Why do some professionals believe there is only one solution to a problem?  Complicated issues, like health care, global warming and sexual violence / domestic violence, require comprehensive solutions.  So I was surprised when I saw the title of the letter from Andy Klein appearing in February 2010 issue of the  National Bulletin on Domestic Violence Prevention is “DV is not a public health problem.” Klein claims that

Declaring DV to be a public health emergency takes our eyes off the ball. DV is a criminal justice emergency, a continuing failure of the criminal justice system to stop criminals from committing crimes repeatedly. Well intended counseling by health professional will not stop their patients’ victimizers.

I will not reduce addressing domestic violence to criminal justice solutions. However, in this article, Klein reduces public health response to health care providers screening while suggesting the value of medical personnel is to “assist law enforcement” by recording victim reports of abuse.
I see a public health approach as much more than screening. Klein identifies Swine flu as a public health emergency (though public health people call it H1N1). The incidence of domestic violence and sexual assault exceed that of Swine flu; and its impact is significant to people’s health and well-being. In a PreventConnect eLearning unit on social justice and public health, I examine how the lessons learned from public health response to disease can influence our efforts to prevent sexual violence.
Public health is more than epidemiology, health care and infectious disease control.  I studied Community Health Education where I learned how public health provided some valuable ways to address issues such as domestic violence and sexual assault:

  • Public health changes the conditions of a community and society to solve a problem,
  • Public health addresses the root causes,
  • Public health goes beyond responding to the problem,
  • Public health seeks to prevent it from happening in the first place.

Public health informed efforts such as DELTA, Rape Prevention & Education, and StartStrong are engaging communities to take action to prevent domestic violence, sexual abuse and teen dating violence. PreventConnect is a online community of people using public health concepts to advance prevention.
I agree with Andy Klein there are limits to the public health approach to preventing domestic violence and sexual violence. A public health framework alone is not enough to understand the problem and develop the solutions; we have to also look to other approaches, such as human rights and justice.  While there are some elements common to public health success stories like tobacco prevention and using car seats, the work to end domestic violence and sexual assault is more similar to the work of the civil rights movement: we must shift norms of how we define men and women, relationships and family, and power itself.
How have you found public health concepts helpful to developing domestic violence and sexual violence prevention initiatives?