|
Abstract
|
Intimate partner violence (IPV) is an urgent pediatric health epidemic, with 1 in 5 children exposed to caregiver IPV1 and 1 in 3 adolescents experiencing adolescent relationship abuse (ARA).2 IPV is often understood as escalating cycles of control and coercion, which can become lethal for people experiencing IPV and their children.3 Firearms are responsible for >60% of IPV-related homicides in the United States4; an IPV perpetrator owning a gun increases risk for IPV-related homicides.5
Using data from the Centers for Disease Control and Prevention National Violent Death Reporting Systems, Wilson et al, in this issue of Pediatrics, document the prevalence and characteristics of firearm-related child homicide precipitated by IPV over a nearly 20-year period.6 They found that 12% of child homicides were related to IPV, with IPV homicides more likely to occur among younger children and girls. The authors note the disproportionate impact of community violence on non-Hispanic Black boys, rooted in structural racism and oppressive policies that have led to concentrated poverty. The current analysis highlights that non-Hispanic Black children were also disproportionately impacted by IPV-related homicides (29% compared with 14% of children in the United States who identify as Black7). These findings are aligned with racial and ethnic disparities in IPV homicide among minoritized adults. Black pregnant women are 3 times more likely than non-Hispanic White women to be killed by an intimate partner,8 and Black, Indigenous, and Latina women die 9 years earlier than non-Hispanic White women because of IPV.9 These cross-cutting disparities underscore how structural racism and concentrated poverty affect survivors and cut them off from affirming and life-saving resources.10
The authors also found that child homicides in the context of IPV are often accompanied by homicides of the parent experiencing IPV, demonstrating the critical need to advance family-centered prevention efforts. Lethality assessments, which include a series of questions indicating when an IPV survivor is at high risk of IPV homicide,11 have been developed for use by law enforcement. Access to firearms, threatening with a weapon, and children at home can all be indicators of higher lethality risk. Less is known about whether such assessments should be used in pediatric clinical settings because there are several concerns including survivor safety, clinician knowledge and comfort, and survivors' fears regarding disclosing IPV. What is clear is that pediatric health care settings represent an important prevention opportunity to support IPV survivors and their children. The AAP Clinical Guidelines recommends use of a strengths-based healing-centered approach, which includes universal empowerment around IPV and its impact on children with provision of resources to everyone, not only those who disclose IPV...
Language: en |