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5 Marrieds and Non-Marrieds

In document Health Education (Page 80-93)

There are known benefits to being married and in a long-term relationship rather than being single, divorced, or cohabiting. The list below shows health benefits from the cohabitation and marriage study of the National Survey of Family Growth. Better mental and physical health with better medical insurance coverage prove to be crucial qualities for marrieds. As far as children are concerned, having better care and better adult outcomes are crucial factors.

Health Benefits Known to be an Advantage among Married Persons in the U.S.

1.Generally better mental and physical health outcomes 2.Longer lives

3.Higher rates of health insurance coverage 4.Lower prevalence of cardiovascular disease 5.Better health and well-being of children

6.Children born to unmarried mothers are at greater risk for poverty, teen childbearing,

poor school achievement, and marital disruption in adulthood than children born to married mothers

There are also known financial benefits when comparing marrieds to non-marrieds. More wealth accumulation, higher assets, and higher monthly income are consistent among marrieds. The first thing you notice is that marrieds have consistently higher annual incomes. In 2007 specifically, marrieds had $28,231 more income than single men and $42,293 more than single women. The difference is even more pronounced if both incomes are taken into consideration for dual income marrieds (i.e., in 2007 dual income couples had $86,435 which is $42,077 higher than single men and $56,139 more than single women).

Married people are also safer and less prone to get into trouble than others. There is a buffering effect that accompanies having a life-long devoted spouse who helps deflect

stress and hardships on a daily basis. Thus some of the health benefits of longer life, less suicide, more stable health coverage, and less illness and addiction. Also, marrieds have more social support, more continuity in long-term relationships, and especially more closeness for men in intimate family relationships. Husbands are less likely to abuse and be violent toward their wives than are boyfriends and partners. Married people have clear life-long goals and tend to buy homes, invest, and plan for retirement more than others. The government and military recognize spouses and reward them with tax breaks, benefits, and other sources of coverage and support more than others. In later life, many elderly report that their family relationships are very supportive and important to them. Studies show that the elderly enjoy their human investment in their children and grandchildren that yields emotional and social rewards throughout their golden years.

Known Benefits Enjoyed by Married Couples in Comparison to Non-Married Persons.

1. Less likely to become victims of crime 2. Less likely to commit crimes

3. Less addiction

4. Fewer accidents (especially among men) 5. Less suicide

6. Better stress management because spouse is a buffer to life's stresses 7. More social and emotional support (less loneliness)

8. More intimate connections to family members

9. Long-term continuity in family relationships of children, in-laws, grandchildren, etc. 10.Lower risk of domestic violence for women

11.Longer life expectancies 12.More and better self-rated sex

13.More emotional and financial security (for both spouses) 14.Less uncertainty about direction of life and goals

15.More cost effective to live in married versus single circumstances 16. Tax deductions 17.More military benefits

18.More accumulated belongings and investments 19.More medical benefits

20.More legal rights

To legally marry in the United States today, one simply goes to the local county or state office and applies for a state marriage license. The state also claims authority in granting divorce rights to couples. Divorce is the legal dissolution of a previously granted marriage.

Most marriages still endure, and the odds are that divorce won’t happen to most marriages.

It is a myth that one in two marriages eventually ends in divorce. There are a few myths about U.S. divorce trends that will be dispelled in this chapter. You might have heard the myth of the Seven Year Itch where divorce happens prior to or shortly after the 7th year. Current government estimates indicate that about 75% of couples make their ten-year anniversary in their first marriage. The myths are false, but divorce does happen more

today than it did 50 years ago and more people today are currently divorced than were currently divorced 50 years ago.

Ten Actions to Minimize the Risk of Divorce.

1. Wait until at least 20 years old to marry, 25 is better.

2. Avoid premarital pregnancy and don’t marry just because of a pregnancy. 3. Become proactive in maintaining your marriage (books, seminars, counseling). 4. Understand risks of cohabitation (cohabitation ≠ divorce).

5. Once married, leave the marriage market; don’t keep an eye open for something better. 6. Learn to compromise with each other. Work around those irreconcilable differences. 7. Keep a positive outlook and look beyond today.

8. Take your time in selecting a mate. Don’t rush into marriage.

9. Take the media with a grain of salt. Don’t assume your marriage will be like the


10.Focus on the positive benefits of being married and don’t dwell on the negatives.

Section 4.6 Violence in Relationships

Violence is a serious public health problem in the United States. From infants to the elderly, it affects people in all stages of life. In the United States, violence accounts for

approximately 51,000 deaths annually. In 2007, more than 18,000 people were victims of homicide and more than 34,000 took their own life.

Estimating the size of this economic burden is helpful in understanding the resources that could be saved if cost-effective violence prevention efforts were applied. The cost of these deaths totaled to $47.2 billion ($47 billion in work loss costs and $215 million in medical treatment).

The number of violent deaths tells only part of the story. Many more survive violence and are left with permanent physical and emotional scars. Violence also erodes communities by reducing productivity, decreasing property values, and disrupting social services.

Understanding Violence

Interpersonal violence is defined as the actual or threatened intentional use of force—

physical, sexual, or emotional—against another person, group, or community. It may result in physical injury, psychological harm, or even death. Violence also includes suicide and nonfatal acts of self-harm.

Unfortunately, violence is a part of our daily life. It exists in all corners of our nation. It affects us all regardless of our age, gender, race, ethnicity, or socio-economic status. More than 50,000 violent deaths occur each year in the United States. The deaths only tell part of the story. Millions of others are left with debilitating physical and emotional injuries. These injuries negatively affect the health of victims for the rest of their lives.

workplace, decrease the value of our homes and businesses, and disrupt essential public and social services. The economic cost of violence is staggering. In 2000, the medical costs and productivity losses associated with nonfatal violence-related injuries and deaths were estimated at more than $70 billion each year. The total burden to society is far greater. The good news is that violence is a problem with a solution. It can be prevented by using a thoughtful and systematic approach. While the field of violence prevention is still

developing, our knowledge of “what works” increases every day.

Types of Violence

• Child Maltreatment (e.g., child abuse and neglect)

• Intimate Partner Violence (e.g., violence by a current or former spouse, boy/girlfriend)

• Sexual Violence (e.g., rape, sexual assault, sexual harassment)

• Suicide (e.g., fatal and nonfatal suicide behavior)

• Youth Violence (e.g., bullying, gang violence, peer violence)

Section 4.7 Sexual Violence

Sexual Violence (SV) refers to sexual activity where consent is not obtained or freely given. Anyone can experience SV, but most victims are female. The person responsible for the violence is typically male and is usually someone known to the victim. The person can be, but is not limited to, a friend, coworker, neighbor, or family member.

There are many types of SV. Not all include physical contact between the victim and the perpetrator (person who harms someone else) – for example, sexual harassment, threats, and peeping. Other SV, including unwanted touching and rape, includes physical contact. SV can impact health in many ways. Some ways are serious and can lead to long-term health problems. These include chronic pain, headaches, stomach problems, and sexually transmitted diseases.

SV can have an emotional impact as well. Victims often are fearful and anxious. They may replay the attack over and over in their minds. They may have problems with trust and be wary of becoming involved with others. The anger and stress that victims feel may lead to eating disorders and depression. Some even think about or attempt suicide.

SV is also linked to negative health behaviors. For example, victims are more likely to smoke, abuse alcohol, use drugs, and engage in risky sexual activity.

Why is sexual violence a public health problem?

SV is a significant problem in the United States:

• Among high school students surveyed nationwide, about 8% reported having been forced to have sex. The percentage of those having been forced to ever have sex was higher among female (11%) than male (5%) students.

• An estimated 20% to 25% of college women in the United States have experienced an attempted or complete rape during their college career

• Nearly 1 in 5 women and 1 in 71 men in the United States have been raped at some time in their lives.

These numbers underestimate the problem. Many cases are not reported because victims are afraid to tell the police, friends, or family about the abuse. Victims also think that their stories of abuse will not be believed and that police cannot help them. They may be

ashamed or embarrassed. Victims may also keep quiet because they have been threatened with further harm if they tell anyone.

Certain factors can increase the risk for SV. However, the presence of these factors does not mean that SV will occur.

Risk factors for perpetration (harm to someone else):

• Being male

• Having friends that are sexually aggressive

• Witnessing or experiencing violence as a child

• Alcohol or drug use

• Being exposed to social norms, or shared beliefs, that support sexual violence. It is important to understand what factors protect people or put them at risk for

experiencing or perpetrating violence. Why are risk and protective factors useful? They help identify where prevention efforts need to be focused.

Risk factors do not cause violence. The presence of a risk factor does not mean that a person will always experience violence. Victims are never responsible for the harm inflicted upon them.

• Risk Factor - Characteristic that increases the likelihood of a person becoming a victim or perpetrator of violence.

• Protective Factor - Characteristic that decreases the likelihood of a person becoming a victim or perpetrator of violence because it provides a buffer against risk.

How can we prevent sexual violence?

The ultimate goal is to stop SV before it begins. Efforts at many levels are needed to accomplish this. Some examples include:

• Engaging high school students in mentoring programs or other skill-based activities that address healthy sexuality and dating relationships.

• Helping parents identify and address violent attitudes and behaviors in their kids.

• Creating policies at work, at school, and in other places that address sexual harassment.

• Developing mass media (e.g., radio, TV, magazines, newspapers) messages that promote norms, or shared beliefs, about healthy sexual relationships.

Sexual Violence: Risk and Protective Factors

Risk factors are associated with a greater likelihood of sexual violence (SV) perpetration. They are contributing factors and may or may not be direct causes. Not everyone who is

identified as "at risk" becomes a perpetrator of violence.

A combination of individual, relational, community, and societal factors contribute to the risk of becoming a perpetrator of SV. Understanding these multilevel factors can help identify various opportunities for prevention.

Risk Factors for Perpetration

Individual Risk Factors

• Alcohol and drug use

• Coercive sexual fantasies

• Impulsive and antisocial tendencies

• Preference for impersonal sex

• Hostility towards women

• Hypermasculinity

• Childhood history of sexual and physical abuse • Witnessed family violence as a child

Relationship Factors

• Association with sexually aggressive and delinquent peers

• Family environment characterized by physical violence and few resources

• Strong patriarchal relationship or familial environment

• Emotionally unsupportive familial environment

Community Factors

• Lack of employment opportunities

• Lack of institutional support from police and judicial system

• General tolerance of sexual violence within the community

• Weak community sanctions against sexual violence perpetrators

Societal Factors

• Poverty

• Societal norms that support sexual violence

• Societal norms that support male superiority and sexual entitlement

• Societal norms that maintain women's inferiority and sexual submissiveness

• Weak laws and policies related to gender equity

• High tolerance levels of crime and other forms of violence

Sexual Violence: Prevention Strategies

Sexual violence is a serious problem that can have lasting, harmful effects on victims and their family, friends, and communities. The goal of sexual violence prevention is simple-to stop it from happening in the first place. However, the solutions are just as complex as the problem.

Prevention efforts should ultimately decrease the number of individuals who perpetrate sexual violence and the number of individuals who are sexual violence victims. Many prevention approaches aim to reduce risk factors and promote protective factors for sexual violence. In addition, comprehensive prevention strategies should address factors at each of the levels that influence sexual violence -the individual, relationship, community, and society.

The most common prevention strategies currently focus on the victim, the perpetrator, or bystanders.

• Strategies that aim to equip the victim with knowledge, awareness, or self-defense

skills are referred to as risk reduction techniques.

• Strategies targeting the perpetrator attempt to change risk and protective factors for sexual violence in order to reduce the likelihood that an individual will engage in sexually violent behavior.

• The goal of bystander prevention strategies is to change social norms supporting sexual violence and empower men and women to intervene with peers to prevent an assault from occurring.

• Other prevention strategies may target social norms, policies, or laws in

communities to reduce the perpetration of sexual violence across the population.

Effective and Promising Programs

Unfortunately, little is known about what works to prevent sexual violence. To date, only one prevention program, Safe Dates, has been shown in a randomized controlled trial to prevent or interrupt sexual violence perpetration. Other programs are accumulating evidence for effectiveness and are moving towards or are currently conducting rigorous evaluations. Until more is known about what works and for whom, program planners can use prevention principles to strengthen their approach and evaluation to determine the effectiveness of new or existing programs.

4.8 Intimate Partner Violence

Figure 1. Couple

Intimate partner violence (IPV) is a serious, preventable public health problem that affects

millions of Americans. The term “intimate partner violence” describes physical, sexual, or

psychological harm by a current or former partner or spouse. This type of violence can occur among heterosexual or same-sex couples and does not require sexual intimacy. The goal is to stop IPV before it begins. There is a lot to learn about how to prevent IPV. We do know that strategies that promote healthy behaviors in relationships are important. Programs that teach young people skills for dating can prevent violence. These programs

can stop violence in dating relationships before it occurs. IPV can vary in frequency and severity. It occurs on a continuum, ranging from one episode that might or might not have lasting impact to chronic and severe episodes over a period of years. There are four main types of IPV:

Physical violence is the intentional use of physical force with the potential for causing death, disability, injury, or harm. Physical violence includes, but is not limited to, scratching; pushing; shoving; throwing; grabbing; biting; choking; shaking; aggressive hair pulling; slapping; punching; hitting; burning; use of a

weapon; and use of restraints or one’s body, size, or strength against another

person. Physical violence also includes coercing other people to commit any of the above acts.

Sexual violence is divided into five categories. Any of these acts constitute sexual violence, whether attempted or completed. Additionally all of these acts occur

without the victim’s freely given consent, including cases in which the victim is unable to consent due to being too intoxicated (e.g., incapacitation, lack of

consciousness, or lack of awareness) through their voluntary or involuntary use of alcohol or drugs.

Rape or penetration of victim – This includes completed or attempted, forced or alcohol/drug-facilitated unwanted vaginal, oral, or anal insertion. Forced

penetration occurs through the perpetrator’s use of physical force against the victim

or threats to physically harm the victim.

Victim was made to penetrate someone else – This includes completed or

attempted, forced or alcohol/drug-facilitated incidents when the victim was made to

sexually penetrate a perpetrator or someone else without the victim’s consent.

Non-physically pressured unwanted penetration – This includes incidents in which the victim was pressured verbally or through intimidation or misuse of authority to consent or acquiesce to being penetrated.

Unwanted sexual contact – This includes intentional touching of the victim or making the victim touch the perpetrator, either directly or through the clothing, on

the genitalia, anus, groin, breast, inner thigh, or buttocks without the victim’s


Non-contact unwanted sexual experiences – This includes unwanted sexual events that are not of a physical nature that occur without the victim’s

consent. Examples include unwanted exposure to sexual situations (e.g.,

pornography); verbal or behavioral sexual harassment; threats of sexual violence to accomplish some other end; and /or unwanted filming, taking or disseminating photographs of a sexual nature of another person.

Stalking is a pattern of repeated, unwanted, attention and contact that causes fear

or concern for one’s own safety or the safety of someone else (e.g., family member or friend). Some examples include repeated, unwanted phone calls, emails, or texts; leaving cards, letters, flowers, or other items when the victim does not want them; watching or following from a distance; spying; approaching or showing up in places

when the victim does not want to see them; sneaking into the victim’s home or car; damaging the victim’s personal property; harming or threatening the victim’s pet;

Psychological Aggression is the use of verbal and non-verbal communication with the intent to harm another person mentally or emotionally, and/or to exert control over another person. Psychological aggression can include expressive aggression (e.g., name- calling, humiliating); coercive control (e.g., limiting access to transportation, money, friends, and family; excessive monitoring of whereabouts); threats of physical or sexual

In document Health Education (Page 80-93)