Promoting Respectful, Nonviolent Intimate Partner Relationships

Intimate Partner Violence as a Public Health Problem

Intimate partner violence (IPV) is abuse that occurs between two people in a close relationship. The term intimate partner includes current and former spouses and dating partners. IPV exists along a continuum from a single episode of violence to ongoing battering. IPV includes four types of behavior: physical abuse, sexual abuse, threats, and emotional abuse:

• In 2005, 1,510 people in the United States died at the hands of an intimate partner.
• The National Violence Against Women survey found that 22.1% of women and 7.4% of men experienced physical forms of IPV at some point in their lives.
• The cost of IPV against women, including medical care, mental health services, and lost productivity (e.g., time away from work), was an estimated $5.8 billion in 1995. Updated to 2017 dollars, that is more than $9.3 billion.

Intimate Partner Violence Prevention

The mission of the U.S. Centers for Disease Control and Prevention's (CDC's) Division of Violence Prevention (DVP) is to prevent violence through surveillance, research and development, and capacity building. Its public health approach to violence prevention complements the methods used by the criminal justice and mental health systems. Its unique features include

• An emphasis on the primary prevention of violence perpetration—CDC emphasizes efforts to prevent violence before it occurs. This requires not only reducing the factors that put people at risk, but also increasing the factors that protect people from becoming perpetrators of violence.
• A commitment to developing a rigorous science base—CDC's approach includes defining the problem through surveillance, using research to identify risk and protective factors, developing and evaluating new prevention strategies, and ensuring widespread adoption of effective programs.
• A cross-cutting perspective—The public health sector encompasses many disciplines and perspectives, making its approach well suited for examining and addressing complex problems like IPV.
• A population approach—Part of a broad public health view is emphasis on population health, not just an individual's health.

Strategic Direction for IPV Prevention

The CDC's strategic direction for IPV prevention is "Promoting respectful, nonviolent intimate partner relationships through individual, community, and societal change."

Characteristics of Respectful Relationships

• Belief in nonviolent conflict resolution
• Belief in a partner's right to autonomy
• Effective communication skills
• Shared decision making
• Ability to negotiate and adjust to stress
• Trust

Key Aspects

Two aspects for promoting respectful, nonviolent relationships are critical to making progress in addressing this strategic direction:

• Reducing social and economic disparities—Social contexts can help create and sustain respectful, nonviolent relationships. One obstacle to the creation of healthy relationships is the disparities that exist in this society. Various studies have found that inequalities with respect to income, race, and sex are all associated with IPV. These disparities are rooted in cultural and institutional practices. It is more difficult to promote respectful relationships in social contexts where attitudes, beliefs, and behaviors support continued inequalities.
• Interrupting the development of IPV—One of the key aspects to preventing IPV is understanding how violent behaviors develop. Understanding the natural development of violence perpetration is essential to identifying prevention methods. The skills and personal characteristics that are the building blocks of respectful relationships are the product of healthy development. A number of developmental pathways for IPV have been hypothesized, including child abuse and neglect, hostile parenting, and witnessing violence between parents.

Strategy

CDC's strategy to prevent IPV is organized around these four general priorities:

1. Measuring Impact

   • Operationalize, measure, and monitor respectful relationships.
   • Develop a national and state-level system for monitoring IPV.

2. Understanding the Development of IPV Perpetration and Respectful Relationships

   • Identify how IPV perpetration develops and the contexts in which IPV occurs.
   • Improve knowledge of the factors that contribute to respectful relationships and protect against IPV.

3. Creating and Evaluating New Approaches to Prevention

   • Identify and evaluate strategies that prevent IPV by promoting respectful relationships.
   • Identify and evaluate strategies that interrupt the development of IPV perpetration.

4. Building Community Capacity

   • Build community capacity to implement evidence-based prevention approaches.
   • Develop prevention and strategy guidance products for communities.
   • Establish partnerships that facilitate dissemination and implementation of evidence-supported prevention strategies.