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  2. Table of Contents
  3. Volume 7 - 2002
  4. Number 1: January 2002
  5. African American Women Partner Violence

Intimate Partner Violence in African American Women

  • Doris Williams Campbell, PhD, ARNP, FAAN
    Doris Williams Campbell, PhD, ARNP, FAAN

    Doris Williams Campbell, PhD, ARNP, FAAN, is a Professor in the Colleges of Nursing and Public Health, University of South Florida, Tampa, FL and Director of Diversity Initiatives, USF-AHEC Program, College of Medicine. Her research focus is on violence and abuse against women, with a special interest in abuse of African American women and other women of color. She has numerous publications related to violence and abuse of women with several having focused on abuse in the lives of African American women. Her areas of clinical specialization are Women’s Health and Minority Health. She serves on the Governor’s Task Force for Domestic and Sexual Violence, State of Florida and the Clemency Review Panel for Battered Women, State of Florida Parole Commission.

  • Phyllis Sharps, PhD, RN
    Phyllis Sharps, PhD, RN

    Phyllis Sharps, PhD, RN, is an Associate Professor of Community Health Nursing at The Johns Hopkins University School of Nursing and Director of Health Services at the House of Ruth Shelter for battered women and their children, Baltimore, MD. Her research focuses on women’s health and violence and abuse as a major health problem for women and children. She has published widely in the area of intimate partner violence and women’s health outcomes, specifically perinatal outcomes. Her areas of specialization are Maternal and Child Health and Community Health Nursing.

  • Faye A. Gary, EdD, RN, FAAN
    Faye A. Gary, EdD, RN, FAAN

    Faye A. Gary, EdD, RN, FAAN, is a Distinguished Professor at the College of Nursing and Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL She specializes in Psychiatric-Mental Health Nursing and Child and Adolescent Psychiatry. She has worked with troubled children and their families for more than thirty years. Within this context, her research has also focused on violence in intimate partner relationships and the role of alcohol in violence and abuse in intimate relationships. She has published widely on several related topics such as children who run away, children in the juvenile justice system, and children impacted by violence within their families and communities.

  • Jacquelyn C. Campbell, PhD, RN, FAAN
    Jacquelyn C. Campbell, PhD, RN, FAAN

    Jacquelyn C. Campbell, PhD, RN, FAAN, is currently the Anna D. Wolf Endowed Professor and Associate Dean for the PhD Program and Research at the Johns Hopkins University School of Nursing, with a joint appointment in the Johns Hopkins School of Hygiene and Public Health. Her research and policy initiatives are in the area of family violence and violence against women, for which she is internationally known. She has received numerous federally funded grants to study abuse and battering of women and was most recently the Principal Investigator on a study of Risk Factors for Intimate Partner Homicide. She has authored or co-authored more than 100 articles and chapters, mainly about battered women and family violence.

  • Loretta Carmen Ramella Lopez, MEd, EdD, ARNP
    Loretta Carmen Ramella Lopez, MEd, EdD, ARNP

    Loretta Carmen Ramella Lopez, MEd, EdD, ARNP, is a specialist in Psychiatric-Mental Health Nursing. She has taught both undergraduate and graduate nursing students in this area, and in the area of nursing research for over twenty years. She most recently taught graduate nursing research courses at the University of Phoenix, Tampa, FL campus. Her research and publications have focused on adolescent and child mental health, including the problems of runaway youth and intimate partner violence.

Contents
Abstract

Violence against African American women, specifically intimate partner abuse, has a significant impact on their health and well being. Intimate partner femicide and near fatal intimate partner femicide are the major causes of premature death and disabling injuries for African American women. Yet, despite this, there is a paucity of research and interventions specific and culturally relevant for these women. This article focuses on issues relevant to intimate partner violence and abuse against African American women by examining existing empirical studies of prevalence and health outcomes of intimate partner violence against women in general, plus what limited research there is about African American women, specifically. It includes a discussion of specific recommendations for research, practice, education, and policy to reduce and prevent intimate partner violence against African American women.

Key wordsviolence and abuse, interpersonal violence, intimate partner violence, spouse abuse, African American women, blacks, domestic violence, ethnic groups

Keywords:

IntimatePartnerViolenceinAfricanAmericanWomen

StrausandGelles(10)reportedthatbetween1.8and3.6millionwomenintheUnitedStatesareseverelyassaultedbytheirintimatepartnerseachyearWomenaremorelikelytobeassaultedorkilledbyamalepartnerthananyothertypeofassailant(Browne&Williams,13)Numerousnationalreportsconfirmthesefindings(Bachman&Saltzman,15;Greenfield,etal.,18;OfficeofJusticePrograms,18)Femicide,thekillingofwomen,isalsomostoftenperpetratedbycurrentorformerhusbandsorboyfriends(Browne,13;Schnitzer&Runyan,15

AmongAfricanAmericanwomenbetweentheagesof15and44,femicideistheleadingcauseofprematuredeath(OfficeofJusticePrograms,18)NearfatalfemicideofAfricanAmericanwomenalsocontributestolongtermdisablinginjuriesandconditionsMostoftenthemenwhokillorabusethesewomenaretheirintimatepartnersi.e.,husbands,lovers,ex-husbandsorex-lovers(Bachman&Saltzman,15;Bailey,etal.,17;Mercy&Saltzman,18)Therefore,"TheNationalBlackWomen'sHealthProject"hasidentifiedthebatteringofwomenasthenumberonehealthissueforAfricanAmericanwomen(Joseph,17

AccordingtotheAmericanMedicalAssociation(12),oneineverythreewomeninthiscountrycanexpecttobebeatenbyamalepartneratsometimeduringtheiradultlifeWhilethesegeneralstatisticsareuseful,violenceandabuseinAfricanAmericanwomenremainsarelativelyunderstudiedarea,despitecallsforgreaterinclusionofAfricanAmericansinstudiesofdomesticviolence(Asbury,187;Coley&Beckett,188;Lockhart&White18;Wyatt,14)Consequently,thereisapaucityofresearchonhowinterpersonalviolenceaffectsthelivesofAfricanAmericanwomen(Coley&Beckett,188;Gary,Campbell&Serlin,18;Koss,etal.,14)Thereareseverallimitationsinthissmallbodyofresearch,suchasinappropriatecomparisonsofAfricanAmericanwomenwithCaucasianwomenandlackofexaminationofcontextualvariablesthatincreaseAfricanAmericanwomen'svulnerabilitytointimatepartnerviolenceandsubsequentconsequences(Campbell,13;Campbell,Masaki&Torres,17;Raj,Silverman,Wingood&DiClemente,1

AfricanAmericanwomen'sresponsestoviolentandabusivebehaviormaybeinfluencedbythechronicexperiencesofracism,andthesocialcontextsinwhichtheyliveThesecircumstancesoftenprovidethemwithdifferentopportunitiesforandrestrictionsontheirresistancetoviolence(Campbell,Campbell,King,Parker&Ryan,2001)PreviousracistorothernegativeexperiencesmaypreventAfricanAmericanwomenfromseekinghelpfrominstitutionalresources,whichtraditionallysafeguardorprotectCaucasianwomenfromabuse(Harvey,186;Wyatt,14)Cultureboundissuesneedtobestudiedandthismaybestbeaccomplishedthroughwithin-groupstudyofrepresentativecommunitysamples(Koss,etal,14;Wyatt,14

Thepurposeofthisarticleistoexaminecurrentissues,relevantspecificallytointimatepartnerviolenceinAfricanAmericans,aformofdomesticviolenceorinterpersonalviolence,ingeneralThefocusisonviolenceandabuseagainstAfricanwomenbasedonempiricalevidenceWeincludeinformationontheincidenceandprevalenceofviolenceandabuseagainstwomeningeneralandAfricanAmericanwomen,specifically,basedonnationalstatisticsaboutnonlethalandlethalviolenceWebrieflydescribesocioculturaltheoryasusedtoexplainviolenceagainstwomenanditsrelevanceforunderstandingthismajorhealthprobleminAfricanAmericanwomenStudies,whichhaveexaminedavarietyofcontextualvariablesthatmightbeassociatedwithviolenceandabuseinAfricanAmericanwomen,arereportedFinally,wepresentrecommendationsforreducingtheunacceptablyhighlevelsofinterpersonalorintimatepartnerviolence(IPV)inAfricanAmericanwomenwithimplicationsfornursingresearch,practice,educationandpolicy.

IncidenceandPrevalence

Non-LethalViolence

TheOfficeofJusticePrograms(18)reportedthatratesofnonlethalintimatepartnerviolencewerehigheramongAfricanAmericanfemalesthanCaucasianfemalesAmongwomen,beingBlackyoung,divorcedorseparated,earninglowerincomes,livinginrentalhousing,andresidinginurbanareasareallassociatedwithhigherratesofintimatepartnervictimizationNonlethalviolentvictimizationincludesrape,sexualassault,robberyandaggravatedandsimpleassault(Greenfield,etal.,18)Suchviolenceismostlikelytooccuratornearthehomeofthevictimandusuallyduringtheeveningandnighthours.

Incidentsofnonlethalviolenceamongwomeningeneralarefrequentlynotreported.

ThereisalackofethnicgroupspecificdataonresponsesofwomentointimatepartnerviolenceIngeneral,womenrespondtonon-lethalviolencebyactivelydefendingthemselvesduringtheincident(threeoutoffour)andreportingtheincidenttothepoliceAfricanAmericanfemalevictimsaremorelikelythanotherstocallthepolice,callingabouttwo-thirdsofthetimecomparedtoabout50%ofCaucasianwomen(Greenfield,etal.,188)andtheassailantisusuallyarrestedWhenAfricanAmericanwomencallthepolicetheycallformoresevereepisodesofabuse.

IncidentsofnonlethalviolenceamongwomeningeneralarefrequentlynotreportedThisphenomenonisnotwellunderstoodAmongthisgroupofbatteredwomen,thereislimitedresearchaboutthefrequencyofpolicecontactsandtheirreasonsfornotcallingthepoliceInasampleofwomenwhowereaskedabouttheirexperienceswiththepolice,twothirdsreportedhavinghadcontactwiththepolice,althoughmostdidnotbelievetheyhadasmuchcontactwiththepoliceasneededtothwartfutureabusiveepisodesAmongthereasonsgivenbythosewhodidnotcallthepoliceweresituationalbarriers,suchasbeingphysicallypreventedfromusingthetelephoneand/orbeingthreatenedwithmoreviolenceFewerwomenreportedthatshame,embarrassment,or"love"weretheirsolereasonsfornotcallingthepoliceUnderreportinghasbeenrelatedtoprevious(negative)experienceswiththepoliceaswellastothelevelofviolenceexperiencedNon-reportingvictimsstatedthattheyconsideredthevictimizationaprivateorpersonalmatter(Greenfield,etal.,18)anddidnotconsider,atthattime,involvingthepolice.

ThousandsofabusedfemalevictimsrespondtoIPVbyseekingordersofprotection,usuallyasalastresortafterothersourcesofseekinghelphadfailed(Zoellner,etal.,2000)Theseauthorsfound,however,thatlessthanhalfofthewomenwhoinitiatedtherestrainingorderprocessactuallyobtainedfinalcourtordersInthissampleofwhom57%wereAfricanAmerican,31%Caucasianand12%Hispanic,women'smaritalstatus(married/livingtogether,notmarried/notlivingtogether)andethnicity(Caucasian/non-Caucasian)werenotrelatedtofinalrestrainingorders(Zoellner,etal.,2000)Wolf,Holt,KernicandRivara(2000)founddifferencesamongwomenseekingrestrainingordersTheyreportedthatwomenwhoobtainedprotectionordersweremorelikelythanvictimswithoutprotectionorderstobeemployedfull-time,bepregnant,bemarried,overage24,andlesslikelytobeinvolvedwithperpetratoratthetimeoftheindexincidentTheyalsofoundthatwomenwhosefamiliesandfriendsarealsothetargetsofabusearemorelikelytoseekaprotectionorder.

Respondingtoviolenceandabusebyleavingtheabusermaybedifficultandinitiallyunsuccessful(Campbell,18;Campbell,Miller,Cardwell&Belknap,14)withabatteredwomanonaverage,makingfiveattemptstoleaveherpartnerbeforesheactuallyendstheabusiverelationshipAfterleaving,partnerviolencefrequentlycontinuesintheformofstalking,threatsandphysicalassault(Campbell,Rose,Kulb&Daphne,18;Kurz,16;Sullivan,Campbell,Angellique,Eby,&Davidson,14;Wilson,Johnson,&Daly,15)TheextenttowhichAfricanAmericanwomenchooseandareabletoleaveabusiverelationshipsremainsunclearandnotwellresearched.

Nearly170,000femalevictimsofviolenceareestimatedtoreceiveservicesfromavictimadvocacyagencyduringthecourseofayear,andthisislikelyanunderestimate(Greenfield,etal.,18)ThesedatawerenotreportedbyracialorethnicgrouporbyagesofthewomenseekingservicesAbouthalfreportaninjuryofsometypeTheinjuriesusuallydonotinvolvetheuseofaweapon,butwhenaweaponischosen,itismostlikelyabatorobjectusedtohit,oraknifeorsharpobjecttocutorpunctureTheweaponleastlikelytobeselectedisafirearmInorderoffrequency,themostcommoninjuriesthatwomensustainarebruisesfollowedbycutsandstabwoundswithinternal,musculoskeletal,concussionandheadinjuries,rape,sexualassault,andgunshotwoundsTherelativeriskofhospitalizationisincreasedamongabusedwomen,causingasignificantimpactonwomen'shealthanduseofhealthcarefacilities(Kernic,Wolf&Holt,2000)Femalesaccountfor3%ofthehospitalemergencydepartmentvisitsforviolence-relatedinjuries,but84%ofthepersonstreatedforinjuriesinflictedbyanintimatepartnerAbout20%ofthesewomenseekmedicalassistanceresultinginhealth-relatedexpensesandothercostsofcrimetotalingabout$150millionannually(Greenfield,etal.,18)Thereislimitedinformationontheuseofsocialservicesagencies,thehealthcaresystemandadvocacyprogramsbyAfricanAmericanfemalevictimsofintimatepersonalviolence.

SlightlymorethanhalfofallfemalevictimsofIPVliveinhouseholdswithchildrenunderage12whofrequentlywitnesstheviolenceagainstthesewomen(Graham-Bermann&Hughes,18a;Graham-Bermann&Hughes,18b;Langhinrichsen-Rohling&Neidig,15)Theseyoungchildrenareatriskfordevelopingavarietyofphysicalandpsychologicalreactionstotheviolencethattheywitness(Lehman,17;Lewandowski,etal.,inpress

LethalViolence

In16,justover1,800murderswereattributabletointimatepartnerviolencewith3outof4ofthesehavingafemalevictim.In16,justover1,800murderswereattributabletointimatepartnerviolencewith3outof4ofthesehavingafemalevictimOverthepasttwenty-fiveyearstherehasbeenadeclineofvictimsofintimatemurderThedeclinehasbeenlargerforspousekillings,comparedtothekillingsofotherintimates,especiallyformalevictims(Fox&Jawitz,2001;Greenfield,etal.,18)However,thepercentageoffemalemurdervictimskilledbyintimateshasremainedstableatabout30%,withsomedeclinesobservedsince13ThenumberofCaucasianfemaleskilledbyintimatesroseduringthemid-180's,declinedafter13,andin17reachedthelowestlevelrecordedoverthepasttwenty-fiveyearsThenumberofintimatehomicidesforallotherraceandgendergroupsdeclinedoverthesameperiod:AfricanAmericanfemaleskilledbyintimatesdecreased53%,AfricanAmericanmalesby75%,andCaucasianmalesby55%Foreveryagegroup,femalemurdervictimsaremorelikelythanmalevictimstohavebeenkilledbyanintimateThedeclineinmurderincludesasharpdecreaseintherateofintimatemurdersofmen,especiallyAfricanAmericanmen,andinthenumberofintimatemurderswithgunsFrom10-18,gunskilledtwothirdsofthespousesandex-spousesvictimsKniveskilledalmosthalfoftheboyfriendvictimsandintimatehomicidesweremorelikelytoinvolveknivesthannonintimatehomicides(Fox&Zawitz,2001)ThereissomeevidenceofaslightincreaseintherateofCaucasianfemaleskilledbyboyfriends(Greenfield,etal.,18

ArecentstudyofRiskFactorsforFemicideinAbusiveRelationshipsconductedbythecurrentauthors,usedamulti-city,casecontroldesignwithconsecutivecompletedfemicidesascasesandrandomlyidentifiedabusedwomenlivinginthesamecommunitiesascontrolsThisstudyexaminednumerousvariablesthatmightbeassociatedwithriskforfemicideinIPV(Campbell,etal.,inreview)Onbivariateanalysis,perpetratorsandtheirfemalevictimsofintimatepartnerfemicideweremorelikelytobeAfrican-American,unemployedandnotlookingforajob,andlesseducatedcomparedtoabusedcontrolsHowever,furthertestingofseveralmultivariatemodelsrevealedthatunemploymentwasthemostimportantperpetratordemographicriskfactorandseemstounderlietheapparentriskattributedtoraceOtherstudiesusingmultivariatemodelsreportsimilarfindings(Centerwall,15;Hawkins,13

SocioculturalTheoriesasExplanationsofViolenceandAbuseintheLivesofAfricanAmericanWomen

Whilethereareseveraltheoriesthatarefrequentlyusedtoexplainhumanviolence,nonearespecifictoAfricanAmericanwomenMosttheoreticalframeworksusedtoexplaindomesticviolenceandabuseofwomenrelyheavilyonpsychologicalmodelsemphasizingindividualcharacteristicsMostofthesemodelsprovideaninadequateexplanationofdomesticviolenceandabuseandresearchbasedonthemhasfailedtofindanyconsistentpatternofpsychopathologyinmenwhobatterorinwomenwhoareabused(Alexander,13;Hotaling&Sugarman,186;Ptacek,184)

Socioculturaltheoriesfocusonthelong-termeffectsofadultbehavioronchildrenaswellaspolitical,economic,structuralandculturalaspectsofsociety(Barnes,1)Socioculturaltheoriesmayexaminephenomenonfromamicrosocialperspective(family)orfromabroadermacrosocialperspective(societalinfluences)Socioculturaltheorieshavealsobeenfrequentlystudied,andarewidelyacceptedasexplanationsfordomesticviolenceOneofthemostfrequentlycitedsocioculturaltheoriesisfeministtheory,whichsuggeststhatviolenceagainstwomenemanatesfrompotentsocializingmessagesfromfamilies,peergroups,media,thelawandotherinstitutionsofasexistsocietythatleadtotheacceptanceandnormalizationofgender-basedviolenceFeministtheoryisdifficulttooperationalizeforempiricalexaminationandisnotoftenusedortestedinresearchforthisreason(Raj,etal.,1

Thetheoriescurrentlyusedindomesticviolencepracticeandresearchgenerallyareunidimensionalinnatureandapplieduniformlyacrossculturalgroups,ignoringethnic-culturaldifferencesandsimilarities(Barnes,1)orculturallyspecificfactorsthatmayadverselyaffectwomen'sresistancetoabusefrommalepartners(Wyatt,14)Overall,theapplicabilityofthesetheoriesforexplainingtheonset,courseandperpetuationofintimatepartnerviolenceinethnicpeopleofcolor,especiallyAfricanAmericans,remainsuncertain(Barnes,1;Hampton&Gelles,14;Wyatt,14)OnepromisingavenueisJanetteTaylor's(18)womanistapproach,anAfricanAmericanspecificapplicationoffeministtheorytoresearchandscholarshipondomesticviolence.

TheContextofViolenceintheLivesofAfricanAmericanWomen

AmongthecontextualvariablesconsistentlyassociatedwithincreasedriskforviolenceandabuseinAfricanAmericanwomenaresocioeconomic(poverty,lowincome),socioenvironmental,problemdrinkingandillicitdruguse,especiallybyperpetrators,andrelationalfactorsNotsurprisingly,ourresearchfoundthatthemostsignificantriskfactorforintimatepartnerfemicideorlethalviolencewasintimatepartnerviolenceHowever,overandbeyondthis,wefoundassociationswithintimatepartnerfemicideinthevariousmodelstestedwitheachofthesecontextualvariables(Campbell,etal.,inreview

AmongthecontextualvariablesconsistentlyassociatedwithincreasedriskforviolenceandabuseinAfricanAmericanwomenaresocioeconomic(poverty,lowincome),socioenvironmental,problemdrinkingandillicitdruguse...

Characteristicsofthesocioenvironmentsuchasneighborhoodpovertyareassociatedwiththeriskofpartnerviolence,particularlyamongAfricanAmericancouples(Campbell,etal.,17;Cunradi,Caetano,Clark&Schafer,2000)However,Centerwall(15),reportedthatasixfolddifferenceinAfricanAmericanandCaucasianratesofintraracialdomestichomicideintwomajorcitiesintheSouthwereentirelyaccountedforbydifferencesinsocioeconomicstatusbetweentherespectiveAfricanAmericanandCaucasianpopulations,withnoresidualdifferencesrequiringculturalexplanationsOurresearchfoundthatthemostimportantperpetratordemographicriskfactorforfemicidewaspartnerunemployedandnotseekingemploymentTheemploymentstatusofthevictimwasnotasignificantriskfactorforfemicideinanyofthemultivariatemodelstestedHigherlevelsofeducation(especiallycollegelevel)wereassociatedwithlowerlevelsoffemicide(Campbell,etal.,inreview)Mostcurrentresearchemployingmultivariatemodelsforanalysisofvariablesexpectedtoberelatedtobothnonlethalandlethalviolencehavenotfoundraceorethnicitytobeindependentlyassociatedwithincreasedriskforviolence(Campbell,etal,inreview;Centerwall,15

Alcoholrelatedproblemsamongbothmaleandfemalepartnerswerefoundtobeimportantpredictorsofintimatepartnerviolenceacrossracial/ethnicgroupsHowever,aftercontrollingforsociodemographicandpsychosocialcovariates,maleandfemalealcohol-relatedproblemsremainedthestrongestpredictorsofintimatepartnerviolenceforAfricanAmericanpartners,butnotforCaucasianandHispaniccouples(Caetano,Nelson&Cunradi,2001;Cunradi,etal.,2000)Inourfemicidestudy,maleproblemdrinkingwasassociatedwithaneight-foldincreaseinpartnerabuseandatwo-foldincreasedriskoffemicide/attemptedfemicideMaleperpetratorsofviolenceandfemicideweremorelikelytobeproblemdrinkers,todrinkmorefrequentlyandtobebingedrinkersInourfemicide/attemptedfemicidesample,thereisanoverrepresentationofAfricanAmericansmaleswithloweducation,lowincomeandperhapsrestrainedinsightforrecognizingtheiralcoholproblemsorhavingtheresourcestoenrollinalcoholtreatmentprograms(Sharps,Campbell,Campbell,Gary&Webster,2001)Ourfindingsareconsistentwiththosereportedbyothers(Campbell,12;Moracco,Runyan&Butts,18;Smith,Moracco&Butts,18

Raj,etal(1),inastudyoftherelationshipbetweensocialandeconomicpowerandmale-perpetratedabuseamonglow-incomeAfricanAmericanwomen,reportedahigherincidenceofpartnersexualjealousy,longer-terminvolvementintherelationship,receivingnoincomefrommalepartner,perceptionsoflowempathyfrompartnerandstrongdesiretohavechildrennow,tobeindependentpredictorsofrelationshipabuseTheserelationalvariablesaccountedfor34%ofthevarianceinabusefrommalepartnersinthiscommunity-basedsampleoflow-incomeAfricanAmericanwomen.

Inourresearchthemostsignificantrelationshipvariablethatwasariskfactorforfemicidewas,firstofall,ahistoryofinterpersonalviolenceInaddition,contributingtoanincreasedriskforfemicidewerethedemographicfactorsofthepartnersneverlivingtogether,thevictimleftoraskedpartnertoleave,andthevictimhadchildrenwhowerestepchildrenoftheperpetrator(Campbell,etal.,inreview

Jasinski(2001),inarecentstudyofphysicalviolenceamongethnicallydiversegroups,suggestedthatthesamefactorsthatmightincreasetheinitialriskforviolentbehaviormightnotaffectwhetherornotthisbehaviorcontinuesInaddition,thesameriskfactorsmayberelatedindifferentwaystovariouspatternsofviolenceamongdiverseracial/ethnicgroups.

ReducingViolenceandAbuseintheLivesofAfricanAmericanWomen

RecommendationsforFutureResearch

MoresystematicresearchisneededtogenerateknowledgeabouttheoreticalandcausalmodelsthatenhanceourunderstandingofthecontextualvariablesthatinfluencetheperpetrationofviolenceagainstAfricanAmericanwomenbytheirintimatepartnersTheoreticalmodelsshouldbemultidimensionalandanalyticalmodelsshouldbemultivariate.

Community-basedstudiesareneededthatexaminesocioeconomicstatusvariablessuchasemployment,education,typesofjobs/careers,anddifferencesinstatusrelatedtothesevariablesbetweenintimatepartnersStudiesshouldexaminehowsocioeconomicvariablesandstatusmayserveasprotectiveorriskfactorsforabuseperpetrationandvictimizationofAfricanAmericanwomenbyintimatepartnersCommunity-basedstudiesofviolenceandabuseofAfricanAmericanwomenshouldspecificallyexaminecontextualfactorssuchaspoverty,singleparenthood,andhistoriesofpreviousintimatepartnerviolenceInaddition,communitybasedstudiesneedtofurtherexaminefemaleandmalepartner'suseofalcoholandotherdrugs,theinteractionofsubstanceuse,andthecontextualfactorsdescribedaboveMoreimportantly,systematicstudiesareneededwhichexaminetheinteractionsofallofthecontextualfactors,substanceuseandtheirinfluenceontheperpetrationofviolenceagainstAfricanAmericanwomenAlsoneededarestudiesthatsystematicallyexaminethenatureofsupportsystemsthatfunctionamongAfricanAmericanfamiliesanddocumenttheactualdomainsofthetypesofsupportthattheyprovideforthevictimsofintimatepartnerviolenceandtheirchildren.

Manyofthetoolsusedforscreening,historytakingandassessmenthavebeenevaluatedprimarilythroughusewithCaucasianwomen...

ResearchisneededwhichfocusesondevelopingandvalidatingculturallysensitiveandrelevantscreeningandassessmenttoolsforAfricanAmericanfemalevictims(Bent-Goodley,2001)Manyofthetoolsusedforscreening,historytakingandassessmenthavebeenevaluatedprimarilythroughusewithCaucasianwomenwhomayhavesignificantlydifferentculturalandsocioeconomicbackgroundsandexperiencescomparedtoAfricanAmericanwomenForexample,assessmenttoolsmightneedtoexploreculturaldifferencesinperceptionsrelatedtophysicalabuseinintimaterelationshipsOncurrenttoolsphysicalabuseinIPVisonlydescribedaspositive(yes)ornegative(no)AssessmenttoolsmightalsoneedtobedevelopedtoprovideforasystematicexaminationofverbalandemotionalabuseanditsrelationshiptophysicalabuseInaddition,thereisaneedtodevelopandtestculturallyrelevantinterventionstrategiesthatfocusonthepreventionofintimatepartnerviolenceinAfricanAmericancommunitiesResearchers,clinicians,andpolicymakershaveaprofessionalobligationtodifferentiateculture-specificthoughtsandbehaviorsfrompsychopathologyWithoutknowledge,sophistication,andskill,onephenomenacaneasilybesubstitutedfortheother.

FutureresearchisalsoneededthatfocusesonAfricanAmericanmaleperpetratorsofIPVInmanyurbanareasAfricanAmericanmalescomprisealmosthalfofthepersonsarrestedfordomesticviolence(Gondolf&Williams,2001)Thereisatleastonepilotstudy,whichprovidespreliminaryresultsoftheeffectivenessofaninterventionusingculturallyfocusedcounselingforAfricanAmericanbatterers(Williams,12,Williams,15)ThisapproachincludesAfricanAmericanmenonly;anAfricanAmericanmaletherapistwhousesacurriculumthatemphasizesthehistorical,socialandculturalcontextformalebattering;andwholeadsthemalecounseling/educationalsessionsResearch,whichevaluatestheoutcomesforbatterersaswellastheirintimaterelationshipsandperceptionsoffemalepartnersafterthemalepartnerscompletetheintervention,isneededIdeally,additionalculturallyfocusedinterventionsforfemalesneedtobedevelopedandtestedfortheireffectivenessinpreventingandreducingviolenceagainstAfricanAmericanwomenItisalsoimportantthatfutureresearchexploretheperceptionthatmainstreamAmericadevaluesAfricanAmericanwomenandtheirplightasvictimsoffamilyviolence,andalsothelong-termeffectsoffamilyviolenceonthechildrenofmotherswhoarebatteredForexample,studiesthatexploretheperceptionsandlivedexperiencesoftherelationshipsamongAfricanAmericanwomenandlawenforcementcouldbeuseful,butarenon-existant.

RecommendationsforPractice

Interventionsshouldbebasedonthepersonalqualities,aswellasissuesandresearch-basedfindingsspecifictoAfricanAmericanwomenOftenAfricanAmericanwomenexperiencethe"triplejeopardy"ofincreasedlevelsofpoverty,vulnerabilitytodiseases,andmentalillnesses,includingsubstanceuse/abuse,andbatteringbyanintimatepartner(Gordon-Bradshaw,188;Sullivan&Rumptz,14)Frequentlythesewomenresideincommunitieswhereresourcestohelpthemdealwiththeseissues,aswellasbattering,arelackingCliniciansneedtobeawarethattheapparentassertivenessandresiliencythatmanybatteredAfricanAmericanwomenpresentwithmaybeastyleofcopingthattheyhavedevelopedbecauseoflimitedpersonalresourcesaswellasalackoftrustforcliniciansandotherhelpingsystems(legal,lawenforcement)whocouldnotbecountedonforassistanceinthepast(Gondolf,18)

InterventionstaffshouldincludeAfricanAmericanpractitionerswhorecognizethestrengthsofthesewomenandaresensitivetotheconcernsofbatteredAfricanAmericanwomen.

ThebasisofallinterventionsforAfricanAmericanwomenshouldbuildontheirstrengthsInterventionstaffshouldincludeAfricanAmericanpractitionerswhorecognizethestrengthsofthesewomenandaresensitivetotheconcernsofbatteredAfricanAmericanwomenItisrecommendedthatcliniciansaskallwomen,includingAfricanAmericanwomen,whopresentforhealthcareinemergencyrooms,primarycare,familyplanning,wellchildcare,mentalhealthandsubstanceabusesettingsaboutintimatepartnerabuseCliniciansshouldinquireaboutconflicts,stresses,andactualandpreferredmethodsofconflictresolution,andchildrearingpracticesforthatparticularfamily,duringtheclinicalvisitIntheassessmentphaseoftheclinicalinterviewandduringsubsequentassessments,thenursecouldfurtherexplorewiththewomanhowcrisesandperiodsofupheavalsaremanagedinherhomeandofferalternatives,literature,classesandotherinterventionmethodsthatwilladdressthespecificconcernsItisimportantthattheseassessmentscontinuebeyondthefirstvisit,withtheclinicianconveyingconcernabouthowindividualand/orfamilyhealthmayberelatedtoabuse,andateachsubsequentcontactfocusingonthehealthandwelfareofeachfamilymemberWhenchildrenandwomenexperienceconditionssuchascontinuouscolds,weightreduction,stress,headaches,sleepdisorders,andothersuchdisorders,thenurseshouldbealertedtothepossibilityofabuse,aswellastohelpthefamilymembersseehowhealthconditionsmayberelatedtoabuseItisimportanttoinvestigateinjuriessustainedbychildrenandwomenwhopresentatclinicsandhospitalsAmongintimatepartnerfemicidevictims,6%hadbeenabusedbeforetheirdeathandatleast41%ofthesewomenhadbeenseeninahealthcaresettingbeforethekillingThesewomenmayhaverepresentedmissedopportunitiesforpreventingfemicide(Sharps,etal.,2001)Althoughforthesefemicidevictims,theremayhavebeenmissedopportunitiesforinterventions,cliniciansshouldbeawareofthepotentialforinterventionforotherabusedwomenwhowillenteranyhealthcaresettinginthefutureEachentrypointintoahealthcaresettinghasthepotentialforinitiatinganinterventionorreferraltopreventorreducefurtherviolenceagainstwomen.

Womenandchildrenshouldbeinvolvedininterventionsthatwillhelpthemtodealwiththeirexperiencedinterpersonalviolenceinthehere-and-nowaswellasthepotentialforintergenerationaltransmissionofviolence

Womenandchildrenshouldbeinvolvedininterventionsthatwillhelpthemtodealwiththeirexperiencedinterpersonalviolenceinthehere-and-nowaswellasthepotentialforintergenerationaltransmissionofviolenceInterventionsmustalsoincludesolutionsthatidentifydomesticviolence(DV)asacommunityissue,byincreasingtheawarenessoftheimpactofDVonchildren,disruptionoffamilies,increasedvulnerabilitytoHIVinfection,andonotheraspectsofwomen'shealthincludingincreaseddeathratesforyoungAfricanAmericanwomenandincreasednumbersofAfricanAmericanwomenbeingincarceratedrelatedtoDVarrestsComprehensivecommunity-basedinterventionsmustincludeanearlyidentificationofabusedwomen,perhapsbyusinglayAfricanAmericancommunityoutreachworkers,appropriatereferralstocommunityresources,sheltersorsupportgroupsCertaininterventionsuchasself-helporsupportgroupsmayneedtobeAfrocentricusingonlyAfricanAmericanparticipantsandleadersFurthercommunity-basedinterventionsneedtoaddresspoverty,accesstosubstanceabusetreatmentsandresourcesthatsupportchildrenandfamiliesforbothfemaleandmalepartnersTheseservicesneedtobeavailableinawaywomencanaccessthemandfindthemusefulCommunity-basedpreventionstrategiesmayincludeschoolbased,churchbasedorneighborhoodviolencepreventionorconflictresolutionprograms.

RecommendationsforEducation

Theeducationofnurses,atalllevels,shouldincludeafocusontheimportanceofinjurypreventionwhichincludesassessingforpartnerabuse,childabuse,andotherformsofpotentiallydestructivemethodsofrelatingbetweenindividualsandwithinfamiliesContentandinterventionsshouldbespecificandincludeculturallysensitiveapproachesformeetingtheneeds,notonlyofAfricanAmericanwomenandchildren,butalsowomenandchildrenofotherethnicgroupsandimmigrantwomenNurses,atalllevels,shouldreceiveinstructionintheefficientuseofvalidatedandreliableassessmentinstrumentssuchastheAbuseAssessmentScreen(Soeken,McFarlane,Parker&Lominack,18),theDangerAssessment(Campbell,15)orothercomparableinstrumentsthathaveevidenceofvalidityandreliablityspecificallywithAfricanAmericanwomenNursesandotherhealthcareprovidersinclinicalpractice,acrosssettings,mustunderstandthatintimatepartnerviolenceandabusecanoccurinarangeofage,ethnic,socioeconomic,andreligiousgroups;theyneedtobeconstantlyalertforpossiblesignsandsymptomsofitsoccurrence.

PoliceandotherlawenforcementpersonnelneedtohaveanunderstandingofintimatepartnerviolenceTheymustalsounderstandtherolesandfunctionsofhealthsystempersonnelinpreventingviolenceandassistingwiththecareofphysicalandmentalhealthneedsthatresultasaconsequenceofviolenceNursesmustbecomefamiliarwithstateandnationallawsastheyrelatetoabuseandviolenceinintimaterelationships,andclearlyunderstandtheresponsibilitiesthatnurseshaveinassistingabusedwomenEquallyimportantaretheapplicationofethicalprinciplesastheylinktohelpingwomenwhoareinabusiverelationshipsForexample,regardingthesafetyofbatteredwomenandtheirchildrenasapriority,assuringconfidentialityandprivacy,andrespectingtheintegrityandauthorityofeachbatteredwomanoverherownlifechoicesarebeginningpoints.

Awomen'sreadinessto"escape"fromanabusiverelationshipcanpresentinvariousstages,andnursesshouldunderstandthesestagesandincorporatethemeffectivelyinaidingawomanwhoisinanabusiverelationship(Landenberger,18)Thislevelofunderstandingwillhelpthenursetorealisticallyassistthewoman,andprotectthenurseagainstpotentialfrustrationsrelatedtotheabusedwoman'sreadinesstoleaveherabusivepartnerTheclinicianshouldhelpthewomantostrengthenhercopingstrategiesduringthetimethatsheisintheabusiverelationship,andsupportherthroughthevariousphasesofseparationandwithdrawalfromtheabusiverelationship.

RecommendationsforPolicy

Acoordinatedcommunityresponsetointimatepartnerviolenceisimperative.

AcoordinatedcommunityresponsetointimatepartnerviolenceisimperativeSustaininganappropriateresponsetodomesticviolencerequiresthatnursesandotherclinicianshavesupportattheinstitutionallevelwheretheypracticeandofthecommunitiestheyserveThisrequiresinstitutionalizedpoliciescoordinatedbyalllevelsofthecommunityincludinghealthcareproviders,community-baseddomesticviolenceadvocacygroups,childwelfareandprotectiveserviceagencies,andthecivilandcriminaljusticesystems.

HealthcaresystemsshouldinstitutionalizepoliciesthatsupportprogramsknowntoreduceintimatepartnerviolenceamongAfricanAmericanwomenandothereconomicallylessadvantagedwomenHealthsystempoliciesshoulddirectclinicalprotocolsforscreeningofwomenforabuseduringhealth-relatedvisitsasaroutinecomponentoftheoverallhealthassessmentandtreatmentprocessProgramsforthetreatmentofsexuallytransmitteddiseases,HIV/AIDSandalcohol,andsubstanceabuseshouldrecognizethedisparateimpactofthesesocialandhealthproblemsontheissuesofintimatepersonalviolence(Cohen,etal.,2000)androutinelyscreenforviolenceandabuseinthesesettingsaswellasinothersWithinhealthcaresettings,culturallyrelevant,languageappropriate,easytoreadandunderstandposters,brochures,andothertypesofmediashouldbereadilyaccessibletowomen.

Ratesofintimatepartnerhomicidehavedecreasedsubstantiallyoverthepast25yearsDuringthesameperiodtherehasalsobeenanincreaseinpublicawareness,andanexpansionofdomesticviolencepolicies,servicesandprogramsThereisaneedtoexaminerelationshipsbetweentheseconcurrenttrendstodocumenttheimpactofsocialresponsesandtypesofresourcesavailabletovictimsofdomesticviolenceonthesetrendsPoliciesaimedatreducingcommunitypovertymaycontributetoeffectivepartnerviolencepreventionstrategies(Campbell,etal.,17;Cunradi,etal.,2000)Are-examinationoflegal,healthandmaterialresourcesforpoorwomenandwomenofcolorcouldbeafirststepThereisevidencethatsomerecentpoliciesmayhaveresultedinabacklasheffectforwomenathighestrisk,particularlyAfricanAmericanwomen,withtheresultinginterventionsaimedatreducingviolenceactuallyincreasingitslikelihood(e.grestrainingorders,mandatoryarrests,shelterprotection)SuchpoliciesmayangerorthreatentheabusivepartnerwithouteffectivelyreducingcontactwiththevictimForexample,negativeconsequencesofcuttingAFDCpaymentlevelsappeartohaveincreasedhomicidesofblackmarriedmen,blackunmarriedpartners,andwhiteunmarriedfemales(Dugan,Naggin&Rosenfeld,2000

Littleisknownaboutwhichwelfaretoworkpoliciesareeffectiveforbatteredwomen,orwhichstrategieswomenonwelfarewhoarebatteredcanusetobecomeeconomicallyself-sufficientManyofthesewomencannotsustainemploymentovertime,eventhoughtheydesiretodoso,unlesstheviolencestopsRaphael&Tolman(17)suggestthatrecentchangesinwelfarelaw,withrigidrequirementsforemploymentandtimelimitsforwelfarereceipt,willplacesomebatteredwomenandtheirchildrenatgreaterriskforcontinuedabuseandincreasedriskforlong-termpovertyStatewelfaredepartmentsshouldcriticallyevaluatethesepoliciesandprogramsfortheirimpactondomesticviolenceThereisaneedtoassurethatdiscrepanciesinimplementationofpolicyorservicesdonoteffectivelylimitthereductioninexposuretoviolencePoorwomenofcolormaybequitevulnerabletoincreasedviolenceiftheydonothaveequalaccesstothetypesofprotectionmandatedbylawandpolicy.

..somemenwhoareuneducated,unemployed,orunderemployedmayfeelabandonedbybothgovernmentalandprivatehelpingsystems...

PoliciesdirectedatunderstandingandinterveningwithabusersarealsoessentialInthecontextofcurrentpolicies,somemenwhoareuneducated,unemployed,orunderemployedmayfeelabandonedbybothgovernmentalandprivatehelpingsystems,increasingtheirneedtocontrolanddominatetheirpartnersTheseedsofconstructiveinterventionswithbattererslieinabetterunderstandingofthedynamicsoftheseabusiverelationships(Raphael&Tolman,17)Policiesthatincreasestrainonrelationshipswithoutreducingcontactmayincreaseriskforhomicidesthatvarybymaritalstatus,raceandgender(Coker,2000)Cokerarguesfirmlythatineveryareaofanti-domesticviolencelawandpolicy,priorityshouldbegiventothoselawsandpolicieswhichimprovewomen'saccesstomaterialresourceswhetheritbedeterminingfundingpriorities,analyzingappropriatecriminallaworarrestpolicies,developingcityordinances,ordraftingadministrativerules.

Conclusion

Therehasbeenlimitedattentiontotheavailabilityandeffectivenessofsupportivecommunityagencies,includinghealthsystems,inaddressingtheneedsofAfricanAmericanandotherwomenofcolorwhoexperienceviolenceandvictimizationAlthoughmanytypesofcommunityservicesexist,theaccessibility,sensitivity,andusefulnesstowomenofcolorarenotknown(Wyatt,14)Highprioritybypublicpolicyandbothpublicandprivatefundingagenciesshouldbegiventoresearch-basedinterventionsthataresensitivetoculturaldifferencesamongvariouspopulations.

Inthefinalanalysis,diligent,seriousandcoordinatedeffortsofgroupswithaninterdisciplinaryfocusmustshapepoliciesthatincludethebestpracticesofpublicpolicyadvocates,healthcareandlegalsystems,lawenforcement,andthereligiouscommunitiesFromsuchefforts,substantialprogresscanbemadeinspecificallyaddressingtheneedsofallwomenforwhomintimatepartnerviolenceisavividandcontinuingreality.

IntimatepartnerviolenceagainstAfricanAmericanwomenisacomplexproblemConsequencesincludeincreaseddisparitiesinbothphysicalandmentalhealthEffortstodecreasevulnerabilityofAfricanAmericanwomentointimatepartnerviolencerequiresabetterunderstandingoftheunderlyingcausesofsuchviolenceandthecontextswithinwhichitoccursEffortstoreduceviolenceinthelivesofAfricanAmericanwomenmustfocusondecreasingvulnerabilityandhealthconsequencesthroughmoreandbetterresearch,improvedpractice,educationandpolicySucheffortsrequirecoordinatedcommunityresponsesincludingnursingandotherhealthcareprofessions,lawenforcementandlegalsystems,policymakers,thereligiouscommunityandcommunitybasedagencies.

Authors

DorisWilliamsCampbell,PhD,ARNP,FAAN
E-mail-dwcampbe@hsc.usf.edu

DorisWilliamsCampbell,PhD,ARNP,FAAN,isaProfessorintheCollegesofNursingandPublicHealth,UniversityofSouthFlorida,Tampa,FLandDirectorofDiversityInitiatives,USF-AHECProgram,CollegeofMedicineHerresearchfocusisonviolenceandabuseagainstwomen,withaspecialinterestinabuseofAfricanAmericanwomenandotherwomenofcolorShehasnumerouspublicationsrelatedtoviolenceandabuseofwomenwithseveralhavingfocusedonabuseinthelivesofAfricanAmericanwomenHerareasofclinicalspecializationareWomen'sHealthandMinorityHealthSheservesontheGovernor'sTaskForceforDomesticandSexualViolence,StateofFloridaandtheClemencyReviewPanelforBatteredWomen,StateofFloridaParoleCommission.

PhyllisSharps,PhD,RN
E-mail-psharps@son.jhmi.edu

PhyllisSharps,PhD,RN,isanAssociateProfessorofCommunityHealthNursingatTheJohnsHopkinsUniversitySchoolofNursingandDirectorofHealthServicesattheHouseofRuthShelterforbatteredwomenandtheirchildren,Baltimore,MDHerresearchfocusesonwomen'shealthandviolenceandabuseasamajorhealthproblemforwomenandchildrenShehaspublishedwidelyintheareaofintimatepartnerviolenceandwomen'shealthoutcomes,specificallyperinataloutcomesHerareasofspecializationareMaternalandChildHealthandCommunityHealthNursing.

FayeAGary,EdD,RN,FAAN
E-mail-fgary@ufl.edu

FayeAGary,EdD,RN,FAAN,isaDistinguishedProfessorattheCollegeofNursingandDepartmentofPsychiatry,CollegeofMedicine,UniversityofFlorida,Gainesville,FLShespecializesinPsychiatric-MentalHealthNursingandChildandAdolescentPsychiatryShehasworkedwithtroubledchildrenandtheirfamiliesformorethanthirtyyearsWithinthiscontext,herresearchhasalsofocusedonviolenceinintimatepartnerrelationshipsandtheroleofalcoholinviolenceandabuseinintimaterelationshipsShehaspublishedwidelyonseveralrelatedtopicssuchaschildrenwhorunaway,childreninthejuvenilejusticesystem,andchildrenimpactedbyviolencewithintheirfamiliesandcommunities.

JacquelynCCampbell,PhD,RN,FAAN
E-mail-jcampbel@son.jhmi.edu

JacquelynCCampbell,PhD,RN,FAAN,iscurrentlytheAnnaDWolfEndowedProfessorandAssociateDeanforthePhDProgramandResearchattheJohnsHopkinsUniversitySchoolofNursing,withajointappointmentintheJohnsHopkinsSchoolofHygieneandPublicHealthHerresearchandpolicyinitiativesareintheareaoffamilyviolenceandviolenceagainstwomen,forwhichsheisinternationallyknownShehasreceivednumerousfederallyfundedgrantstostudyabuseandbatteringofwomenandwasmostrecentlythePrincipalInvestigatoronastudyofRiskFactorsforIntimatePartnerHomicideShehasauthoredorco-authoredmorethan100articlesandchapters,mainlyaboutbatteredwomenandfamilyviolence.

LorettaCarmenRamellaLopez,MEd,EdD,ARNP
E-mail-lccrl@aol.com

LorettaCarmenRamellaLopez,MEd,EdD,ARNP,isaspecialistinPsychiatric-MentalHealthNursingShehastaughtbothundergraduateandgraduatenursingstudentsinthisarea,andintheareaofnursingresearchforovertwentyyearsShemostrecentlytaughtgraduatenursingresearchcoursesattheUniversityofPhoenix,Tampa,FLcampusHerresearchandpublicationshavefocusedonadolescentandchildmentalhealth,includingtheproblemsofrunawayyouthandintimatepartnerviolence.

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2002OnlineJournalofIssuesinNursing
ArticlepublishedJanuary31,2002

January 31, 2002

DOI: 10.3912/OJIN.Vol7No01Man04

https://doi.org/10.3912/OJIN.Vol7No01Man04

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Citation: Campbell, D., Sharps, P., Gary, F., Campbell, J., Lopez, L., (January 31, 2002). "Intimate Partner Violence in African American Women". Online Journal of Issues in Nursing. Vol. 7 No. 1, Manuscript 4.

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