Fostering an Evidence-Based Approach: Data

efforts to collect data on sexual assault currently exist but are insufficiently coordinated and lack a focus on underlying causes necessary for effective prevention. This is in large part because data are often collected after the fact. The CDC, for example, uses surveys of victims to determine the prevalence of sexual violence and the demographic characteristics of victims.269 _{Where CDC data collection}

focuses on behavioral risk, it looks to the risk of becoming a victim rather than the risk of becoming a perpetrator.270

268. While Part II.C divides these interventions into categories, in reality laws are likely to be far more interconnected. Changes to education law would require and be informed by increased data collection and funding to test curricular requirements. Educational requirements would likely interact with programs that address social determinants, such as models that use a combination of curricular requirements and home visits to help support struggling families. See generally Sorenson & Dodge, supra note 232 (studying the Fast Track childhood intervention program).

269. See CDCSURVEY, supra note 66. The National Electronic Injury Surveillance System- All Injury Program provides data on nonfatal injuries treated in U.S. hospital emergency departments, including those related to sexual violence. The National Violence Against Women Survey interviewed women about their general fear of violence, emotional abuse, physical assaults, forcible rape, stalking, and threats of violence. See CTRS. FOR DISEASE CONTROL & PREVENTION, SEXUAL VIOLENCE DATA SOURCES, http://www.cdc.gov/violenceprevention/ sexualviolence/datasources.html [https://perma.cc/V28Y-VE69] [hereinafter CDC DATA

SOURCES].

270. The Behavioral Risk Factor Surveillance System (BRFSS) tracks health conditions and risk behaviors in the United States through surveys conducted by state health departments. The CDC briefly funded an optional module to the BRFSS on sexual violence victimization between 2005 and 2007. CDCDATA SOURCES, supra note 269. Private institutions tend to take the same tactic. For example, when the Association of American Universities created a survey of campus sexual assault, they focused on the prevalence of nonconsensual sexual contact and the demographics of the victims. They did not collect data on perpetrators or on the attitudes and norms that are associated with rates of nonconsensual sexual contact. See DAVID CANTOR,

This focus is somewhat predictable. Surveys can more easily collect data from victims than perpetrators, who may be less likely to admit their actions. Analyzing causes of sexual assault, such as the effect of norms and attitudes, is also more difficult than determining the number of sexual assaults from crime statistics or telephone surveys.

A robust public health law framework, however, requires a concentrated effort to meet these challenges. Public health law’s focus on evidence-based prevention necessitates coordinated data collection on causes, in particular on what causes sexual-violence perpetration. Surveys that collect data on perpetrator behavior, attitudes, and beliefs can provide insights into the norms that contribute to sexual aggression. The obstacles to collecting this data are not insurmountable. Evidence suggests, for example, that surveys of perpetrators or potential perpetrators are more likely to be successful if they ask about specific behaviors rather than value-laden terms like rape (for example, “Have you ever coerced somebody to intercourse by holding them down?” instead of, “Have you ever raped somebody?”).271

A public health framework therefore requires a strong mandate for national, state, and local public health authorities to conduct data collection on the causes of sexual assault and risk. This legislative mandate would be most effective if it set forth minimum standards for data collection. Previous legislative mandates provide examples of strong and coordinated mandates. For example, the ACA mandates national data collection on racial health disparities.272

Similarly, VAWA mandates data collection on domestic and sexual violence.273

Public health authorities can also partner with other experts to generate creative ways to collect data. A legislative mandate can, for

BONNIE FISHER,SUSAN CHIBNALL,REANNE TOWNSEND,HYUNSHIK LEE,CAROL BRUCE & GAIL THOMAS,REPORT ON THE AAUCAMPUS CLIMATE SURVEY ON SEXUAL ASSAULT AND

SEXUAL MISCONDUCT (2015).

271. See Edwards et al., supra note 103, at 188, 190; Mary P. Koss, Hidden Rape: Sexual Aggression and Victimization in a National Sample of Students in Higher Education, in 2 RAPE AND SEXUAL ASSAULT 3 (Ann Wolbert Burgess ed., 1988).

272. See U.S.DEP’T OF HEALTH &HUM.SERVS.,IMPLEMENTATION GUIDANCE ON DATA

COLLECTION STANDARDS FOR RACE,ETHNICITY,SEX,PRIMARY LANGUAGE, AND DISABILITY

STATUS (2011) [hereinafter DATA COLLECTION STANDARDS],https://aspe.hhs.gov/basic-report/ hhs-implementation-guidance-data-collection-standards-race-ethnicity-sex-primary-language- and-disability-status [https://perma.cc/6NEM-AUJS].

273. See, e.g., NAT’L INST. OF JUSTICE, DOMESTIC AND SEXUAL VIOLENCE DATA

example, require the collection of data in public schools on behaviors, gender norms, and attitudes about sexual behavior and consent. Congress can expand Title IX requirements to require similar data collection in universities.

Such mandates can and should take advantage of partnerships with private and educational institutions. State or local public health authorities may have limited capacity to collect data or may lack the resources or expertise to analyze the nuanced causes of sexual violence. Legislative mandates can respond to this problem by allowing partnerships with other public and private institutions. The ACA, for example, allows federally funded population surveys on health care disparities to be contracted to private actors.274 _{A public health law}

framework for rape should take advantage of the broad scope of public health law by encouraging partnerships with community organizations, private actors, and educational institutions.