Presented by Kenneth Steinman, PhD, at The HealthPath Foundation of Ohio's Community Connections Workshop on April 20, 2012.

1. Kenneth Steinman, PhD, MPH
kjsteinman@gmail.com
Community Connections Workshop
Gahanna, OH
April 20, 2012
1

2. 1. Describe the “spectrum of prevention”
2. Describe 3 principles for making a
compelling case for family violence
3. Access and use data for grant-writing
2

3. » Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t
we use them? Why bother?
» How should I use data?
» Q&A
3

4. » When it works, nothing happens!
» Individual costs >> benefits
˃even when societal costs << benefits
» Someone pays, someone else benefits
4

5. » is often easier than intervention
˃less political, more agencies
» can be cost-effective
˃economies of scale
» can work!
5

6. » more than teaching healthy behaviors
» multiple, complementary levels
» at each level, identify most important effort(s)
6
Prevention Institute (1999)

7. 6. Influencing policy and legislation
5. Changing organizational practices
4. Fostering coalitions and networks
3. Educating providers
2. Promoting community education
1. Strengthening individual knowledge and skills
7
Prevention Institute (1999)

8. 6. Influencing policy and legislation
8

9. 5. Changing organizational practices
9

10. 2. Promoting community education
10

11. 11
1. Strengthening individual knowledge and skills

12. % of US adults smoking daily, 1995-2010
20 19.9
19
18
17
16
15
14
13
12
12.4
11
10
1995 1997 1999 2001 2003 2005 2007 2009
12
BRFSS (2011)

13. 6. Influencing policy and legislation
5. Changing organizational practices
4. Fostering coalitions and networks
3. Educating providers
2. Promoting community education
1. Strengthening individual knowledge and skills
13
Prevention Institute (1999)

14. » Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t
we use them? Why bother?
» How should I use data?
» Q&A
14

15. (Consider) Show how our problem is…
» Common
» Consequential
» Changeable
15

16. » Common: “Every day, I see…”
» Consequential: “I lost my childhood…”
» Changeable: “The program saved me…”
16

17. » Common
» Consequential
» Changeable
17

18. » 1 in 5 US adults smoke daily, 1995
18

19. Actual causes of death, US, 1990
firearms
toxic agents
tobacco
microbial
agents
alcohol
diet and
activity
patterns 19
McGinnis & Foege, 1993

20. 20

21. » Common
» Consequential
» Changeable
21

22. » Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t
we use them? Why bother?
» How should I use data?
» Q&A
22

23. Quantifiable information about
risk factors for,
scope of,
consequences of
family violence.
23

24. Risk factor Consequence
Family
Risk factor Consequence
Violence
Risk factor Consequence
24

25. Substance abuse APS investigations
among adult caregivers and interventions
Elder Accelerated move to
Elder’s social isolation
abuse LTC facility
Elder’s significant needs
for assistance Premature Mortality
Each year in Clark County…
2,137 seniors live alone in rental properties
>1,300 elders are physically abused, neglected or financially exploited 25
62 APS reports are filed for abuse, neglect or exploitation

26. 26

27. » Case reports
˃OIBRS, SACWIS, OVDRS
» Case tallies
˃Adult protective services summary reports (ODJFS)
˃Police call data (BCI)
˃Shelter data (AGO)
˃Civil protection orders (SCO)
» Surveys
˃YRBS: teen dating violence
27
˃OFHS: physical IPV

28. www.hpio.net/familyviolence
28

29. The study’s not valid
The study’s not valid because it because it didn’t include
didn’t include women who didn’t emotional abuse.
seek help.
The study’s not valid
because it didn’t include
Latinas. The numbers don’t
capture what’s really
going on here.
You can get statistics to say
anything you want.
Quantitative studies
I don’t care what the suppress victims’ voices.
research says, we need
to do [X]!
I’m afraid to use I’ve helped fill out
statistics because the forms these data
I don’t really get are based on. I know 29
them. they’re flawed.

30. » Every source is imperfect
˃especially for complex issues like FV
» Different “case” definitions
˃fear of undercounting
» Difficult to find and report
˃Access local level data
30
˃Skills to report findings accurately

31. » If you don’t count it, it doesn’t count
» Build credibility
» The data favor FV
31

32. » Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t
we use them? Why bother?
» How should I use data?
» Q&A
32

33. » Planning
Use data to find an answer
» Evaluation
» Grant-Writing
Use data to support an answer
» Advocacy
33

34. » Lifetime prevalence (“Have you ever?”)
˃compelling
˃hard to change
» Annual incidence (new cases past year)
˃current scope
˃hardest to measure
» Case reports
˃incomplete 34
˃easiest to measure, hard to compare

35. » Rates
» Raw numbers
35

36. » Association with other outcomes
˃e.g., illness & injury; employment; disability
˃hard to quantify
» Cost
˃economic analyses
˃agency burden
36

37. » Highlight differences
˃By jurisdiction
˃By time
» Program evaluation
37

38. Mean # of Child Maltreatment Incidents per year (with 95% CI)
per 1,000 Children Under 18 in 88 Ohio counties, 2001-2007
80
70
60
50
Statewide mean=33.8
40
30
20
10
0
38
Source: Ohio SACWIS
Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio
and The Ohio State University College of Public Health, 614.292.3373 or ofvpp@cph.osu.edu

39. » Keep it local
» Put it in context
39

40. IPV annual incidence
US: 2,135,000
Ohio: >88,000 40
Montgomery County: >4,100

41. » Period
˃How does my county compare to last year?
» Place
˃How does my county compare to others?
» Problem
˃How does IPV compare to other problems in my
county ?
41

42. # new civil protection order filings per 1,000 residents:
5 major metropolitan counties, 1996-2008
4
3
2
Franklin
1
0
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Source: Supreme Court of Ohio
Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio
and the Ohio State University College of Public Health. 614.292.3373 ofvpp@cph.osu.edu

43. # new civil protection order filings per 1,000 residents:
3 major metropolitan counties, 1996-2008
4
3
Franklin
2
Hamilton
1
Lucas
0
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Source: Supreme Court of Ohio
Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio
and the Ohio State University College of Public Health. 614.292.3373 ofvpp@cph.osu.edu

44. Selected threats to women’s health
in Ohio
Estimated number of cases per year
new cases of cancer 30,719
motor vehicle accident
54,409
injuries
physical intimate partner 66,000
violence*
*not including sexual violence or emotional abuse
For sources, see notes. Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio
and The Ohio State University College of Public Health, 614.292.3373 or ofvpp@cph.osu.edu

45. » www.hpio.net/familyviolence
» Common, Consequential, Changeable
45

46. Belmont County
These data describe common types of violence perpetrated by family members or caregivers in our county each year. We present
the best available, most recent estimates. Nonetheless, our figures are conservative and represent only part of the burden family
violence places on our families and communities. All figures are estimates or annual averages.
Each year in our county…
adults are physically abused seniors in the community are
180 – 280 children are abused or
neglected 550 – 720 by a current or former 680 – 870 abused, neglected or
intimate partner financially exploited
reports of abuse or seniors in LTC facilities are
325 neglect are filed with n/a people are arrested for
intimate partner violence 50 – 100 abused, neglected or
children’s services financially exploited
reports of abuse, neglect or
87 children are placed in
custody 35 people file petitions for
civil protection orders 79 exploitation are filed for
seniors in the community
adults seek shelter in reports of abuse, neglect or
36 domestic violence shelters in 18 exploitation are filed for
the county seniors in LTC facilities
• It is difficult to measure the true prevalence of family violence; many victims never come to the attention of
authorities.
• Reports to local children’s service agencies typically exceed the estimated number of abused or neglected
children. This is likely due to multiple reports filed for a single child. Also, many children are placed in custody
for reasons other than abuse or neglect (e.g., delinquency).
• n/a = figure not available because of missing data.
• Elder abuse/neglect figures exclude self-neglect and victims <60 years old. (LTC = long term care)
This profile is part of an 88-county series provided by the Ohio Family Violence Prevention Project – a collaborative project of the Health Policy Institute of Ohio and the Ohio
State University College of Public Health with support from the HealthPath Foundation of Ohio. For additional copies and a detailed description of how we calculated these
figures, please visit: www.healthpolicyohio.org/OFVPP_CountyProfiles.html
Suggested citation: Health Policy Institute of Ohio. Family Violence in [county name] County. Columbus, OH: Health Policy Institute of Ohio; 2010.

47. In Belmont County, how does family violence compare to other threats among…?
teenage girls (age 15-19, est. # /year) adult women (age 18+, est. # / year) seniors (age 60+, est. # / year)
physical
cigarette use intimate partner injuries from
320-560 violence 350-480 falls 490-960
dating violence 150-230 motor vehicle 274 elder 680-870
crash injuries abuse/neglect
mothers without
pregnancies 117 1st trimester 130 new cancer
prenatal care cases 330
motor vehicle new cancer motor vehicle
crash injuries 59 cases 230 crash injuries 85
• For example: each year in our county between 350 and 480 adult women experience physical intimate partner violence;
in comparison, 274 adult women are injured in motor vehicle crashes.
How do we compare to other counties? Is family violence increasing?
Mean of 29 It is hard to say. Mean annual rate of petitions for
Belmont Appalachian State Some data sources civil protection orders, per 10,000 adults,
County counties mean suggest family Belmont County, 2000-2008
Civil protection order petitions violence is
(per 10,000 adults) 6.4 28.9 21.6 increasing; others
suggest it is stable
Reports of abuse, neglect or or decreasing.
exploitation in LTC facilities 1.8 2.2 2.3 Within a
(per 100 resident beds)
county, changes
• Belmont County has a lower rate of petitions for civil protection over time are 6.5
5.5
6.4
orders (CPO’s) compared to similar counties in Ohio. largely due to 2000-02 2003-05 2006-08
changes in victims’
• Belmont County has about the same rate of reports of ability to access for example, suggests no significant
services. This graph,
abuse, neglect or exploitation in LTC facilities compared to change in petitions for CPO’s in our county. This trend could
similar counties in Ohio. reflect no changes in the awareness or ability of victims to
• Differences in data collection limit our ability to compare other request CPO’s. For a discussion of when differences are
indicators of family violence across counties. noteworthy, please see the introduction.
Child Abuse Hotline: 1-800-4-A-CHILD
To talk with someone about family violence, contact: Ohio Domestic Violence Network 1-800-934-9840
Ohio Area Agencies on Aging: 1-866-243-5678

48. » Each year in our county at least 350 adult
women experience physical intimate partner
violence. In comparison, 274 are injured in
motor vehicle crashes and are 230 newly
diagnosed with cancer.
48

49. » Each year in our county, local courts handle
35 petitions for civil protection orders and 36
adults seek shelter in local domestic violence
shelters.
49

50. » Compared to Belmont County, the rate of
petitions for civil protection orders is nearly
four times greater in other Appalachian
counties (6.4 vs. 28.9 per 10,000 adults).
Supporting our legal advocacy program will
help us close this gap.
50

51. 51

52. » FV is not equally common everywhere
» FV is not always getting worse
» Not all programs and policies work
52

53. # of adult protective service reports in Preble County, Ohio:
FY2007 – FY 2009
150
100
50
0
FY2007 FY2008 FY2009*
53
Source: Ohio Dept of Job & Family Services; US Census Bureau *projected
Slide prepared by the Ohio Family Violence Prevention Project, a project of the Health Policy Institute of Ohio
and The Ohio State University College of Public Health, 614.292.3373 or ofvpp@cph.osu.edu

54. » Framing prevention
» Framing the problem
» What are “family violence” data? Why don’t
we use them? Why bother?
» How should I use data?
» Q&A
54

55. 1. Describe the “spectrum of prevention”
2. 3 principles for making a compelling case
for family violence
3. Access and use data for grant-writing
www.hpio.net/familyviolence
55

56. What if this
makes
my agency
look bad?
56

57. 57