The Public Health Crisis of Sexual Violence

Looking at rape and other sex crimes as an epidemic

Published on February 11, 2013by Elaine Meyer

When rapes are covered in the media, they are usually treated as isolated—albeit horrifying—events and are prosecuted individually. But the recent gang rapes in Delhi and in Steubenville have 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 Jan. 25 symposium at Columbia University called “Global sexualized violence: From epidemiology to action.”

The group of academics, journalists, activists, and policymakers who came together that day said sex crimes must be 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 public health problem across the globe. According to a World Health Organization multi-country survey of women ages 15-49, reports of physical and/or sexual violence are prevalent in rich and poor countries alike—from as low as 15 percent in Japan to as high as 72 percent in Ethiopia.

Many women and girls reported their first sexual experience as forced – ranging from 17 percent in rural Tanzania, to 25 percent in rural Peru, to 30 percent in rural Bangladesh.

The idea to hold a symposium addressing sexualized violence as a global epidemic came out of a partnership between Dr. Karestan Koenen, an associate professor of epidemiology at the Mailman School 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.

Rates of sexualized violence are 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, the deputy director of the Veteran Administration’s women’s health sciences division in Boston. In the wars in Iraq and Afghanistan, 25 percent of women and one percent of men reported sexual assault, and 51 percent of women and 11 percent 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 dealt with 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 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 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.

In some cases, the repercussions of reporting a rape can be very severe. In Egypt, for instance, will not to go to the police to report a rape, because of fear of stigmatization, victim-blaming, and even of being raped again, according to Women Under Siege.

There are certainly inherent difficulties in these types of studies, said panelists. Data is very difficult to collect because of privacy issues and the traumatic nature of these events.

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 the Mailman School, was Dr. Diana Russell’s 1982 San Francisco survey. She found that prevalence of rape in a representative sample was six to seven times higher than what had been reported in earlier nationwide surveys.

Unlike those earlier studies, Dr. Russell and her team conducted in-person interviews, 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 on 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 also 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 not covered 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.”

“Thus we entirely neglect to look at why rape fails to decline while 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. “