
The framework of public health rests on primary, secondary, and tertiary prevention of illness, injury, and disease. The goal of primary prevention is to reduce the incidence of new cases by changing behavior or environmental factors, a truly proactive stance. The secondary level of prevention goes beyond identification to include appropriate early intervention (Flitcraft, 1993). Tertiary prevention is basically reactive, providing services as appropriate after the incident to lower repeated incidents of battering. The public health approach to domestic violence is committed to prevention at these various levels—a very different approach than that taken by the criminal justice perspective.
One of the major public health documents is the Healthy People objectives for the nation. This document, first published in 1990, lays out goals for health promotion on a wide variety of health problems to reduce the incidence of disease, disability and death and promote greater quality of life.
Despite its prevalence, domestic violence has only recently been recognized as a public health issue, with the Healthy People 2000 objectives specifically addressing the reduction of violence against women. After a decade of effort, considerable progress was made on many of the nineteen Health People objectives on Violence Prevention, with the notable exception of the goal of reducing the number of battered women turned away from shelters, in which there was movement away from the stated goal (National Center for Health Statistics, 1999).
Healthy People 2010 lists Violence Prevention as one of its major focus areas, and deems violence as one of the ten leading indicators of the country’s overall health (US Department of Health & Human Services, 2000). Many of the remaining health indicators are very much related to domestic violence; among them are:
The goals of Healthy People 2010:
For more information on Healthy People 2010, click on www.healthypeople.com.