Public Health Approach to Prevent Sexual Violence

1. The Public Health Approach to Sexual Violence Prevention Abby Kelly-Smith, Chair Sexual Violence Primary Prevention Council Indiana State Department of Health

2. The Impact of Sexual Violence on Physical and Mental Health • Physical Health • Injuries • Disability • Unwanted/unplanned pregnancy • Sexually transmitted diseases • Increased risk for onset of chronic disease and early death (Adverse Childhood Experiences Study) • Mental Health • Increased risk for substance abuse (tobacco, alcohol, drugs) • Increased risk of depression, anxiety, post-traumatic stress disorder, and suicide

3. What is Public Health?

4. The Public Health Approach:Primary Prevention • Primary Prevention:Approaches or activities that take place before sexual violence has occurred to prevent initial perpetration or violence/victimization; (universal and selected interventions) • Prevention is:A systematic process that promotes healthy environments and behaviors and reduces the likelihood or frequency of violence against women. Source: Centers for Disease Control and Prevention, The Prevent Institute

5. Sexual Violence is Preventable! • “Violence can be prevented and its impact reduced, in the same way that public health efforts have prevented and reduced pregnancy-related complications, workplace injuries, infectious diseases, and illnesses resulting from contaminated food/water in many parts of the world. The factors that contribute to sexual violence…can be changed”. • Dahlberg and Krug, 2002

6. Assure Widespread Adoption Identify Risk & Protective Factors The Public Health Approach to Violence Prevention Develop & Test Prevention Strategies Step 4 Step 3 Define the Problem Step 2 Step 1

7. A Social Ecological Approach Community Relationship Individual Societal

8. Why the Social Ecology? • “It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.” - Institute of Medicine

9. Risk Factors for Perpetration Community Relationship Individual Societal -Poverty -Lack of economic opportunities -Weak community sanctions -General tolerance of sexual violence in the justice system -Social and cultural norms supportive of sexual violence, such as male superiority/sexual entitlement -Alcohol & Drug Use -History of physical and/or sexual abuse -Hostility towards women -Hyper-masculinity -Sexually aggressive peers -Strongly patriarchal family -Observing family violence

10. Protective Factors Against Perpetration Community Relationship Individual Societal -Social norms supporting gender equity -Strong policies against sexual violence -Low tolerance for violent crime -Educational and extracurricular/social opportunities -Collective efficacy of the community -Low tolerance of SV in the community justice system -Relationships with peers who exhibit respectful behaviors to others -Observing equality, respect, and non-violence in the family -Strong sense of respect for others -Connectedness to school -No history of physical or sexual abuse

11. Potential Interventions Community Relationship Individual Societal -Bystander intervention and healthy relationship skill development in various settings -Parenting classes -Policy development & implementation for no tolerance of SV in workplaces, schools, the justice system, etc. -Positive youth development opportunities -Engagement of multiple partners to change laws and social norms related to violence and gender inequity -Social marketing -Interventions targeting social, cognitive skills and behavior -Educational Sessions

12. For this presentation and more resources, visit: http://www.in.gov/isdh/23820.htm