Is sexual assault a public health issue? You bet it is…

A conversation with WCASA’s Rose Hennessey, MPH

April is Sexual Assault Awareness Month (SAAM)! And, April 1–7^th is National Public Health Awareness Month.

Last month, WCASA welcomed Rose Hennessey to our staff as the Prevention & Evaluation Coordinator. Rose studied at the University of Minnesota, where she was Violence Prevention Intern and coordinated college events for Sexual Assault Awareness Month. While doing this work she developed an interest in prevention and decided to do her Masters in Public Health Education at UCLA. There, she worked on Project Erin (Emergency Response Intervention Network) at the Children’s Institute, Inc. where she did case management on domestic violence cases with mostly Spanish speaking children and families. She was also therapeutic support advocate for their PCIT (Parent‐Child Interaction Therapy) program.

SM sits down with Rose H.

WCASA’s Violence Prevention & Communications Coordinator sat down with Rose to discuss the intersection of public health and sexual violence.

You can view the interview via YouTube (15 min)

The following is an excerpted transcript of that conversation:

Stephen Montagna, Violence Prevention and Communications Coordinator: What made you want to pursue a degree in Public Health?

Rose Hennessey: When I was in my undergrad, I was a Biology major. I was interested in science and interested in that kind of research development; but I was also a prevention educator. So I was going into fraternities, and talking to… anyone in the community really; I think I counted more than fifty presentations when I was there. I thought: this is really where my heart is – preventing violence. Most people who go into the field, they’re maybe lawyers, or therapists, or advocates. And I just felt, I really want to do the prevention work. I remember sitting down with someone and saying “well, how do we prevent violence?”, and they said “well, we use the public health model”, and I said “what’s that?” – and they said “you should go learn about it”!

SM: So your prevention work actually pre-dated the public health, you actually saw the public health work as a means toward accomplishing a prevention goal?

RH: Yes.

SM: What’s the connection between sexual assault and public health? When someone said, “check out these models”, what did those models tell about – what did you learn from public health about sexual assault?

RH: I think that it doesn’t take much digging to look at the health impacts. Especially in sexual assault, we’re looking at the impact of STD’s, HIV, that’s I think the most obvious, clear link. I think I just read that 40% of IPV (intimate partner violence) or sexual assault [incidents] have a physical injury, that go with them. Whether thats a broken arm, scrapes, lesions, something like that; so we already see those health effects there, leading up to, unfortunately to death. And anything that is a cause of death I think can be linked to being a public health problem.

SM: I find myself using the comparison with the word pandemic. We think of an epidemic, an outbreak; a pandemic, something that spreads world-wide. Is that appropriate? Are public health practitioners making that comparison – sexual assault is just like a disease in some ways?

RH: Very much so.

SM: Different because it’s not caused by a biological agent, it’s caused by personal behavior. But still, in terms of how wide-spread it is, we can think of it as a pandemic.

RH: Yeah, and I think especially because we have been able to do things and see tangible prevention results, if it’s something we can prevent, just like we can prevent onset of diabetes…then the model of prevention from the public health framework is going to be a really good fit. And is a really good fit.

SM: What can the SA prevention movement learn from the Public Health movement?

RH: Well I think the nice thing about the public health background is this science-y, research background that they’re really bringing in. Especially in terms of surveillance and tracking systems, so some of these great national reporting systems – but even just the ability to track and measure things over time. I think that sometimes that’s not something that we’ve had the money or time or knowledge, resources in the sexual assault movement to always accomplish. I also think that if we’re going to invest time in prevention, we should be doing things that we think really work well, not just maybe feel good. And I think that’s something that the public health folks and their models have really taken in looking at those outcomes and making a commitment to continue the things that are effective, and modify those things that aren’t, or discontinue them.

SM: So what about the other direction? Do you think there’s anything the public health movement can learn from the SA prevention movement?

Well I think about this a lot; I feel like it’s very difficult for folks in public health to come into domestic violence, child abuse, sexual assault prevention. More so than it is to go into poison prevention, cancer research, or that kind of thing. And I think it’s because there’s such a strong root in social change work, in social organizing, this movement that has originated from feminist upbringing. When you look at the framing of violence prevention as a public health issue, I think the first real great documentation is 1979, there was a health report released in the United States… but that’s a pretty young movement. When you think about the movement of ending violence against women – I mean, this has been going on and on and on. The activism that you see in our movement, the number of people calling legislators to pass VAWA, the Take Back The Night events happening globally. We see some of that in Relay for Life, some of your breast cancer awareness [campaigns], but I don’t think the investment and the activism is as strong and I think that’s something that the public health movement could really learn from the sexual assault movement.

SM: As someone who started in the movement as a prevention person, there are times where prevention and advocacy can – for lack of a better term, metaphorically – “butt heads”, because advocacy is responding to the real experiences of survivors, and prevention people tend to play with hypotheticals.  And because the movements really started as a sort of call for perpetrators to be [held] accountable. We know these crimes are perpetrated by individuals, or by groups, we want those people held accountable. When you’re talking about a public health model – taking a step back and trying to see the causes that lead to this, there can be a tendency for some people on the advocacy side to think that you’re actually letting the perpetrator off the hook. How do you mitigate that?

RH: That’s interesting. I think it’s something that would come up in certain contexts. I think it comes down to this idea that the act is never okay. Whatever is causing it is never okay. Now, if we just leave it at that, we’re not going to have enough knowledge to prevent it. So it’s important to take it another step. But, I think that that has been a tension; and holding those folks accountable – I was really excited when I saw WCASA’s state prevention plan because offender accountability is one of those objectives. And I thought, that’s really wonderful, because it’s making it really clear that in the midst of all of this we’re not going to forget, that if we live in a society where people can do whatever they want and are never held accountable, we’re probably not going to prevent this.

SM: Where would you like to see the SA prevention movement go? What are we not (yet) doing that we should be?

RH: Well, in my perfect world, where I have as much funding as I want, and time… I think that it’s really common that when we are doing prevention efforts we are only doing one thing because that’s what we have capacity to do. So maybe in this town they’re doing — you know, events for Sexual Assault Awareness Month; and maybe over here they’re doing a curriculum with their teens; and over here they’re doing something else. But, we know that if we’re really going to prevent sexual assault it’s got to be a multifaceted approach. And that it’s never going to be enough; that every input that comes at us as human beings, that’s pushing us in certain directions, that we’re not going to mitigate that with a one-hour presentation. I would like to see more multifaceted approaches that are really targeting multiple levels. And, with that I would really like to see more RCTs — or randomized controlled trials — of what’s going on, because when you’re looking at literature, if you’re looking for prevention, our evidence-based practices very frequently are based on one study that hasn’t been replicated in other settings and as we saw with the crime prevention stuff in the Chicago area — CeaseFire, when that was replicated in other cities they didn’t get the same results because the cities were different. But they got wonderful results in Chicago. So I think I would like to see more research done in a rigorous manner so that we know it’s effective and if we’re gonna talk about best practices we can be more educated about it. Specifically, in some of our unique communities, too, that really have different risk and protective factors that might not be targeted by some of those interventions made for the mainstream.

SM: When we think of the public health model, and Public Health Awareness Week going into Sexual Assault Awareness Month, what are some of the ways in which people can actually think in a public health way as they’re celebrating or marking the month? I know for instance, towards the end of the month we will have a lot of activities here in Dane County. We’ll have Denim Day. Is Denim Day a public health opportunity?

RH: I think a lot of the sexual assault awareness month events are in and of themselves, awareness. Any time we have an awareness event it’s a great platform to include prevention, and to think about those risk and protective factors; how can we talk about them? How can we engage in them? So, if were doing denim Day let’s talk about healthy sexuality at the same time. Let’s talk about would have healthy masculinity looks like.

SM: Steubenville [OH] Which is so much in the news right now, is that a good opportunity to have public health dialog?

RH: Well I think that using that framework is very good. There are times that the public health movement has been critiqued for not having enough of a social justice basis as well. And I think there is some very valid reasons for that claim. That’s something that’s really nice about working in our field, is that I think we bring I think we bring some of those social justice [sensibilities]. I’d say that having a public health discussion about that situation could definitely be the case. And anytime were talking about this also remembering a social justice framework, and bringing in some of those concepts can be really important.