Sexualized Violence as a Public Health Crisis

The recent gang rapes in New Delhi and in Steubenville, Ohio not only made worldwide headlines, they shined a spotlight on the cultural roots of sexualized violence. Bringing this issue out of the shadows is essential to finding solutions, said panelists at a recent Mailman School symposium titled "Global sexualized violence: From epidemiology to action." The event was the third Columbia University Epidemiology Scientific Symposium of the academic year.

The Epidemiology Panel discussed improving the quality of data collection to better understand sexualized violence's underlying causes and trends.

The group of academics, journalists, activists, and policymakers who came together for the event on January 25 said sex crimes must treated not as isolated events but as a global public health crisis that cuts across cultures and nations and that demands the same intervention resources as any other public health issue.

Sexualized violence is a serious problem across the globe. A World Health Organization survey of women ages 15 to 49 in 10 countries had these findings:

• Prevalence ranges widely. In Japan, 15% of surveyed women reported physical and/or sexual violence at some point in their lives; in Ethiopia, the figure was 71%
• Many women reported that their first sexual experience was forced:  17% in rural Tanzania, 25% in rural Peru, 30% in rural Bangladesh
• Between,  0.3% and11.5% of women reported experiencing sexual violence by a non-partner after age 15

The idea for a symposium addressing sexualized violence as a global epidemic came out of a partnership between Dr. Karestan Koenen, an associate professor of Epidemiology who specializes in trauma research, and the Women’s Media Center, an advocacy group for women in the media. Dr. Koenen has worked with Lauren Wolfe, director of the Center’s Women Under Siege Project, to raise awareness about sexualized violence in conflict.

Over the course of the day, presenters considered sexualized violence from a population health perspective, looking at how such crimes are rooted in larger cultures and societies, the wide-ranging impacts on women’s physical and mental health, and how to use public health tools to gather statistics and take action.

Several panelists spoke about the "cult of masculinity," in environments like the military and fraternities, where rape and other forms of sexual assault are often treated as rituals. Sexualized violence is often high in these "hyper-masculinized environments" said panelist Dr. Rita K. Noonan, who as associate director for program development at the CDC’s Injury Center, has worked on translating research on sexual and dating violence into prevention efforts.

In the U.S. military, sexual harassment and abuse is a significant problem, said Dr. Amy Street, deputy director of the Veteran Administration’s women’s health sciences division in Boston. In the wars in Iraq and Afghanistan, 25% of women and 1% of men reported sexual assault, while 51% of women and 11% of men reported sexual harassment.

"Those are pretty striking numbers," Dr. Street said. In these situations, she noted, the victim usually knows the perpetrator. "It’s an incredible betrayal, especially since there is an emphasis on teamwork and working together."

Journalist Helen Benedict’s 2009 book, The Lonely Soldier: The Private War of Women Serving in Iraq, documents this culture at the ground level with intimate portraits of seven women who faced sexual and other abuse while on active duty in the Middle East.

She said part of the problem is an intensely misogynistic culture. She cited, for example, a comment made by a soldier she met in Iraq: 
"He told me that Vietnam had prostitutes but they don’t have them in Iraq, so they send women soldiers instead," said Benedict, who is also a professor at the Columbia School of Journalism.

According to Tia Palermo of SUNY-Stonybrook, the growing body of research on sexualized violence is crucial to changing these cultures and reducing these crimes. "Some activists have argued that we don’t need expensive studies and more statistics, but any response will depend on an accurate and complete understanding of causes, dynamics, and trends of sexualized violence and conflict," she said.

However, quantifying sexualized violence is not straightforward. There have been widely divergent reports of prevalence found by researchers, which has led skeptics to accuse feminists of inflating the numbers. Panelists noted that there are inherent difficulties in collecting data on sexualized violence because of privacy issues and the traumatic nature of these events. Moreover, victims frequently do not want to report rape because of shame and fear of repercussions. Most of the time, rape and other forms of sexualized violence are committed not by strangers but by husbands, boyfriends, and acquaintances. Studies have found that women are less likely to report rape if they know the perpetrator.

Nonetheless, scientists have been able to improve the accuracy of data collection. One of the best examples of this, said Dr. Leslie Roberts, an associate clinical professor of Population and Family Health at Mailman, was a 1990 study by Dr. Diana Russell. She found that prevalence of rape in a representative sample was six to seven times higher than what had been reported in an earlier nationwide study. Unlike that earlier survey, Dr. Russell and her team conducted in-person interviews with a representative sample of women in San Francisco, where they asked women not just whether they were raped but whether a partner had forced her to have sex or had sex with her in her sleep.

The Women Under Siege Project has been a leader in using epidemiologic and journalistic methods to document reports of sexual violence in the civil war on Syria through a live, crowd-sourced map.

“By plotting each report on a map, we are hoping to not just collect documentation that may otherwise be lost, but also to make people pay attention to the victims,” says Wolfe. “The work also gives us indicators of what kinds of medical and psychosocial services may be required, and where. It is documentation that may one day be used toward evidence in potential war crimes trials.”

The project has drawn significant attention to sexualized violence being committed by the Syrian army, and it is one of the leading examples of new journalistic models that are being used to draw attention to the epidemic of sexualized violence, which panelists said is largely uncovered by the mainstream media.

One problem, said Maria Hinojosa, an anchor for PBS and NPR, is that oftentimes male editors and producers think of sexualized violence as a “women’s topic” that would not be of interest to men. Because she was committed to telling these stories, Hinojosa started her own production company, the Futuro Media Group, which has produced an award winning documentary on child brides. "As a journalist, if you care about these stories, you have to find your own way," she said.

Helen Benedict encouraged journalists to pitch stories that examine novel angles of these issues that have not been covered. Such angles might include examining the link between porn and sexualized violence and how or when men "learn to rape." Said Benedict: "Any mother who has had a son knows that boys are not born rapists."

"We entirely neglect why this crime continues to rise as other crimes drop," she added.

Jimmie Briggs, a former journalist and the director of ManUp, a global campaign to stop violence against women and girls, offered a male perspective. His organization works to get men and boys involved in reducing and sharing responsibility for the problem of violence against women, through shifting negative gender norms.

Even though there are many dedicated activists, journalists, and policymakers working toward ending sexualized violence, public health scientists are needed now more than ever, said conference participants. Academics are needed in this fight, said author and activist Robin Morgan, a co-founder of the Women’s Media Center: "They carry a weight that activists still do not."