October 24, 2017

Since 1987, National Domestic Violence Awareness Month has been observed in October. It is a call to action meant to bring attention to the issue of domestic violence (also called “intimate partner violence”) during the month and throughout the year.  By taking a stand, we intend to remind the nation that there are still countless people--victims and survivors, their children and families, their friends, their communities--impacted by domestic violence.  We, all of us, should not stop until society has zero tolerance for domestic violence and until all victims and survivors can be heard. – from the National Coalition Against Domestic Violence (NCADV) website

More than 1 in 3 women (35.6%) in the United States have experienced rape, physical violence, and/or stalking by an intimate partner in their lifetime. Intimate partner violence, defined by the Centers for Disease Control as physical violence, sexual violence, stalking and psychological aggression (including coercive acts) by a current or former intimate partner, is extremely common and has far-reaching impacts on individuals, families, communities and health systems.

“This epidemic of intimate partner violence has huge current and future health implications for the woman experiencing violence. It also has ripple effects for families, as even watching violence as a child impacts future health outcomes,” explains Dr. Mona Mittal, assistant professor of family science in the School of Public Health, whose research focuses on prevention and intervention efforts for women with experiences of intimate partner violence (IPV). “We really have to address IPV to have healthy communities.”

Implications for women’s and children’s health

The estimated 15.5 million children being exposed to intimate partner violence annually are at increased risk for long-term health problems. These include poor mental health, higher risk for chronic diseases, substance abuse, and being a victim or perpetrator of violence and ending up in unhealthy relationships themselves.

“We know that exposure to IPV is considered one of the risks for long term adverse consequences, as documented by the ACEs [Adverse Childhood Experiences] study, which examined the links between traumatic experiences and reduced health and well-being later in life,” notes Dr. Mittal.

Negative impacts of IPV to women’s physical health include not only bruises, fractures, lacerations and head trauma from physical violence, but also sexually transmitted infections and unintended pregnancies as a consequence of sexual violence.

Mental health impacts include an increased risk of depression, anxiety, sleep problems, headaches, posttraumatic stress disorder, and suicide, among others. These adverse health effects are amplified in pregnancy, with an increased risk of poor pregnancy outcomes such as preterm birth and low birthweight.

Risk Factors

“IPV does not discriminate, any woman can experience it,” says Dr. Mittal. “But there is research showing that those of lower socioeconomic status are at higher risk, as are African American, Latina and Native American women.”

It is a significant health disparities issue both because of who is at increased risk and because those experiencing IPV are vulnerable to so many health risk factors.  

IPV is associated with 9 of the 12 Leading Health Indicators for Healthy People 2020, which translates into women experiencing IPV being at increased risk for smoking, substance abuse, mental health problems, and obesity, among other factors.

Intimate Partner Violence in Our Community

Homicide is the most extreme consequence of intimate partner violence. Startlingly, pregnancy increases women’s risk of becoming a victim of murder by an intimate partner.

One such tragic loss is the recent death of Marylander Laura Wallen, a 31 year-old Howard County high school teacher, beloved by her students, who was reported missing when she didn’t show up to teach at Wilde Lake High School on the first day of school this fall. Ms. Wallen was four months pregnant. Within days, her long-term boyfriend and father of the baby, Tyler Tessier, was charged in her death.

This news hit home not just because the victim was local, but because her mother, Gwen Wallen, PhD, is a University of Maryland alumna who graduated from the Department of Health Education (now Behavioral and Community Health) and is an adjunct faculty member and mentor to students in our school.

“We are deeply saddened by the death of Laura Wallen and her unborn son. Our hearts go out to the Wallen family as they endeavor to live with the immense grief over the senseless loss of their daughter and grandchild,” said Dr. Barbara Curbow, professor and chair of the Department of Behavioral and Community Health. “We also remember and honor the life of Mariam Folashade Adebayo, a graduate of our school who was murdered by an ex-boyfriend in 2015.”

When victims of intimate partner violence, such as Ms. Wallen and Ms. Adebayo, are connected to our UMD community, it causes us to be ever more aware of the need to raise awareness of and to prevent the violence and murder of so many women, named and unnamed.

Responding to Red Flags

“We have drawn up walls about what we think is polite and impolite,” suggests Dr. Mittal. “When we see red flags, it is critical that we express concern and create an opening for the person to seek help and support.”

“Obvious physical injury would be one sign that a woman is experiencing a violent relationship. You can ask them if they are okay.  Also, if you are noticing comments about a manipulative or controlling partner, such as ‘My partner doesn’t want me to go out’ or ‘I have to get home to make dinner or he will get angry,’ ask questions, don’t assume that it is normative. You can say ‘It sounds like you might want to talk to someone about your relationship.’ Stay in the language of healthy and unhealthy relationship dynamics instead of labeling the experience as violence. Create an opening – say ‘It might be worthwhile to check in with someone about what you are going through.’ Provide a reference to a counseling resource if you can.

“I think that we should not isolate ourselves. We need to be aware of who our neighbors are and we should get to know people. It’s not about poking your nose in people’s business, it is about social connectedness, getting to know what people are dealing with.

“All it takes is one person to connect a woman with help. Don’t minimize your power; we all have that power to break some of the barriers we have created in our communities and within ourselves. That will help in creating a safer world.”

Dr. Mona Mittal is working to develop evidence-based interventions to assist women experiencing intimate partner violence. Her research interests include the physical, emotional, and sexual health of women with a specific focus on psychological trauma, interruption of the intergenerational cycle of violence, and physiological mechanisms linking IPV and adverse health outcomes across the lifespan.