Human Rights: The Violence Against Women Act Reauthorization Is Due

The Violence Against Women Act (VAWA; https://www.congress.gov/bill/103rd-congress/house-bill/3355), drafted by former senator Joe Biden and signed into law by former President Bill Clinton in 1994, provides critical support to survivors of violence. This year, 2018, the VAWA reauthorization is due. In our current, tumultuous political environment, public health professionals must advocate continued funding of this important legislation. Although all women are vulnerable to violence, factors that influence access to power—including poverty, race, and ethnicity—can heighten women’s vulnerability. Consequently, violence against women is also a human rights issue, which demands legislation, activism, and empirical research to support survivors and prevent further violence. As declared by Hillary Clinton at the United Nations (UN) Fourth World Conference on Women in 1995, “Human rights are women’s rights and women’s rights are human rights.”¹

Empirical research can and should lend additional urgency to current worldwide grassroots movements, including the #MeToo movement, the Time’s Up movement, the 2017 and 2018 Women’s Marches, the United Nation’s UNiTE to End Violence Against Women campaign, and the United State of Women 2016 and 2018 Summits (hereafter “Summit”). Although each of these movements is important, a particular 2016 Summit recommendation to change our national culture deserves attention. According to former vice-president Joe Biden, our culture “condones, [and] too often promotes violence against women.”² This means that gender norms that oppress women, along with fundamental social risk factors (e.g., poverty and differential access to power), must be addressed first if interpersonal and structural violence against women is to end.

POWER

“It’s all ultimately about the abuse of power,” Biden added. “It’s all about power. . . . We have to give women and girls a greater voice. But that’s not enough. They have to be assured that their voices will be heard.”² The concentration of power among men largely explains why women and girls worldwide are disproportionately the victims of sexual, physical, and psychological violence. According to economist and philosopher Amartya Sen, power inequalities prevent “the sharing of different opportunities” and can devastate those who are far removed from the “levers of control.”^3(pxvi)

In patriarchal societies, women are typically far removed from the levers of control, and the resulting power asymmetry makes women vulnerable to violence, sexual predation, and other power abuses. Regardless of whether the source of differential power is on the basis of gender, race, ethnicity, age, physical strength, education, or, importantly, wealth, men must be more involved in efforts to change national cultures and end violence against women. “Healthy masculinity” requires that men recognize that imbalances in power between men and women hurt everyone and that equitably sharing power with women benefits everyone. Therefore, the title “feminist” applies to anyone who actively supports equitably distributing social, political, and economic power between both sexes.

INTERSECTIONALITY

A diversity of women’s voices, identities, social statuses, and life experiences is reflected in many of the current advocacy movements. Such diversity calls for an intersectional perspective in both research and policy to represent the significant variance in women’s access to power and levers of control. Kimberlé Williams Crenshaw, the pioneer intersectionality scholar, suggested, “The violence that many women experience is often shaped by other dimensions of their identities, such as race and class” and “Ignoring [such] differences frequently contributes to tension among groups,” which makes meaningful progress even more difficult.^4(p1)

Women gain social and political power through the collective strength of shared experiences of survival or being at greater risk for violence. Therefore, a theoretically well-grounded understanding of the social, economic, and political systems that intersect to disempower women with multiple identities in terms of race, ethnicity, religion, immigration status, social class, gender identity, sexual orientation, and so on will help us develop more effective interventions at both the social policy and grassroots levels. The use of mixed methods research will be especially important in gaining a more complete understanding of violence among women living at these intersections. Developing evidence-based culturally adapted strategies that are informed by intersectional feminism and designed to demolish structures that put women at high risk for violence should be the shared goal of researchers, social advocates, and policymakers.

STRUCTURAL VIOLENCE

Paul Farmer et al. defined structural violence as “social arrangements that put individuals and populations in harm’s way. The arrangements are structural because they are embedded in the political and economic organization of our social world; they are violent because they cause injury to people.”^5(p1686) Structural violence can endure because it is fueled by differential access to political power, legal standing, education, and health care, among other factors.⁵ Hence, the sustainability, relevance, and effectiveness of any public health intervention designed to prevent violence against women will always fail if it does not have a parallel social policy intervention to interrupt structural violence, that is, the social arrangements that oppress women and normalize gender-based violence. Recommendations from empirical research and current advocacy efforts are wholly compatible with the policy-level recommendations from the Summits on the basic social and economic rights of women, including “equal pay for equal work, raising the minimum wage, paid family and sick leave, and affordable childcare.”⁶

As the national debate about funding the Affordable Care Act and reauthorizing the VAWA continue, linked research and advocacy efforts to reduce poverty among women, and thus their vulnerability to violence, remain important. Such efforts underscore the urgency of maintaining strong social safety nets to protect vulnerable women and the need to change policies and social norms that allow structural violence against women to be tolerated.

HUMAN RIGHTS

As public health professionals celebrate the upcoming 70th anniversary of the 1948 proclamation of the Universal Declaration of Human Rights and reflect on its historical advances and current threats to it, we must use this energy and attention along with that fostered by grassroots movements to promote a sustained dialogue about changing cultures and policies that tolerate any form of violence, especially the most prevalent form—violence against women. We must also advocate legislation that supports survivors of violence, such as the VAWA, as well as initiatives promoting social and economic equity for women and inclusion in positions that have real power.

One such initiative, the Convention on the Elimination of All Forms of Discrimination Against Women, has yet to be ratified by the United States, despite being adopted by the UN in 1979, signed by President Carter in 1980, and ratified by more than 95% of the UN member nations. We must facilitate this work by using our own power, privilege, and ballots to support others with less power and privilege. As Michelle Obama challenged at the 2018 Summit, “Many of us have gotten ourselves at the table but we are still too grateful to be at the table to really shake it up. . . . Now, we have to take some risks for our girls. We have to be willing to lose a little bit of something. Just holding on to our seats at the table won’t be enough to help our girls be all that they can be.”⁷ Our work should and can advance health equity for vulnerable populations, especially women, through public health research and policy interventions designed to carefully examine and dismantle explicit and implicit connections between politics, culture, racism, sexism, poverty, and violence against women. There are few public health or human rights challenges more urgent than this.