"Terrorism on the Home Front" Donna E. Shalala Secretary of Health and Human Services Boston Herald May 8, 1994 I know of a woman who is well-educated and a professional success. Twice last year she wound up in the emergency room. First it was a broken finger. Then a few months later, she was on crutches. The first time, the story was that she hit her hand on the wall. The second time, that she accidentally fell down the stairs. But the truth is, in the first incident, she and her husband got in an argument and he punched her while she was holding their infant son; the other time, he shoved her down the stairs. Domestic violence is an unacknowledged American epidemic. Until now, this was something the federal government never talked about -- but now we will. I think it's time to call this violence what it really is: terrorism in the home. Domestic terrorism is a leading cause of injury to women in our country. The fact is, it's just about as common as giving birth -- about four million instances every year. Think about that statistic: hopelessness and hope, equally weighted in our society -- and all too often, intermingled in the same woman's life. We know that 17 percent of women interviewed in public pre-natal clinics have reported being assaulted during pregnancy. However, we don't have precise numbers for all pregnant women -- that's one project we've asked the Centers for Disease Control and Prevention to take on. Worse, it's hard for women to escape from terrorism at home. Financial dependence, the care of one's children, low self- esteem, and the desire not to be uprooted all keep women from making a break. Also, many women stay with an abuser because they fear being stalked and killed. Make no mistake, this fear is often justified: a majority of women murdered by their abusers are killed after choosing to walk out and live independent lives. A battered woman's reluctance to take action is pretty typical. Last year, a major survey found that 92 percent of women who were physically abused by their partners did not tell their doctors. Health professionals must do a better job identifying and then responding to the needs of battered women. For example, a study by the Family Violence Prevention Fund of San Francisco found that only 23 percent of California hospitals had trained emergency room staff to detect victims of domestic abuse. This, despite the fact that the American Medical Association has issued protocols for emergency room personnel to identify and help victims of domestic violence. And despite the fact that studies find that 20 to 30 percent of the women who show up at emergency rooms were hurt by their domestic partner. All health professionals must look for the warning signs of domestic violence and be familiar with the support services available to victims and their children. But we need to do even more. We need everyone to understand in no uncertain terms that beating one's wife or girlfriend is a crime. That goes for perpetrators, and it also goes for police departments. Some communities have worked with law enforcement officers to protect women from abuse. In Newport News, Virginia, all calls to the police by a woman in crisis are immediately followed up -- even if the woman calls back and says she's all right. When the officer finds probable cause of domestic violence, the perpetrator is taken into custody. Even if the woman withdraws her complaint, the policy is mandatory arrest. This takes the control out of the hands of the abuser. This may not be the precise answer in every community, but in Newport News it has saved lives. In 1984, about the time the arrest policy went into effect, 13 of 20 murders there were related to domestic violence. In 1992, not one murder was related to domestic abuse. In District Court in Quincy, Massachusetts, former Chief Judge Al Kramer said arresting the perpetrator wasn't going far enough. In court, he assigned advocates to battered women. And he gave convicted abusers the hard line -- for some, treatment; for the rest, jail. Terrorism in the home is not new; what's new is that the federal government is willing to speak out against it -- and back up our words with substantial resources. The Violence Against Women Act, included in the Senate- passed version of the Crime Bill, authorizes $1.8 billion over five years to help police, prosecutors, battered women's shelters and community-prevention programs. It also establishes a national family violence hotline. At the Department of Health and Human Services, for the first time we're making major investments in researching and preventing domestic terrorism as part of our broad women's health agenda. Our Centers for Disease Control and Prevention has received significant funding for research into domestic violence, and we are implementing a new $1 billion Family Preservation and Support Program that addresses the multiple factors placing families at risk, such as joblessness, poor housing, substance abuse and lack of day care. This program aims to prevent problems in the home by teaching skills that can prevent fighting. It does not try to keep families together no matter what. Substantial resources are devoted to making sure that children are protected from danger. That's critical, because millions of children are forced to witness violence between their parents every year -- and the consequences can be devastating. Just as charity and learning begin at home, so does violence. Some children learn to be aggressive towards others; others learn to be passive when they are being abused. Both are tragedies. Battered women -- whether a friend, a family member, or someone we will never meet -- need to know that the police, the courts, the health care system, and the social service system will respond if they are terrorized by someone they know. As a society, we must acknowledge the terrible secret of terrorism in many of our nation's homes, take steps to protect those who are terrorized, and punish those who inflict the terror.