Pandemic elevates concerns about violence, harm at home

Today’s guest post is authored by injury epidemiologist Amy Hunter, MPH, PhD, and medical anthropologists Susan DiVietro, PhD, and Rebecca Beebe, PhD, all of whom are research scientists at the Injury Prevention Center at Connecticut Children's Medical Center-Hartford Hospital.

Intimate partner violence and child maltreatment are pervasive and often co-occurring public health problems. IPV includes patterns of behavior where one partner in an intimate relationship tries to control the other using physically, emotionally and financially abusive behaviors. 

One in three women and one in seven men will experience IPV in their lifetime. Child maltreatment encompasses sexual, physical and emotional abuse, as well as various forms of neglect. Approximately 700,000 children in the U.S. are identified as victims of child maltreatment each year. 

Social, or physical, distancing measures have the potential to increase the frequency and severity of IPV and child maltreatment, as many of the shared risk factors attributed to financial and emotional stress are amplified by the COVID-19 pandemic. Stay-at-home orders have restricted victims from accessing traditional areas of support and escaping from violent partners or parents. 

Additionally, the pandemic creates new ways for perpetrators of IPV to control partners: preventing access to health care, withholding items such as hand sanitizer and masks or threatening to kick them out of the home. Educators and health care providers may be the only people who are able to connect with victims during the COVID-19 pandemic. 

For example, Chromebooks and online platforms permit educators, the largest proportion of child maltreatment reporters annually, to interact with students through virtual classrooms. This free resource may be one way to keep children safe by allowing teachers to engage students through regularly scheduled meetings and individual check-ins.  

Similarly, health care providers should build safe screening for IPV into every patient interaction, whether in-person or using a virtual platform. Existing literature has shown that considerations for child maltreatment are consistently omitted from disaster planning, and plans for IPV service providers often do not account for the increased service burden. 

This leaves many families without social support or services needed to cope with these challenging circumstances. In response, some states have taken legislative actions, such as allowing applicants to file for family violence restraining orders electronically. 

Complicating matters further, because of the universal impact of the COVID-19 pandemic, workers who can help by intervening are now restricted in their ability to enter homes and assess child safety. 

Moving forward, public health professionals must develop innovative strategies for safety during this and future emergencies. In France, pop-up counseling centers in supermarkets allow victims to get help while they run errands. In the U.S., some police departments have instituted new units to specifically address IPV. 

More strategies are needed that address health inequities exacerbated by this pandemic. Families living in poverty are more likely to have complex health conditions, which can increase risk for COVID-19 and complicate plans for safety. They are also less likely to have disposable income and less likely to have the option to work from home. 

National and local programs are available via calls, text and web chat to assist victims by providing support, safety planning or connecting to additional resources. If you are anyone you know is in need of immediate help, call 911. For more assistance, call the Childhelp National Child Abuse Hotline, 1-800-422-4453, and the National Domestic Violence Hotline, 1-800-799-7233.

Images, from top: Amy Hunter, MPH, PhD; Susan DiVietro, PhD; and Rebecca Beebe, PhD.