Essential Health Care Services Addressing Intimate Partner Violence (2024) / Chapter Skim
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3 Intimate Partner Violence and Public Health Emergencies
3 Intimate Partner Violence and Public Health Emergencies
Pages 63-98
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From page 63... ...
Examples include infectious disease outbreaks; extreme weather events such as hurricanes, heat waves, or wildfires; earthquakes; and technological disasters such as mass power outages, nuclear incidents, or oil spills. Terms and Approaches Five Phases The five phases or steps of emergency management are prevention, mitigation, preparedness, response, and recovery (DHS, 2015)
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. Actors and Roles in Public Health Emergency Response Initially, all disaster response is local in nature and consists of local emergency services supplemented by state and volunteer entities.
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For example, under DHS, the Federal Emergency Management Agency (FEMA) is responsible for coordinating the response to emergencies and disasters that overwhelm SLTT governments.
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The most relevant federal declarations to ensure access to essential health care services related to IPV during a PHE are made under Section 319 of the PHSA and the various declarations available under the Stafford Act. A Section 3197 PHE declaration allows HHS and its multiple subagencies, including CMS, to suspend or waive specific federal requirements, including requirements rising out of the Health Insurance Portability and Accountability Act (HIPAA)
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CMS Emergency Preparedness Rule The CMS Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule (EP rule) has particular relevance to PHE planning relevant to ensuring access to essential intimate partner violence (IPV)
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. The rule mandated the documentation of annual disaster response training; drill exercises; and plans for communicating how to contact local, state, and federal emergency preparedness officials (CMS, 2016)
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. These unique relationships are recognized within the American emergency preparedness and response structure at the federal level through amendments to the Stafford Act.15 These amendments allow tribal governments to declare emergencies and request presidential disaster declarations independent of the states.
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. In a PHE, these entities are the essential health care organizations providing a comprehensive range of health and supportive services, including support and care to individuals experiencing IPV.
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The NDRF may be applied to an incident without a federal emergency or disaster declaration. It provides a flexible structure for disaster recovery managers to work in a unified manner and is intended to foster resilience in U.S.
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. Additional protections are required for essential health care workers to continue providing care for people experiencing IPV during a PHE.
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. Public Health Emergency Response Strike Teams Public Health Emergency Response Strike Teams are active duty officers with the U.S.
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Public Health Emergencies and Health Disparities The scientific and lay literature has demonstrated that historically and structurally marginalized populations experience worse outcomes during disasters and PHEs (NASEM, 2019)
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The acute disruption of a disaster can exacerbate these potential vulnerabilities for older adults. Almost 50 percent of deaths attributed to Hurricane Katrina were among adults aged 75 and older (Brunkard et al., 2008)
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In other words, historically and structurally marginalized populations face more harm from natural disasters, but they are also more likely to face them. ¯ Vancouver Seattle M Denver St Louis W San Francisco Los Ange Angeles Na u a Ha a d M ndex Sum H G H w F GURE 3 2 Na ura Hazards ndex NH v2 0 No es For de a ed documen a on nc ud ng ava ab e hazard ayers by reg on da a n erpre a on and m a ons and v ews o nd v dua hazard ayers v s he Na ura Hazards ndex pro ec homepage w h ve map app ca on a h ps b y com hazards ndex Th s oo s a hazards map no a r sk map and can be used as a p ann ng oo bu does no ac or n oca m ga on and preparedness e or s or popu a on exposure SOURCE Co umb a C ma e Schoo Na ona Cen er or D sas er Preparedness 2023
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SOURCE: ATDSR, 2023. INTERSECTION OF PUBLIC HEALTH EMERGENCIES AND INTIMATE PARTNER VIOLENCE Effects of Public Health Emergencies on the Prevalence and Severity of Intimate Partner Violence PHEs are a time of increased prevalence and severity of IPV.
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. Researchers have examined data from IPV hotlines, hospitals and other health care settings, IPV support service providers, and surveys to gain insight into IPV during the COVID-19 pandemic.
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. Similarly, in a cross-sectional online survey in the spring of 2020, 18 percent of respondents reported IPV, with increased odds of experiencing IPV among those with employment or income change due to the pandemic than those without change (Jetelina et al., 2021)
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reported increases in the lifetime prevalence of gender-based violence and IPV in the 2 years after Hurricane Katrina, with associated increases in depressive symptoms and suicidal ideation. Intimate Partner Violence During Technological Disasters Technological disasters are caused by the breakdown or malfunction of a technological system (Lindsey et al., 2021)
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. Double Survivorship Women experiencing IPV during PHEs experience double survivorship, in the form of enduring IPV (one survivorship experience)
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Barriers to Accessing Intimate Partner Violence Care During Public Health Emergencies Barriers to accessing care during PHEs include damage to health care facilities, displacement of survivors and health care staff, dysfunctional
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Presented at Sustaining Essential Health Care Services Related to Intimate Partner Violence During Public Health Emergencies Meeting #3B, Washington, D.C.
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Presented at Sustaining Essential Health Care Ser vices Related to Intimate Partner Violence During Public Health Emer gencies Meeting 2, Irvine, CA.
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. Accessing IPV-related health care services during PHEs requires a workforce to deliver that care.
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. Among people experiencing IPV, access to safer housing (e.g., domestic violence shelters)
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IPV AND PUBLIC HEALTH EMERGENCIES 87 BOX 3-3 IPV Service Providers' Adaptations During the COVID-19 Pandemic "…in 2020 a lot really had changed. In our county, we all had to shelter in place beginning, I think it was March 16th, 2020, when all of our school districts were ordered to go to work remotely from home.
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. EXISTING GUIDANCE FOR INTIMATE PARTNER VIOLENCE HEALTH CARE DURING PUBLIC HEALTH EMERGENCIES The committee sought to identify existing, widely available guidance or standard protocols for disaster and emergency responders specific to IPV care during PHEs in the United States.
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. CDC's most recent Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health, last updated in 2019, mentions the need to include community-based organizations in planning and the need to prioritize the development of behavioral health services for families (CDC, 2019)
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. The National Resource Center on Domestic Violence's online information center, VAWnet, includes a Disaster and Emergency Preparedness and Response collection.22 The majority of resources and information in the collection are targeted at informing and preparing domestic violence and sexual violence organizations for disasters.
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2023. Association of the COVID-19 pandemic with unstable and/or unsafe living situations and intimate partner violence among pregnant individuals.
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2023. Acculturation, acculturative stress, adverse child hood experiences, and intimate partner violence among Latinx immigrants in the US.
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2018. The deepwater horizon oil spill: Resilience and growth in the aftermath of postdisaster intimate partner violence.
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2011. Experience of Hurricane Katrina and reported intimate partner violence.
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2019. Social isolation, acculturative stress and intimate partner violence (IPV)
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2020b. Supporting intimate partner violence survivors and their children during the COVID-19 pandemic.
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2022. Sociodemographic character istics, depressive symptoms, and increased frequency of intimate partner violence among LGBTQ people in the United States during the COVID-19 pandemic: A brief report.
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