigger sense to reduce domestic violence," says Beth Froehling, public policy specialist for the N.C. Coalition Against Domestic Violence. "I think that's why there is more of a shift--what else can we do to break the cycle?"

While the rate of violent crime has been falling--including domestic crimes--thousands are still being killed and millions injured each year by "intimate partners." And women are the targets 95 percent of the time.

The national Violence Policy Center's latest rankings put North Carolina ninth in the nation in the rate of women murdered by men--the vast majority by men they knew. Last year, the state domestic violence coalition--currently the only organization that collects such data--logged 81 domestic violence-related homicides compared to 71 in 2003. Among them were women who died from being strangled, stabbed and beaten with a bat.

If family violence were considered a threat to public health, supporters of the new approach say, such statistics would galvanize the whole community, not just victims and their advocates.

"People have this idea that domestic violence is a women's issue," says Cutler Andrews, youth educator and outreach coordinator for the Orange County Rape Crisis Center, who spoke at the recent men's conference. "But everyone probably knows someone who's been affected."

More than any one model, experts say, the new push is about a mindset. "Public health redefines what is acceptable," says James Mercy, associate director for science at the CDC's Division of Violence Prevention, the locus of federal anti-violence efforts since its founding in 1994. "What we want to do is get to the tipping point where this behavior is unacceptable."

What does domestic violence work look like when viewed from a public health angle? On this rainy morning in south Raleigh, it looks like a training session in the basement of a Baptist church where the topic is the role that religious organizations can play in stopping battering and abuse. At long tables in the basement meeting room, clergy in dark suits mingle with crisis shelter workers in printed skirts and dangling earrings. They pray, take notes and brainstorm about ways to preach on the problem.

Herbert Lowry has come from Siler City, where he's pastor of Piney Grove/Hickory Grove United Methodist church and a member of Faith Partners for Family Peace--a working group organized by Chatham County's domestic violence outreach program.

For too long, Lowry says, religious leaders have avoided talking about the issue. "We've convinced ourselves that it doesn't happen in our congregations," he says. "But violence against any person isn't only illegal, it's a sin. So now we're trying to work on how we recognize and prevent it from going on."

Experts say such efforts at community "buy in" are one way the public health model differs from other anti-violence work. And unlike counseling batterers who have already lashed out or training emergency room doctors to recognize signs of abuse--work everyone agrees should continue--the new line of attack starts further back.

"We prevent people from getting sick by cleaning up dirty water. We prevent people from getting infectious diseases by giving them shots," says Stephen Orton, co-director of PREVENT, a national CDC-funded training program at UNC-Chapel Hill. "Now, we're trying to find out how you inoculate people for violence."

So far, it's too early for researchers to have identified any one vaccine. But Orton, whose program is housed at UNC's Injury Prevention Research Center, says battered women's organizations can draw inspiration from advances public health has made in curbing other seemingly intractable social ills. "If you look at the progress that's been made on these things that looked so hardwired into the culture, like drunken driving or smoking, there's been a major cultural shift," he says.

Marcia Owen knows something about what it takes to get there. As outreach coordinator for the Religious Coalition for a Nonviolent Durham, she's been working to convince community leaders that gun violence is a public health issue--with some success. Owen's group holds regular sidewalk vigils to draw attention to the number of gun deaths in the Bull City. Two years ago, the coalition cooperated on a study with the Injury Prevention Center that found victims of local shootings were overwhelmingly black and from neighborhoods in East Durham--research it hopes will steer more resources there.

For Owen, the light bulb went off some years ago at a workshop she attended in Chicago where public health experts likened the epidemic of street violence to polio.

"When you talk about it like that, it takes it out of the realm of politics or ideology and makes it everyone's problem," Owen says. "It becomes, 'We are going to find a cure for this disease that everyone will have access to.' It's about sharing with the public what we know about this issue that could be used to protect us."

Research has expanded what we know about family violence and its toll. Nationally, nearly 1,300 women are murdered each year by intimate partners and 1.5 million are raped or physically assaulted, according to the CDC. The agency puts the price tag for family violence in medical care, lost wages and poor productivity at $5.8 billion a year--a figures that doesn't include costs on the criminal justice side.

"And then there are the children..." says Kiersten Stewart, director of public policy for the California-based Family Violence Prevention Fund, letting her trailed-off sentence do the talking.

New studies are peeling back layers to show the onion-like complexity of the problem. For instance, the now widely accepted idea that kids from violent homes grow into violent adults has evolved into an understanding that children who witness violence in their homes are at risk for becoming either perpetrators or victims later on. But whether they do so or not depends on "protective factors" that help them avoid that threat--a loving parent, a mentor, maybe even a program on dating violence in school.

The same is true of the idea that family violence crosses all social lines. It's true, but it doesn't explain why the rates of "intimate partner violence" are higher for some groups than others. (Researchers still haven't found the answer to that one.)

And there are layers beneath the layers. While studies have found that African Americans and Native Americans have higher rates of family violence than whites, those differences shrink when socioeconomic status is added to the mix, suggesting that race may be less of a risk factor than class. Research has also revealed more about the triggers for family violence, including job losses and natural disasters, such as flooding after Hurricane Floyd (one study showed domestic abuse rates in Sampson County rose nearly 40 percent in the year after the storm).

Even without federal grants, battered women's organizations have been working to put new knowledge into practice--particularly with young people. Interact, a Raleigh nonprofit that runs a crisis shelter and other services for victims of domestic and sexual abuse, recently launched a pledge program to inspire high school athletes to speak out against violence--including dating violence if it comes up.

"We can use what they've seen on TV with the violence involving athletes," says Gene Hughes, one of two youth education specialists at Interact who do programs in Wake County schools. "This is a group of kids that can see themselves as having some influence."

In Chatham County, Family Violence and Rape Crisis Services has been offering anti-violence classes in public schools for nearly two decades. A recent session at Northwood High School in Pittsboro was a sophisticated "media literacy" primer, where students analyzed images from magazine ads, movies and music videos to explore how gender roles are linked to violence against women.

What's needed now, advocates for battered women say, is a more concerted push, one where domestic violence isn't either ignored or an afterthought. "It needs to be more than us going into a class for three hours," says Betsy Wing, school program counselor for Family Violence and Rape Crisis. "I'd like to see this be a whole semester-long course--not just on dating violence but on everything that's related to violent behavior."

The public health model can help, advocates say, by keeping the focus on research, risk groups and links between domestic violence and other issues. A new study by the Durham-based Center for Child and Family Health found the incidence of child abuse is four-and-a-half times greater in households where there is also domestic abuse, suggesting that's a key place to intervene.

The ripple effects don't show up as easily in the criminal justice arena, where domestic violence is about cases, not patterns of behavior, says Leslie Starsoneck, former head of the N.C. Council for Women and Domestic Violence, who now directs a project on child well-being for Prevent Child Abuse North Carolina. "If you only see it through that lens, it doesn't give a full picture of what's really going on."

Media play a major role in determining which lens gets trained on the problem. A new report by the Raleigh-based N.C. Center for Public Policy Research credits The News & Observer's 2003 series on lower conviction rates for domestic crimes with helping get the state's new domestic violence law passed (go to www.nccppr.org for a full summary).

Esther Thorson has been studying media coverage of crime and violence for years at the Missouri School of Journalism. When a public health frame is adopted, she says, news stories become more issue-oriented and less likely to blame the victims.

For domestic violence--which has only relatively recently been recognized as a crime (it still lacks separate status under North Carolina law)--that's huge.

"Instead of just focusing on episodes, it focuses on the causes and the consequences," says Thorson, who is associate dean of graduate studies at the journalism school. "So it's not just 'Hey, he beat her up,' but 'What are the costs to the taxpayers and what is the impact on children long term?' When you put the episode in context like that you are saying to the reader, this is a public policy issue and we can do something about it."

Historically, the "doing something" part has been left largely up to the grassroots battered women's shelter movement that began in the 1970s. With so many organizations caught up in the daily struggle to provide services to victims, education and outreach are still a "luxury" too few can afford.

Consider that 17 of North Carolina's 100 counties--including Orange--have no shelter beds. The N.C. Coalition Against Domestic Violence reports there are just 43 beds for all of Chatham, Durham, Orange and Wake. ("We have more animal shelters than shelters for women," protests Tanisha Bagley of Apex, a former battered wife who's launched a career as a local anti-violence speaker.)

The same dynamic is true of public schools, which are now studying ways to fulfill requirements to teach more violence prevention.

"This might be considered as one of those unfunded mandates," says Marguerite Peebles, section chief for the state Department of Public Instruction's Alternative and Safe Schools initiative. "We haven't found many barriers to people wanting to do this. We have found we need more resources."

But federal and state prevention dollars remain scarce. The CDC's Violence Prevention Division got just 1 percent of the agency's $7.7 billion budget this year. In North Carolina, the public policy center's new report found only a fraction of a percent of the $27 million the state spent on domestic violence programs in 2003-2004 went to community education, anti-violence programs in schools or other preventive efforts .

Public health leaders say prevention has always been a hard sell because it´s about what doesn't happen. As a result, research and programs are scattered and vulnerable to short-term changes in legislation, funding or political will.

"We don't have a national institute of violence the way we have a National Cancer Institute" to consolidate funding and findings, says Beth Moracco, a researcher at Pacific Institute for Research and Evaluation in Chapel Hill and a member of the state Commission for Women and Domestic Violence. "As a researcher, I'm frustrated about the lack of long-term focus on this issue. I'm not optimistic that enough resources are being devoted to it."

Signals from Washington are not encouraging. The Bush administration wants to "zero out" grants made under the Violence Against Women Act (VAWA), the 1994 law that supports domestic violence and sexual assault services--making it even more unlikely that prevention will move to the top of anyone's agenda.

Clouds on the federal funding horizon have already caused a negative trickle-down at the state level. This year, the N.C. Governor's Crime Commission decided to change the way it distributes the state's VAWA block grant, reviving a competitive process and funding some groups for two years rather than one. While the block-grant total increased from $4.6 million in 2004 to $6.6 million this year and some groups got increases, 46 of 88 organizations funded by the commission will see cutbacks.

The resource squeeze means the tension between prevention and "intervention" is very real, Orton says. "We've heard that over and over in the focus groups that we've done. People are at pains to make clear to funders and policymakers that they don't see the need for intervention going away."

Advocates for prevention argue that if more resource were devoted to stopping violence, costs could be reduced in other areas through lower incarceration rates, fewer visits to hospital emergency rooms and fewer kids dropping out of school because of problems at home.

"Really, the hardest sell is convincing people what we believe," says Jo Sanders, co-director of Family Violence and Rape Crisis, which founded the Coalition for Family Peace. "That if you were to reduce domestic violence, you'd have an impact on a lot of other social problems."

Besides, say a growing number of advocates for battered women, ignoring prevention is no longer an option.

"We just can't leave it in the hands of the cops," says Paige Hall Smith, director of the Center for Women's Health and Wellness at UNC-Greensboro who has published studies on domestic violence. "They're the cleanup crew."

T here are three reasons why Fran Bumgarner is interested in domestic violence prevention: her 2-year-old grandson, Kendall Dianis, his 21-year-old mom, Cordae Lee, and her 24-year-old friend, Valerie Gates. All three were murdered by Gate's father, who is now serving a life sentence without parole.

On a July night in 2002, Alan Gates sneaked into his estranged wife's trailer in Orange County armed with a length of rope, a pistol and a plan to "talk some sense" into her about her having found a new boyfriend. Gates, who had a record of domestic abuse, worked himself into a drunken rage waiting for his wife to come home. Instead, Valerie arrived with Bumgarner's grandson and his mom--they'd stopped off there on their way to see Spirit at a local theater. Gates made them lie on the floor in a back bedroom and shot them one by one at close range. Kendall was last, shot in the side as he lay next to his mother.

On this night nearly three years later, Bumgarner drives from her home in Durham to a ceremony at the State Capitol in Raleigh to mark National Crime Victim's Rights Week. There, she hopes to meet Cordae's mother, Phyllis McEleney, who has become a close friend and a fellow spokeswoman for violence prevention.

Bumgarner doesn't see McEleney in the crowd making its way up the winding staircase to the restored legislative chamber on the top floor. So we take our seats behind one of the polished wooden desks in the circular room. It's unsettling to realize that most everyone is here because they've lost someone. Like Bumgarner, many in the audience hold silver spoons marked with the names of loved ones--a symbol of empty places at the table.

"People ask all the time if talking about this is healing," says Bumgarner, a tall woman with stylishly short silver hair, as we wait for the ceremony to start. "I don't think it's healing. But it's all we have left to do."

For her, the strongest argument for prevention is that nobody is immune from family violence. "You know Gates was raised in a violent home," she says. "They need to get this into the schools and get it early on. There are people who say this is too much for children to talk about, but there are children who are already living with this."

During the ceremony, there are God-and-country speeches and a children's choir that sings a song about "crying American tears." At the end, the names of crime victims--including Kendall and Cordae--are read aloud. It's a welcome moment for Bumgarner but something about the event feels like a slowly deflating party balloon. Invitees don't even get to keep the spoons. They return them to a display case on the ground floor.

Outside, we run into McEleney and the two women exchange hugs. Bumgarner lights up a cigarette. McEleney smooths her elegant, pulled-back hair and takes a seat on a nearby park bench.

We talk about how it's been for them the past three years. The nightmares. The depression. The domestic rifts. The memories--both terrible and precious.

For these two friends, the question is not how can we prevent domestic violence, but why aren't we doing more? They understand the public health perspective on a gut-wrenching level. Right now, family violence is too often tolerated they say, because too many people think they're safe from it. And the losses are immeasurable.

"Every day I pick up the paper and watch the news and we add more people to the list. But what do we do about it?" McEleney asks. "I never thought my daughter would be murdered. People have to learn you don't have to be in an abusive family for this to happen. It's kind of too late by the time they grow up. People just don't realize the damage this does."

Bumgarner breathes out a wreath of smoke in silent assent. Nobody says anything for a minute. Then, the two women make their way through the darkening streets to their cars as the lights go out at the capitol.

PILOT PREVENTION PROGRAMS
The CDC has funded pilot prevention programs coordinated by domestic violence coalitions in 14 states, including North Carolina. Three community-based projects in North Carolina are now receiving $71,000 annually under the CDC's DELTA (Domestic Violence Prevention Enhancement and Leadership Through Alliances) program: The Coalition for Family Peace in Chatham County; the Albemarle Hopeline in Elizabeth City; and Domestic Violence Shelter and Services in Wilmington. The aim of the program is to develop community responses to family violence. This year is the second year of the three-year program. The CDC is now reviewing applications for renewed funding for the 14 original grantees.

The CDC has also funded a new $3.68-million training program at the Injury Prevention Research Center at UNC-Chapel Hill. Launched in 2003, the PREVENT program trains people who work with victims and perpetrators of domestic violence in applying prevention concepts.

LANDMARK LEGISLATION
N.C. House Bill 1354, which passed in 2004, toughens penalties and boosts funding for services for victims of domestic violence in North Carolina. The bill:

  • Requires all convicted offenders to complete abuser treatment
  • Creates a new felony crime of nonfatal strangulation
  • Calls for a study of anti-violence education in public schools
  • Permits judges to award custody to victims of family violence during protective order hearings when children are at risk
  • Prohibits job discrimination against domestic violence victims who take time off work to attend court hearings

    FAMILY VIOLENCE IS WIDESPREAD

  • Nearly 5.3 American women ages 18 and older are victims.
  • One in four women in the U.S. have been raped or physically assaulted by an intimate partner at some point in their lives.
  • One in six U.S. women and 1 in 33 men have experienced an attempted or completed rape as a child or adult.
  • Up to 324,000 women each year are targets of domestic violence during their pregnancy.
  • High risk groups: women, minorities, people with low incomes, children who have witnessed violence in their family, families where power is concentrated in the hands of men, men living with male intimate partners, people with disabilities.

    FIVE THINGS MEN CAN DO TO PREVENT GENDER VIOLENCE

  • Approach gender violence as a men's issue.
  • If a brother, friend, classmate or teammate is abusing his female partner...don't look the other way.
  • Have the courage to look inward. Question your own attitudes.
  • If you suspect a woman close to you is being abused...gently ask if you can help.

  • If you are emotionally, psychologically, physically or sexually abusive to women, or have been in the past, seek professional help.

    (Source: MVP Strategies)

    To learn more
    Here are some resources on domestic violence issues:

  • N.C. Coalition Against Domestic Violence: www.nccadv.org
  • Interact, Wake County: 828-7501
  • Family Violence Prevention Center of Orange County: 929-3872
  • Durham Crisis Response Center: 403-9425
  • Family Violence and Rape Crisis Services, Pittsboro: 919-542-5445; Coalition for Family Peace, Siler City: 919-742-7320
  • PREVENT project at UNC: prevent.unc.edu
  • N.C. Department of Health and Human Services, Injury Prevention and Violence Branch: 733-3732
  • CDC's Injury Prevention division: www.cdc.gov/ncipc
  • U.S. Dept. of Justice Violence Against Women Office: www.ojp.usdoj.gov/vawo
  • More by Barbara Solow

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