¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬

Robert Wood Johnson Foundation 4 Intimate Partner Violence in Immigrant and Refugee Communities

In 2007 the Robert Wood Johnson Foundation (RWJF) asked the Family Violence Prevention Fund (FVPF) to gather information on the challenges, prevention and treatment of intimate partner violence (IPV) in immigrant and refugee communities. The FVPF team reviewed current literature on IPV in immigrant and refugee communities; examined existing prevention and treatment programs targeted at IPV; and interviewed a number of stakeholders. This report describes what the FVPF researchers learned. It discusses the challenges that confront immigrants and refugees in regard to IPV; describes promising models of prevention and treatment of IPV in immigrant and refugee communities; outlines the findings of a stakeholder meeting that offered recommendations; and summarizes suggestions for funding.

The literature review by Mieko Yoshihama, Ph.D., L.M.S.W., A.C.S.W., Associate Professor, University of Michigan School of Social Work (see Appendix B) stressed that research on IPV in immigrant and refugee communities is limited and often flawed. It can be misleading to aggregate different groups in one study; it is difficult and expensive to study each population group. Victims and organizations that serve them may be reluctant to participate in studies due to concerns about confidentiality and safety. And, as Yoshihama stated, "there exists a very limited body of literature on program evaluation."

Based on the available data, Yoshihama concluded that "IPV is not more prevalent, and, in fact, is probably less prevalent, among immigrant and refugee population groups compared to other groups." But IPV does exist in such groups, and Yoshihama identified several factors that make it especially difficult for victims in these populations to seek or obtain help. Among these are: Abusive partners may use the victim's immigration status against her, in effect, threatening deportation. Language barriers and a lack of familiarity with the U.S. social system may prevent a victim from seeking help. A victim may also be afraid that if she reports violence to the authorities, she and/or her partner will be treated with insensitivity, hostility, and/or discrimination. That fear may be justified; mainstream organizations may lack sociocultural understanding and/or may have discriminatory or insensitive attitudes toward immigrants and refugees.

The interviews with individual service organizations and the remarks of service providers at the March 2008 meeting generally confirmed Yoshihama's observations. They also illustrated how difficult it would be for organizations to act on Yoshihama's goal that "changing community members' attitudes and social norms is critical not only to lessening victim-blaming and promoting help-seeking, but ultimately, to preventing IPV." The strategies that service organizations have adopted to win victims' trust and avoid 5 Intimate Partner Violence in Immigrant and Refugee Communities

That fact, in itself, is consistent with undertaking a strong prevention effort. And skills training-by making women more self-sufficient-can serve a prevention purpose. But some of the organizations, quite deliberately, never openly identified themselves as engaged directly in IPV prevention, for fear of alienating the community. (If a victim identified herself, she would quietly be directed to IPV services.) It's hard to raise community awareness about IPV if it is never even discussed.

Even the organizations that believed they should be engaging in aggressive community-changing activity had a hard time identifying successful efforts. Organizations reported little or no success in engaging existing 'community leaders' (such as religious leaders) in the fight against domestic violence. Most found it difficult 6 Intimate Partner Violence in Immigrant and Refugee Communities

Thus, the discussions with the contacted service providers did not contradict Yoshihama's conclusion that "changing community members' attitudes and social norms is critical," but the comments did suggest that it may not always be practical to expect every organization to engage in such an effort directly and explicitly. And these findings underscored that if funders expect serious community organizing from service organizations, they need to recognize that resources must be allocated specifically to that effort.7 Intimate Partner Violence in Immigrant and Refugee Communities

There are some general truths that apply to domestic violence programs serving immigrants and refugees, just as they apply to programs serving other women. By themselves or with partners, programs should offer comprehensive services because victims of violence need: shelter and safety planning; help coordinating with police and courts; as well as a range of supports that may include employment, housing, and services for children.

Fund Programs That Take the Steps Necessary to Win Victims' Trust. Funders should recognize that there are significant barriers that make it extremely difficult for service providers to win the trust of immigrant and refugee victims. Programs that provide a variety of services-from the victim's urgent need for direct services to language classes to 'community centers' to employment services-by themselves or with partner programs may, over time, have a better chance at building that trust. Therefore, funders should support community-based programs that provide an array of services reasonably calculated to both meet clients' needs and win their trust, keeping in mind that there are no one-size-fits-all formulas. This may include funding programs that do not make domestic violence the centerpiece of their agenda but that understand and address, however indirectly, the dynamics of IPV and maintain a firm basis in the community.

Fund Efforts to Improve Mainstream Services. Funders should support efforts that can help mainstream service providers better serve victims of violence who are immigrants and refugees-either when funding these providers directly, or through separate projects designed to help many programs learn to better serve these populations all at once.

It is vitally important that police, courts, health care providers, shelters and VOLAGs approach domestic violence in appropriate and effective ways in immigrant and refugee communities. Funders need to take this into account when issuing grants. A community may need advocates (1) who can get the mayor's ear to tell him or her to insist that the 8 Intimate Partner Violence in Immigrant and Refugee Communities

police chief make the department more accessible to immigrant and refugee victims of violence; (2) who can work effectively with the health care system; (3) who can help domestic violence service agencies develop the language capacity to help immigrants and refugees new to the community; and (4) who can work effectively with VOLAGs. But while together these four actions can save lives, funding implementation of just one or two of them may have little or no impact at all, even if the funded advocates are effective in carrying out their discreet assignments. A holistic approach is essential.

Provide the Resources Necessary to Develop Community Leaders and Change Attitudes. Funders should recognize that developing community leaders and engaging community members to help change social and community norms takes significant resources. If a community has a coherent plan to do so, or an organization with strong connections to the community has a program that is likely to work well there, funders should consider supporting these efforts even if they will not include direct services to aid individual victims of violence and their families.

Ask Questions About the Program's Strategy. Funders should learn about a program's strategy and whether it makes sense in the context of what has or has not worked in the past by asking the following questions:

Is the agency going to dedicate significant resources to changing the culture and ¦¦practices of mainstream service providers such as the police, or not?

Will the organization try aggressively to develop a cadre of survivor advocates and, if ¦¦so, are they willing to pay them?

Does the agency serve only victims of domestic violence or does it provide a broader ¦¦range of services in the community? Does the organization advertise the full range of services it provides?

Does it have the financial resources to succeed as well as a sustainability plan? ¦¦

Is it going to openly and actively work to "change community norms," or not? If so, how? ¦¦

Program Evaluation. With respect to program evaluation, funders should ask organizations to not only keep track of obvious indicators (number of people served, outcomes in individual cases), but also to monitor language and cultural competency, effectiveness of efforts to improve relations with mainstream service providers, leadership development within the community, and related issues discussed above. 9 Intimate Partner Violence in Immigrant and Refugee Communities

Service organizations should take into account all the factors that funders should. In addition-and perhaps above all-they should be purposeful in determining what role to play in addressing domestic violence, thinking through all the roles they can play and determining what makes most sense for them and what will be most beneficial for the community.

Research projects are needed to provide greater information about the incidence of IPV in specific communities, factors associated with perpetration, continuation, and cessation of domestic violence, and effective strategies to enhance victim safety and empowerment, as well as prevention approaches. Such studies should incorporate measures that prioritize victim safety and protect confidentiality. Data collected must avoid the problems cited by Yoshihama (such as misleading aggregation). Good research depends on good data. Analysts would have much more material to work with if service providers conducted more self-evaluation. As discussed above, funders can help ensure that meaningful self-evaluation takes place. 10 Intimate Partner Violence in Immigrant and Refugee Communities

Section 1: Background

Intimate partner violence (IPV) is a pattern of assaultive and coercive behaviors designed to establish control by a person who is, was, or wishes to be involved in an intimate or dating relationship with an adult or adolescent. Assaultive and coercive behaviors include physical assault, psychological or emotional abuse, sexual assault, progressive social isolation, stalking, deprivation, intimidation and threats. Intimate partners, of the same or opposite sex, include current or former spouses (including common-law spouses), dating partners, or boyfriends and girlfriends. Intimate partners may or may not be cohabiting.1

Primarily a crime against women, IPV occurs throughout the world, cutting across social, economic, religious, and cultural lines. In interviews with 24,000 women conducted in 15 sites in 10 countries, 15 percent to 71 percent of women disclosed physical or sexual violence by an intimate male partner at some point in their lives.2

Nearly one-third of American women (31%) experience physical or sexual abuse by a husband or boyfriend at some point in their lives.3 Annually in the United States, approximately 1.5 million women are raped and/or physically assaulted by an intimate partner.4 From 2001-2005, about 96 percent of females experiencing nonfatal intimate partner violence were victimized by a male and about 3 percent reported that the offender was another female. IPV is difficult to measure because it often occurs in private and victims are often reluctant to report incidents to anyone because of shame or fear of reprisal.5

1 Preventing Domestic Violence: Clinical Guidelines on Routine Screening, Family Violence Prevention Fund, 1999, San Francisco; See Measuring Intimate Partner Violence Victimization and Perpetration: ACompendiumof Assessment Tools, National Center for Injury Prevention and Control, Centers for Disease Control (2006), Glossary, available at www.cdc.gov/ncipc/dvp/Compendium/Glossary-References.pdf; CDC Fact Sheet: Understanding Intimate Partner Violence (2006), available at www.cdc.gov/ncipc/dvp/ipv_factsheet.pdf.

2 WHO Multi-Country Study on Women's Health and Domestic Violence against Women: Summary Report of Initial Results on Prevalence, Health Outcomes and Women's Responses. Geneva, World Health Organization, 2005, at p. 15, available at www.who.int/gender/violence/who_multicountry_study/summary_report/summary_report_English2.pdf.

5 Bureau of Justice Statistics, U.S. Department of Justice, Intimate Partner Violence in the United States, 1993-2005 (December 2007), available at www.ojp.usdoj.gov/bjs/intimate/ipv.htm#contents.11 Intimate Partner Violence in Immigrant and Refugee Communities

75 percent of them female. One-third of female murder victims were killed by an intimate, while approximately 3 percent of male murder victims were killed by an intimate. Further, more than two-thirds of victims who were known to be spouses and ex-spouses of their assailants were killed by guns.6

According to a survey of literature conducted by Yoshihama for this project, available research indicates that IPV is not more prevalent, and may be less prevalent, among immigrant and refugee population groups than others.7 The few IPV prevalence studies that yield data for Latinas and Asian women report somewhat or considerably lower IPV rates for them compared to women of other races and ethnicities. However, virtually no population-based prevalence estimates are available for other immigrant and refugee groups. Thus, research on rates of IPV in immigrant and refugee communities is far from conclusive as the limited data that is available cannot be aggregated because there are essential differences among subgroups.

Furthermore, differences by race and ethnicity tend to decrease or even disappear when considering other factors such as socioeconomic status and partners' substance abuse.8 For additional discussion of limitations on research, see Section 4.

Yoshihama also reports that, while non-fatal IPV may be lower for Latinas and Asian immigrants and refugees, immigrants of Hispanic and Asian/other descent experience a higher risk of homicide in general than U.S.-born persons. Homicide reviews and analyses have consistently documented an overrepresentation of immigrant and refugee women among IPV-related homicide victims. These higher IPV-related homicide rates may indicate a failure and/or inadequate response by existing systems and institutions such as law enforcement and the courts.9

Many immigrant and refugee women experience IPV in the context of language difficulties, confusion over their legal rights, and the overall stress of adaptation to new cultural and social structures. While the exercise of power and control underlies all IPV, many immigrant and refugee women are especially vulnerable because of poverty and other factors.10 Examples of the impact of these disparities include:

6 Fox JA. and Zawitz MW. Homicide Trends in the U.S., Bureau of Justice Statistics, US Dept. of Justice (July 2007), available at www.ojp.usdoj.gov/bjs/homicide/homtrnd.htm#contents.

7 Yoshihama, supra, note 4, at p. 7.

10 See a detailed list of examples of power and control tactics used against immigrant women in Somewhere to Turn: Making Domestic Violence Services Accessible to Battered Immigrant Women A "How To" Manual for Battered Women's Advocates and Service Providers (AYUDA, May 1999). Chapter 1, "Overview of Domestic Violence and Battered Immigrant Issues", pp. 4-8, available at http://new.vawnet.org/Assoc_Files_VAWnet/BIW99-c1.pdf. See also the Immigrant Battered Women Power and Control Wheel, produced and distributed by National Center on Domestic and Sexual Violence, Austin, TX, available at www.endingviolence.org/files/uploads/ImmigrantWomenPCwheel.pdf and adapted from original wheel by Domestic Abuse Intervention Project, Duluth, Minn.12 Intimate Partner Violence in Immigrant and Refugee Communities

Limited language proficiency.¦¦ IPV perpetrators frequently rely on foreign-born women's limited English proficiency skills to control their behavior. For example, perpetrators who possess greater English language skills might silence their victims by serving as the family's sole communicator in English. The limitations of a victim's English language skills also serves as a barrier to obtaining services (see discussion in Section 2 below).

Disparities in economic and social resources.¦¦ While IPV cuts across all social and economic classes, and economics can affect all women's experiences with violence, some types of marriages and relationships involve uneven social and economic resources that can make foreign-born women especially vulnerable to their partners' power and control. These relationships include marriages to U.S. military personnel, marriages through international brokers or dating services, and international arranged marriages. Many of these marriages are based on stereotypical views of women as subservient and passive.11

Social isolation.¦¦ The isolation experienced by immigrant and refugee battered women can be severe because they may be isolated both within their communities and within the dominant U.S. culture. A number of factors affect isolation, including beliefs about the dominant roles of men, religious doctrines, shame and fear. Many foreign-born brides enter the United States without knowledge of their rights, socially isolated and financially dependent.12

Immigration status.¦¦ Immigration status can increase a woman's vulnerability to IPV and further reduce her options. Abusers use immigration status to threaten deportation and also to warn that the abuser could be deported if the violence were disclosed. Violence Against Women Act (VAWA) immigration remedies can prevent or interrupt an actual deportation of an IPV immigrant victim (see discussion above) but the threat remains and is exacerbated when a victim lacks information about her rights and options. Even though refugees reside legally in the United States, IPV abusers also use the threat of deportation as an effective control tactic because many refugee victims lack accurate information about their legal resident status.

11 Yoshihama, supra note 4, at pp. 10-11.

12 ibid. at p. 10. Abusive husbands of foreign-born brides frequently reinforce these factors to establish and maintain control.13 Intimate Partner Violence in Immigrant and Refugee Communities

Section 2: Needs and Challenges of Immigrant and Refugee IPV Victims and Service Providers

The remaining sections of this document will discuss the needs of immigrant and refugee women for meaningful access to comprehensive intervention services-and the specialized challenges that service providers face. The remaining sections rely in part on interviews in 2007 with seven key informants from local programs whose work addresses the needs of immigrant and/or refugee victims of IPV.

Programs that work in immigrant and refugee communities to help victims of domestic and sexual violence address many of the same issues that violence prevention and service programs face in working with victims born in the United States, but they also must overcome significant obstacles that are specific to immigrants and refugees. In examining the work of seven organizations that do this work, the Family Violence Prevention Fund 14 Intimate Partner Violence in Immigrant and Refugee Communities

Difficulty getting victims to talk about painful, personal and (to some victims) ¦¦shameful experiences.

Convincing victims that they can be safe if they confront or leave their abusers. ¦¦This means giving them full confidence that the program can: keep them safe from retaliation; provide food and shelter and meet other basic needs; ensure that they will not lose their children, and more.

Reforming institutions such as the police and the courts so victims see them as allies.¦¦

Developing leadership including a cadre of advocates (ideally including survivors) who ¦¦will support individual victims and raise awareness in the community.

Changing cultural norms regarding intimate partner violence by creating a social ¦¦environment in which community leaders and the public acknowledge and condemn domestic violence and support victims.

Language barriers.¦¦ Without staff members or volunteers who can speak the language an immigrant or refugee survivor speaks, a program will not be able to do all it could 15 Intimate Partner Violence in Immigrant and Refugee Communities

Unfamiliarity with systems and legal rights.¦¦ It is hard for any victim to talk to a stranger about her abuse. For an immigrant or refugee victim of IPV, English-speaking, American-born social service providers, legal experts or others may seem intimidating, unsympathetic or even terrifying. Often it takes time to convince victims that people want to help, in particular because some victims had bad experiences with 'authorities' from their home countries (for instance, if you have been victimized by a corrupt or violent police force, it may be hard to believe that a police officer here is trying to help you). Victims may not understand their legal rights and may fear deportation if they challenge their husbands. Some come from cultural backgrounds where men have near-absolute power, and it may be unimaginable to them that authorities would intervene on their behalf.

Social and economic isolation.¦¦ A victim in a small community of immigrants or refugees may worry that, if she leaves her abuser, she will have no safe place to go and will lose connection to her entire community. Even though some small communities can provide little help to victims of IPV, leaving the community may be unthinkable to a victim. As Refugee Family Services explains, some "have never been in the job market and are dependent on their husbands."

Lack of cultural competence by service providers.¦¦ Some service providers-police, the court system, health care providers, even those in the domestic violence system-lack a fundamental understanding of the cultures of immigrant and refugee communities. Consequently service providers may lack the ability to work with community members in culturally competent ways and may not be as sympathetic as they could be to immigrant and refugee victims. Even if they are not antagonistic, they may think that violence is something that happens in "that community" and there is little or nothing to do about it. Here, too, the language barrier poses a real problem.

Lack of community awareness about IPV.¦¦ Because they do not understand intimate partner violence, community members may not want to 'air their dirty laundry in public' and may feel that any community member who talks about the violence is exposing the community to scorn. That does not mean that domestic violence is viewed more favorably or condoned in immigrant and refugee communities than in other communities. But it does make it harder for service organizations to identify and assist victims.

Political and environmental landscape.¦¦ Anti-immigrant sentiment runs high in many parts of the United States, fueled by the current political environment. Consequently, some immigrant and refugee communities may feel besieged and as a result, community members may be suspicious of outsiders and guarded in dealing with the outside world.

The seven organizations the Family Violence Prevention Fund team interviewed encountered various challenges at varying levels of intensity, and dealt with or overcame them in many different ways. A brief description of the programs and the services each provides follows.16 Intimate Partner Violence in Immigrant and Refugee Communities

The mission of the Asian Women's Shelter (AWS) is to eliminate domestic violence by promoting the social, economic and political self-determination of women. This agency has 17 staff members and 110 on-call advocates in San Francisco. The Asian Women's Shelter is committed to every person's right to live in a violence-free home and focuses specifically on addressing the cultural and language needs of immigrant, refugee and U.S.-born Asian women and their children. AWS has adopted a broad strategy that integrates culturally competent and language-accessible shelter services, educational programs, and community advocacy. Founded in 1988, AWS provides safety, food, shelter, healing, intensive case support, advocacy and other resources to assist women and children in rebuilding violence-free lives. Direct services include: Emergency-to-17 Intimate Partner Violence in Immigrant and Refugee Communities

Staff also state that "[l]aw enforcement are no longer getting the dominant aggressor training, and what training they do [get] does not talk about immigrant women, language barriers, etc." Staff mentioned a state legislative bill "to make clear primary aggressor and dominant aggressor." 18 Intimate Partner Violence in Immigrant and Refugee Communities

CDE does talk about adopting a "strength-based" approach of providing support to women to solve their own problems rather than "taking care of them." Some of the other organizations also addressed the issue of trying to strike the right balance in that respect. 19 Intimate Partner Violence in Immigrant and Refugee Communities

Ultimately, agency leaders decided they could be most effective if they stopped providing direct domestic violence services entirely, and instead focused on "community building, building up women leaders, putting things in the hands of the women." They will still work as a referral agency to direct service providers but will concentrate on areas that they feel make a difference in women's lives-community activities, including establishing a neighborhood community center for Middle Eastern women, and 20 Intimate Partner Violence in Immigrant and Refugee Communities

The Iowa Coalition Against Domestic Violence (ICADV) is a statewide nonprofit organization that provides assistance and education to programs that serve battered women and their children, working to end violence in intimate relationships. The ICADV's MUNA Legal Clinic was created in 1997 to address the specific needs of immigrant clients across Iowa who have no other opportunities for legal representation. MUNA serves low-income immigrant survivors of domestic abuse and sexual assault 21 Intimate Partner Violence in Immigrant and Refugee Communities

Refugee Family Services (RFS) works to support the efforts of refugee women and children to achieve self-sufficiency in the United States by providing education and economic opportunity. RFS serves refugees in the metro Atlanta area, focusing on the women and children who are often left behind by other programs. Since the 1980s thousands of refugees have resettled in the metro Atlanta area. Today, RFS provides services to refugees who come from a myriad of cultures suffering the effects of protracted civil wars and massive human suffering: Bosnians, Somalis, Sudanese, Liberians, Burmese, Burundi, Vietnamese, Arabic and Kurdish-speaking Iraqis, and Meskhetian Turks. RFS provides a range of services to refugee women and their children including crisis intervention and shelter placements to ensure the safety and health of refugee women who are victims of domestic violence. RFS operates from a refugee community center and an activity center in close proximity to refugees who have resettled in Stone Mountain and Clarkston, Ga., two cities in the metro Atlanta area.22 Intimate Partner Violence in Immigrant and Refugee Communities

While RFS does not advertise that it works on domestic violence issues, the organization does engage in some community events on a limited basis. "If there is something going on amongst other service providers, [they] may participate" in a candlelight vigil or other prevention-oriented event. Some caseworkers have tried to work with 'community influencers' like religious leaders, but "this is very challenging.caseworkers are seen as having different views and.are not welcomed." 23 Intimate Partner Violence in Immigrant and Refugee Communities

RFS leaders describe its violence program as a success. Initially, they doubted they would have many clients, but have served 75 in a nine-month period, and now have a long waiting list. They serve 100 clients a year in the violence prevention program.24 Intimate Partner Violence in Immigrant and Refugee Communities

Section 3: Recommendations for Funders, Service Providers and Policy-Makers: Serving Today's Survivors, Preventing Tomorrow's Victims

Based on interviews with service providers, as informed by the literature review, a series of (often overlapping) recommendations for funders, service providers and policy-makers have emerged.

The Imperative to Win Victims' Trust. Funders should recognize that there are significant barriers that make it extremely difficult for service providers to win the trust of immigrant and refugee victims. Programs that provide a variety of services-from the direct services victims urgently need to language classes to community centers to employment services-by themselves or with partner programs may, over time, have a better chance at building that trust. Therefore, funders should support programs that provide an array of services reasonably calculated to both meet clients' needs and win their trust, keeping in mind that there are no one-size-fits-all formulas. This may include funding programs that do not make domestic violence the centerpiece of their agenda.

The Imperative to Improve Mainstream Services. Funders should consider supporting efforts that can help mainstream service providers better serve victims of violence who are immigrants and refugees-either when funding these providers directly, or through separate projects designed to help many programs learn to better serve these populations all at once.

At present, many mainstream intimate partner violence programs lack adequate language capacity and have not ensured that they can address the cultural needs of immigrants and refugees. Programs serving refugees face the additional challenge of meeting the needs of victims without creating hostility within resettlement service agencies that, as a rule, try to avoid splitting family units. 25 Intimate Partner Violence in Immigrant and Refugee Communities

It is vitally important that police, courts, health care providers, shelters and VOLAGs approach domestic violence in appropriate and effective ways in immigrant and refugee communities. Funders need to take this into account when issuing grants. A community may need advocates who: (1) can get the mayor's ear to insist that the police chief make the department more accessible to immigrant and refugee victims of violence; (2) can work effectively with the health care system; (3) can help domestic violence service agencies develop the language capacity to help immigrants and refugees new to the community; and (4) can work effectively with VOLAGs. But while together these four actions can save lives, funding implementation of just one or two of them may have little or no impact at all, even if the funded advocates are effective in carrying out their discreet assignments. A holistic approach is essential.

The Imperative to Develop Community Leaders and Change Attitudes. Funders should recognize that developing community leaders who can help change social and community norms takes significant resources. If a community has a coherent plan to do so, or an organization with strong connections to the community has a program that is likely to work well there, funders should consider supporting these efforts even if they will not include casework to aid individual victims of violence.

Ask Questions About the Program's Strategy. Funders should know what the program's strategy is, and whether it makes sense in the context of what we know about what has worked-or not-in the past. Questions to ask include:

Is the agency going to dedicate significant resources to changing the culture and ¦¦practices of mainstream service providers such as the police, or not?

Will the organization try aggressively to develop a cadre of survivor/advocates and, if ¦¦so, are they willing to pay them? 26 Intimate Partner Violence in Immigrant and Refugee Communities

Is the agency a domestic violence service provider serving victims only, or does it ¦¦provide a broader range of services in the community?

Does the organization advertise the full range of services it provides?¦¦

Does it have the financial resources to do well? (Or will have, depending on the level ¦¦of the funder's generosity?)

Is it going to openly and actively try to "change community norms" or not? If so, how? ¦¦

Service organizations should take into account all the factors that funders should, and ask themselves the same questions that funders should ask. In addition-and perhaps above all-they should be purposeful in determining what role to play in addressing domestic violence, thinking through all the roles they can play and determining what makes most sense for them and what will be most beneficial for the community.

At the federal level, the Office on Refugee Resettlement of the U.S. Department of Health and Human Services should work with VOLAGs to improve their sensitivity and response to IPV issues. Congress should continue to support the Violence Against Women Act and its provision to protect immigrant women and children. At the state and local level, policy-makers should ensure that police, courts, shelters, hospitals and social service agencies have (or have access to) reliable translators for as many languages as possible, to serve IPV victims. They should also ensure that personnel in those areas are trained (and ordered) to treat people from various cultural and national backgrounds with respect. 27 Intimate Partner Violence in Immigrant and Refugee Communities

Section 4: Evaluation and Research

As Yoshihama reports in her literature review for this project, very few studies have focused exclusively on immigrants or refugees, as opposed to specific population groups identified by race or ethnicity (e.g., Latinas and Asian/Pacific Islanders, a broad category in itself). The vast majority of literature is descriptive, documenting the prevalence, scope, dynamics, risk protective factors, and consequences of IPV. Yoshihama also describes numerous limitations in the research, including aggregation (lumping various racial and ethnic groups together as one group); exclusion of large groups of immigrant and refugee populations; lack of attention to sociocultural context; and limited comparability with respect to such methodological aspects as sampling criteria, measures/instruments, data collection methods, and study framework. Yoshihama notes that it is delicate and difficult to strike a balance between standardized instruments, which enhance data comparability across studies, and the use of community-specific instruments that ensure greater sociocultural relevance. She adds that the high cost of multilingual research projects, requiring studies in multiple languages and managing translatability issues, is a major barrier to researchers who are interested in conducting studies of IPV in immigrant and refugee communities.28 Intimate Partner Violence in Immigrant and Refugee Communities

The service programs need resources and assistance in developing evaluation systems that measure the quality of services and their impact on victims, while preserving victim confidentiality and trust. Funders thus need to both request that programs conduct self-evaluation, and help ensure the resources are there to get the job done. Funders should ask organizations to not only keep track of obvious indicators (number of people served, outcomes in individual cases), but also to evaluate themselves with respect to language competency, effectiveness of efforts to improve relations with mainstream service providers, leadership development within the community, and related issues discussed above. Documenting organizational processes and supporting formative research are also important. 29 Intimate Partner Violence in Immigrant and Refugee Communities

Section 5: Conclusion

In examining the real-world experiences of domestic violence service providers, it is reasonable to conclude that everything is important, but an organization can be highly effective without doing everything.

Finally, it is critical for funders and policy-makers to recognize that the success of service organizations is limited by surrounding circumstances-Federal immigration law, the sensitivity of VOLAGs to domestic violence issues, the attitude and resources that law enforcers, courts and hospitals bring to dealing with IPV in immigrant and refugee communities. Federal, State and local policy-makers should take firm action to improve the legal and practical climate for IPV victims in these communities. Funders can support such changes on those issues through public education efforts, or give resources to service organizations to undertake such education themselves. 30 Intimate Partner Violence in Immigrant and Refugee Communities

Appendix A: Legal Structure and Financial Assistance Relating to Immigrants and Refugees

A vast and complex maze of laws, regulations and support systems both challenge and support IPV victims in immigrant and refugee communities. People in these communities share the commonalities of birth outside the United States and many of the difficulties that arise when persons migrate to new countries. Critical differences between the two communities, however, distinguish immigrants' and refugees' experiences with domestic violence and their access to supports and services. An understanding of these differences depends, in part, on information about the underlying legal structure and processes for the entry of refugees and immigrants into the United States.

By the end of 2005, the estimated refugee population worldwide was 13 million, the lowest level in 25 years; 8.7 million of these refugees were under the care of the United Nations High Commissioner for Refugees (UNHCR).13 The U.S. Immigration and Nationality Act (INA) defines a refugee as a person who is outside (and in some instances within) his or her country and who is unable or unwilling to return because of persecution or a well-founded fear of persecution on account of race, religion, nationality, membership in a particular social group, or political opinion. This definition conforms with the definition used in the United Nations Convention and Protocol relating to the status of refugees. The INA includes a separate provision for granting of asylum on a case-by-case basis to persons who are physically present in the United States or at a land border or port of entry and who meet the definition of refugee.14

Upon referrals from the UNHCR, the U.S. State Department handles the overseas processing and admission of refugees to the United States from abroad; the U.S. Citizenship and Immigration Services (USCIS) of the Department of Homeland Security (DHS) makes final determinations about eligibility for admission. The USCIS determines whether an individual qualifies for refugee status and is otherwise admissible under U.S. immigration law. The INA sets forth various grounds of inadmissibility, which include health-related grounds, security-related grounds, public charge (i.e., indigence), and lack of proper documentation. Some inadmissibility grounds (public charge, lack of proper documentation) are not applicable to refugees. Others (except security-related grounds) can be waived by the U.S. Attorney General.15

13 Proposed Refugee Admissions for Fiscal Year 2007, Report to the Congress by the President of the United States, U.S. Department of State, p 11, available at www.wrapsnet.org/LinkClick.aspx?fileticket=bgxSKUZ8KGM%3d&tabid=180&mid=605&language=en-US.

14 Bruno A. Refugee Admissions and Resettlement Policy, Congressional Research Service, The Library of Congress (updated Jan. 25, 2006), pp. 4-5, available at www.wrapsnet.org/LinkClick.aspx?fileticket=dR%2fcVscHXNc%3d&tabid=180&mid=605&language=en-US. The INA definition of a refugee excludes any person who participated in the persecution of another.

By Michael W. Runner, director of Legal Programs, Family Violence Prevention Fund31 Intimate Partner Violence in Immigrant and Refugee Communities

Despite annual admission ceilings of 70,000 since 2000, the actual numbers of refugees admitted to the United States decreased dramatically in the years after the terrorist attacks of September 11, 2001. Only 27,110 refugees were admitted to the United States in 2002; this number had increased to 53,813 in 2005. Annual admissions of refugees between 1998 and 2001 ranged from a low of 69,304 (2001) to a high of 85,525 (1999). A system of priorities-distinct from whether a person qualifies for refugee status but reflective of the urgency of a person's resettlement needs-guides State Department processing.16 The stated U.S. goal is to provide an opportunity for U.S. resettlement to at least 50 percent of all UNHCR referrals, depending on availability of funds. In calendar year 2005, the United States resettled more than 61 percent of the UNHCR-referred refugees who were resettled in third countries.17

Unlike immigrants (see discussion below), refugees cannot choose a particular country, or a specific region of that country, in which they will resettle. Most refugees flee their home countries to host-frequently neighboring-countries. When conditions in home countries do not permit repatriation and the host countries cannot or will not permit local integration, refugees in urgent need of protection are resettled to third countries, such as the United States. Thus, for most refugees who are permitted to enter the United States, this is their third country of relocation. Both refugees and asylees (those granted asylum) may apply for legal permanent resident status one year after receiving admission to the United States.18

In contrast to immigrants who choose to enter the United States, refugees are admitted on humanitarian grounds and need not demonstrate economic self-sufficiency (see discussion below). The Office of Refugee Resettlement (ORR) within the U.S Department of Health and Human Service (HHS) administers an initial transitional assistance program for temporarily dependent refugees. ORR supports the refugee cash assistance (RCA) and refugee medical assistance (RMA) programs administered by the states. RMA benefits are based on a state's Medicaid program, and RCA payments are now based on the state's Temporary Assistance for Needy Families (TANF) payment to a family unit of the same size. Before the 1996 Welfare Reform Act (and subsequent amendments) imposed time limitations,19 refugees who otherwise met the requirements of federal public assistance programs were immediately and indefinitely eligible to participate in them, just like U.S. citizens.20

19 Refugees and asylees are eligible for SSI benefits and Medicaid for seven years after arrival, and for five years under TANF. Refugee/asylee treatment is accorded to Cuban/Haitian entrants, certain aliens whose deportation/removal is withheld for humanitarian purposes, Vietnam-born Amerasians fathered by U.S. citizens, and victims of human trafficking. See Wasem RE. Noncitizen Eligibility for Major Federal Public Assistance Programs: Policies and Legislation, Congressional Research Service, The Library of Congress (updated Mar. 17, 2004), pp. 4-5, available at www.immigrationforum.org/documents/CRS/PublicAssistance_CRS_3-17-04.pdf.

20 ibid. at pp. 12-13.32 Intimate Partner Violence in Immigrant and Refugee Communities

and basic health services.21 VOLAGs provide assistance and services to refugees for the first 30 days after their arrival in the United States. Services may include cultural orientation, counseling, English language training, and job skills training and placement. VOLAGs either provide these services directly or arrange for them to be provided by local government agencies or social service organizations that include faith- and community-based entities.22

In contrast to refugees, immigrants may choose to migrate to a particular country and select a region of that country in which to resettle. Strict U.S. immigration quotas (each with a numerical limit) established by U.S. immigration law restrict the number of immigrants who may enter this country annually with processing of documentation by the USCIS.23 Persons who receive priority immigration status as potential legal permanent residents (LPRs or green card holders) include foreign nationals who have: (1) a close family relationship with a U.S. citizen or legal permanent resident;(2) specified job skills; (3) residence in countries with relatively low levels of immigration to the United States; or (4) refugee or asylee status (see discussion above). In 2007, 1,052,415 immigrants applied for LPR status. Of that number, 431,368 were new arrivals to the United States. Females comprised 55 percent of these new LPRs, and 58 percent of the new LPR applicants were married.24

The INA sets forth numerous grounds for prohibiting the entry of foreign-born persons into the United States (referred to as "grounds for inadmissibility").25 The significant grounds that control the numbers of legal immigrants relate to health, security, indigence (referred to as "public charge"), and lack of proper documentation. A person who emigrates to the United States without proper documentation (i.e., a green card) or who overstays a temporary visitor or student visa, for example, would be inadmissible as a legal immigrant. Likewise, unlike a refugee who is eligible for government services, an immigrant seeking status as a lawful permanent resident (LPR or holder of a "green card") must establish that he or she will not become a "public charge" on the United States through receipt of certain cash or public benefits. Consequently, many immigrants who enter the United States without proper documentation or overstay their visas have no avenues to convert to legal status after arrival. If they are discovered and deported from the United States, additional grounds for inadmissibility under the INA will preclude their return for three to 10 years.

21 In fiscal year 2008, the U.S. State Department contracted with 10 national VOLAGs with some 350 local offices across the United States. See Fact Sheet, Bureau of Population, Refugees, and Migration, U.S. Department of State (Dec. 18, 2007).

22 Fact Sheet, Voluntary Resettlement Agencies, California Department of Social Services (Jan. 2008), available at www.dss.cahwnet.gov/RefugeeProgram/Res/pdf/FactSheets/VOLAGs_FactSheet.pdf.

24 Jefferys K and Monger R. U.S. Legal Permanent Residents: 2007, Annual Flow Report, Department of Homeland Security, Office of Immigration Statistics (March 2008), available at www.dhs.gov/xlibrary/assets/statistics/publications/LPR_FR_2007.pdf.

25 8 U.S.C. §1182.33 Intimate Partner Violence in Immigrant and Refugee Communities

Hispanic Center in March 2006, based on current population surveys, approximately 11.5 million to 12 million undocumented immigrants reside in the United States, accounting for about 30 percent of the U.S. foreign-born population. Since 2000 the undocumented immigrant population has increased more than 500,000 persons per year.26

Because of work by the Family Violence Prevention Fund, the National Network to End Violence Against Immigrant Women, and others, the Violence Against Women Act (VAWA) now provides protections for IPV victims who are immigrants. Generally, U.S. citizens and LPRs file an immigrant visa petition with the USCIS on behalf of a spouse or child, so that these family members may emigrate to or remain in the United States. The petitioner controls when or if the petition is filed. Some violent or abusive U.S. citizens and LPRs misuse their control of this process, however, by threatening to report spouses to immigration authorities if the victims report the violence they are experiencing. As a result, many immigrant IPV victims are afraid to report abuse to police or other authorities. Under the amendments to VAWA, IPV victims who are or were married to a U.S. citizen or LPR may be able independently to petition legal residency without their abusers' cooperation or knowledge.27 A key goal of VAWA's immigration protections is to cut off the ability of abusers to blackmail victims with threats of deportation, and thereby avoid prosecution. An additional federal law permits victims of human trafficking who cooperate with law enforcement to secure documented immigration status.28

Immigrants to the United States do not receive the resettlement assistance provided to refugees and asylees. In general, documented immigrants who are legal permanent residents (LPRs) become eligible for the full range of public assistance benefits only after 10 years' employment, documented by Social Security or other records. LPRs who entered the United States after August 22, 1996, are barred from TANF and Medicaid for five years, after which their coverage becomes a state option, and generally they are ineligible for Supplemental Security Income (SSI) until they become naturalized citizens. LPRs also may not obtain food stamps for five years after entry to the United States, with exceptions for LPR children and certain recipients of disability assistance who are eligible immediately. Most states have not exercised their option to bar LPRs from TANF or Medicaid.29 Complicated rules and regulations of public benefits programs mean that immigrants urgently need support in order to determine whether their individual circumstances make them eligible for these benefits.

Federal legislation in 1996 barred undocumented immigrants from eligibility for food stamps, TANF, and other major federal public benefits, except emergency medical care (through Medicaid). Immigrant victims of domestic violence who receive VAWA immigration relief become eligible for food stamps and potentially additional benefits depending on their circumstances. Trafficking victims who receive VAWA immigration relief become eligible for food stamps, TANF, and Medicaid similarly to the program benefits received by asylees or refugees.30

26 Passel, JS. The Size and Characteristics of the Unauthorized Migrant Population in the U.S., Pew Hispanic Center (March 7, 2006), available at www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/Reports/Hispanics_in_America/PHC_Immigration_0306.pdf. The CPS, a monthly survey of about 50,000 households conducted jointly by the U.S. Bureau of Labor Statistics and the Census Bureau.

30 ibid. at pp.17-18. For a basic description of refugee eligibility for public benefit programs, see text of note 15.34 Intimate Partner Violence in Immigrant and Refugee Communities

Appendix B: Literature on Intimate Partner Violence in Immigrant and Refugee Communities: Review and Recommendations

Violence against women is an issue that cannot wait. A brief look at the statistics makes it clear. At least one out of every three women is likely to be beaten, coerced into sex or otherwise abused in her lifetime. Through the practice of prenatal sex selection, countless others are denied the right even to exist. No country, no culture, no woman young or old is immune to this scourge. Far too often, the crimes go unpunished, the perpetrators walk free. (Remarks by United Nations Secretary-General Ban Ki-moon to the Commission on the Status of Women, New York, February 25, 2008)

Violence against women is prevalent across the globe, cutting across national, racial, ethnic, and sociocultural boundaries. The prevalence of violence against women in general, and intimate partner violence specifically (also known as domestic violence), has been extensively documented.1-3 Violence against women takes many forms, hinders women's social participation and compromises their well-being. Violence against women is supported by, and simultaneously reinforces, women's lower status and male domination in society. Intimate partner violence (IPV) is the most prevalent form of violence against women. Although variations in research methodologies challenge the comparability of findings across studies, estimates from population-based studies indicate that between 10 percent and 40 percent of women experience IPV sometime in their lifetimes. Some estimates are as high as 50 percent or more.

This report focuses on IPV experienced by immigrants and refugees who now reside in the United States. Immigrants to the United States come from a wide range of countries; the largest numbers come from Mexico, China, the Philippines and India.4 In terms of refugee populations, the largest numbers come from Cambodia, Columbia, Cuba, Ethiopia, Haiti, Liberia, Iran, Sudan, Somalia, Ukraine, Russia, and Vietnam.5 Reflecting that the vast majority of cases of IPV are perpetrated against women and that the literature focuses almost exclusively on IPV in heterosexual relationships, this report discusses IPV perpetrated by men against women, unless otherwise specified.

The National Violence Against Women Survey estimated that approximately 1.5 million women in the United States are raped and/or physically assaulted by an intimate partner annually.6 IPV is a major threat to the health of people; Healthy People 2010, issued by the U.S. Department of Health and Human Services, includes an objective pertaining specifically to the reduction of IPV: Objective 15-34: Reduce the rate of physical assault by current or former intimate partners with a target rate of 3.3 physical assaults per 1,000 persons aged 12 years and older from the baseline rate of 4.4. 35 Intimate Partner Violence in Immigrant and Refugee Communities

As foreign-born individuals currently make up 12.6 percent of the U.S. population and are a steadily growing group (they were 7.9% of the population in 1990 and 11.1% in 2000),4, 7 addressing IPV in immigrant/refugee communities is an urgent national health agenda. A higher proportion of immigrants/refugees and their U.S.-born children under age 18 live in poverty (16.9% compared with 11.4% for natives and their children), and a much higher proportion of foreign-born individuals lack health insurance (33.8% compared with 13.0% for native-born individuals).7 These socioeconomic disparities make initiatives to address IPV in immigrant/refugee communities even more compelling and urgent.

This report will provide an overview of the current literature on IPV in immigrant/refugee communities in the United States. It should be noted that very few studies have focused exclusively on immigrants or refugees; most studies focus on specific population groups, such as Latinas and Asian/Pacific Islanders (API) that are known to include a high proportion of foreign-born individuals. Many Latina and Asian ethnic groups have a foreign-born rate of over 60 percent, compared with the national average of 12.6 percent.7-9 Descriptions of racial/ethnic groups (e.g., Latino/a, Hispanic, Asian, Asian/Pacific Islander, Black, African American, White, non-Hispanic White, Anglo, Caucasian) vary among authors, each representing a historical and political standpoint. In reporting findings from previous studies, original terminologies used by authors are retained where possible.

Aggregation (e.g., lumping people of Latina/o descent or those of API descent into one broad racial category, regardless of ethnicity, immigration status, or acculturation levels) is also prevalent. Aggregation hampers the identification of within-group variations by ethnicity, immigration status, or generational positions, which can be considerable. Because of enormous diversity in the sociocultural, sociohistorical, and sociopolitical contexts across immigrant/refugee population groups, developing and implementing a valid study is a major challenge. The balance between the use of standardized instruments, which help data comparability across studies and the use of community-specific instruments to ensure sociocultural relevance, is a delicate and difficult one to strike. 36 Intimate Partner Violence in Immigrant and Refugee Communities

Dating violence/IPV against adolescents/youth¦¦10-14

IPV against women in same-sex relationships¦¦15-22

IPV against men in same-sex relationships¦¦15, 17, 18, 23-25

While over half a dozen national population-based studies have assessed and reported prevalence estimates of IPV for Latinas, only a few have provided prevalence data for other immigrant/refugee population groups (Table 1). One such study, the National Violence Against Women Survey of 1995, found the following estimates for lifetime physical IPV: 21.2 percent for Latina women; 12.8 percent for API women; 26.8 percent for African-American women; 30.7 percent for American Indian/Alaskan women; 27.0 percent for women of mixed race; and 21.3 percent for White women.6 37 Intimate Partner Violence in Immigrant and Refugee Communities Table 1. Studies of IPV Prevalence in Latina and Asian/Paci c Islander Communities Authors Data Coll. Method Sample Measures Physical Violence Sexual Violence Physical and/or Sexual Violence N Characteristics Lifetime Past year Lifetime Past year Lifetime Past year Both Latina and Asian/Paci c Islanders Black & Breiding, 2008 [BRFSS Survey] T-RDD P NA 988 Hispanic women 4 PSV Qs in BRFSS Survey 20.5% 156 Asian women 9.7% 8,375 White women 26.8% 903 Black women 29.2% Tjaden & Thoennes, 2000 [Ntl VAW Survey] T P N 16,005 8,000 women; 8,005 men Adopted CTS PA/stalking/rape 628 Hispanic women 21.2% 7.9% 23.4% 133 API women 12.8% 3.8% 15.0% 780 African-Amer women 26.3% 7.4% 29.1% 88 Amer Indian/Alaskan Native 30.7% 15.9% 37.5% 397 Mixed race 27.0% 8.1% 30.2% 6,452 White 21.3% 7.7% 24.8% Latina Straus & Smith, 1990 [1985 Ntl Family Violence Resurvey] T P N Respondents of 1985 NFV Resurvey CTS 721 Hispanic 17.3% 4,052 White 10.8% Sorenson & Telles, 1991 F P R ECAB Study Los Angeles sample "Have you ever hit or thrown things at your spouse/partner? If yes, did you ever do so fi rst?; if so, more than once?"C 1,243 Mexican American <men & women> 20.0% 705 born in Mexico 12.8% 538 born in US 30.9% 1,149 White men & women 21.6% Kantor, Jasinski, Aldarondo, 1994 [Ntl Alcohol & Family Violence Survey] F P N 743 Individuals living as a couple CTS 105 Puerto Rican 20.4% 327 Mexican 10.5% 175 Mexican American 17.9% 136 Cuban 2.5% 1,025 Anglo 9.9% Jasinski, Asdigian, Kaufman Kantor, 1997 [Ntl Alcohol & Family Violence Survey] F P N Individuals living as a couple CTS 702 Hispanic 12.3% 812 Anglo 10.5%38 Intimate Partner Violence in Immigrant and Refugee Communities Table 1. Studies of IPV Prevalence in Latina and Asian/Paci c Islander Communities Authors Data Coll. Method Sample Measures Physical Violence Sexual Violence Physical and/or Sexual Violence N Characteristics Lifetime Past year Lifetime Past year Lifetime Past year Latina (continued) Jasinski, 2001 [Ntl Survey of Familes & HHs (NSFH1 & 2)] F P N individuals 19+, married or cohabiting 3QsD 240 Hispanic/Latino 11.4-13.8% 14.9-9.7% 235 African American 3,473 Caucasian 9.0-6.6% Caetano, Cunradi, Clark & Schafer, 2000 [1990 Ntl Alcohol Survey NAS] F P N Individuals 18+ married & cohabiting CTS + 1 SV Q (forced sex) 527 Hispanic couples 17.0% 358 Black couples 22.9% 555 White couples 11.5% Field & Caetano, 2003 cited in Field & Caetano, 2004 [2000 NAS] F P N 1,025 Racially "intact" couples; 72% of surviving couples from 1995 NAS sample adapted CTS 387 Hispanic 20.6% 232 Black 19.9% 406 White 7.8% Lipsky & Caetano, 2007, Ntl Survey on Drug Use & Health [NSDUH] F-CAPI P N 7,924 married or cohabiting women 18-49 in this study 1 Q "How many times during the past 12 months did your spouse or partner hit or threaten to hit you?" 5.1% nr Hispanic 6.7% nr Black 11.0% nr White 4.0% Lown & Vega, 2001a [Mexican American Prevalence and Services Survey] F-CAPI P R 1,155E Latina female 18-59 y/o, Fresno Co, Calif. 1PV (push, hit w/ fi st, use knife or gun, try to choke or burn) & 1 SV (force to have sex against will) 9.5% 4.0% 10.8% Lown & Vega, 2001b [Mexican American Prevalence and Services Survey] F-CAPI P R 1,155E Latina female 18-59 y/o, Fresno Co, Calif. 1PV (push, hit w/ fi st, use knife or gun, try to choke or burn) & 1 SV (force to have sex against will) 10.7% 58.3% Mexico-born 7.1% 41.7% US-born 15.8% McFarlane, Groff, O'Brien, & Watson, 2005 F NP R 7,443 women 18-44 y/o, spoke E or S, at 5 public clinics adopted March of Dimes Assault Screening Protocol (those positively screened were asked to complete SAVAWS & DAS) 5.8% 4,955 Hispanic 5.3% 1,884 African American 6.0% 604 White 8.9% (continued)39 Intimate Partner Violence in Immigrant and Refugee Communities Table 1. Studies of IPV Prevalence in Latina and Asian/Paci c Islander Communities Authors Data Coll. Method Sample Measures Physical Violence Sexual Violence Physical and/or Sexual Violence N Characteristics Lifetime Past year Lifetime Past year Lifetime Past year Latina (continued) Denham, Frasier, Hooten et al., 2007 SA or OAF NP R Female employees 18+ y/o at 12 (blue-collar) work sites in rural North Carolina "Did a partner or ex-partner ever push, shove, hit, slap, kick or otherwise physically hurt you?"; "Did a partner/ex-partner yell at you, put you down, yell at you in public or make you feel bad about yourself?" 119 All Latina 19.5% 95 Spanish-speaking Latina 15.9% 24 English-speaking Latina 33.3% 499 White 25.2% 594 African American 31.8% Ingram, 2007 T-RDD P RG 12,039 men & women Modifi ed CTS; 16 items y-n response (not clear if SV is included) 57.2% 16.2% 1973 Latino/a (M&F) 50.6% 18.7% 9982 non-Latino/a (M&F) 58.5% 15.7% Hazen & Soriano 2007 F P R Latina women 18-45 y/o, w/ contact w/ intimate partner last 12 mos., unduplicated cases @ com. health care system in San Diego, Calif. CTS2, PMWI-SF 33.9% 18.5% 20.9% 14.4% 126 US-born 48.4% 25.4% 29.4% 21.4% 117 Immigrant 22.2% 12.8% 12.0% 5.1% 49 Migrant/seasonal 24.5% 14.3% 20.4% 18.4% Asian/Paci c Islanders Yick, 2000 T P R 262 Chinese <133 men, 129 women> CTSC 18.1% 6.8% Hoagland & Rosen, 1990 F NP R 54 Filipina, undocumented physical, emotional, or sexual abuse 20%H Yoshihama, 1999, 2001; Yoshihama & Gillespie, 2002; Yoshihama & Horrocks, 2003; past-year rates are unpublished F P R 211 Japanese Expanded CTSI and 11 sexual violence items 39.8-51.7% 12.8-14.7% 20.3-29.9% 6.2-8.5% 54.5% 19.0% Age adustedJ 57.4% 35.2% CTS-equivalentK 26.5-33.6% 7% Song 1996 FL NP R 150 Korean Multiple itemsM; sexual violence was assessed by one item: "My husband/ partner forced me to have sex with him." 22.0% 60.0% Kim & Sung, 2000 T NP R 256 Korean CTS 18.0% (continued)40 Intimate Partner Violence in Immigrant and Refugee Communities Table 1. Studies of IPV Prevalence in Latina and Asian/Paci c Islander Communities Authors Data Coll. Method Sample Measures Physical Violence Sexual Violence Physical and/or Sexual Violence N Characteristics Lifetime Past year Lifetime Past year Lifetime Past year Asian/Paci c Islanders (continued) Lee, 2007 SA NP R 136 Korean women CTS2 29.4% Raj & Silverman, 2002 SA NP R 160 South Asian CTS2 30.4% 26.6% 40.8% 36.9% Hurwitz, Gupta, Liu, Silverman & Raj, 2006 SA NP R 208 South Asian Adopted from MA Behavioral Risk Factor Surveillance System 21.2% 14.9% Data collection method: CAPI=Computer Assisted Personal Interviews; F=Face-to-face interviews; T=Telephone interviews; T-RDD=Random Digit Dialing telephone interviews; OA=Orally-administered questionnaires; SA=Self-administered questionnaires Sample: P=Probability sample; NP=Non-probability sample; N=National sample; R=Regional/Local sample; nr=Not reported Measures: AAS=Abuse Assessment Screen; BRFSS Survey=Behavioral Risk Factor Surveillance System Survey; CTS=Confl ict Tactics Scale; CTS2=Confl ict Tactics Scale 2; DAS=Danger Assessment Screen; ISA=Index of Spousal Abuse; PMWI-SF=Psychological Maltreatment of Women Inventory-Short Form; SAVAWS=Severity of Violence Against Women Scales; PV=Physical Violence; SV=Sexual Violence; PSV=Physical and/or Sexual Violence 16 states and 2 territories A. Epidemiologic Catchment Area Study B. Respondents were both female and male; the prevalence was not reported separately for women and men. C. 3 Qs used in NSFH: 1) "When you have a serious disagreement with your husband/wife/partner how often do you: end up hitting or throwing things at each other?"; 2) "Sometimes arguments between partners become D. physical. During the last year, has this happened in arguments between you and your husband/wife?"; 3) if Rs indicated yes to (1) or (2), "During the past year, how many fi ghts with your h/w/p resulted in YOU (or h/w/p) hitting, shoving, or throwing things at him/her?" Weighted sample size is 1,188 E. Self-administration with some (most Spanish-speaking) respondents, and face-to-face oral administration with others F. 10 non-random sites and 10 comparison sites matched on sociodemographic characteristics (as part of a study to evaluate the impact of CCRs) G. Including emotional violence H. 31 types of physical violence, including all 9 items of the physical aggression subscale of the Confl ict Tactics Scale (modifi ed, original 9 times split into 17 items). Additional forms of physical and sexual violence were drawn I. from studies in Japan and the United States. Based on the Kaplan-Meier estimator, which took into consideration the probability that some women who have not been abused at the time of the interview may experience an intimate partner's violence at a later time J. Based on the 17 types of physical violence included in the CTS physical aggression subscale (original 9 items split into 17 items) K. Augmented by group administration of written questionnaires L. Including: Low (yell, swear, destroy property, threw an object); Moderate (threaten to hit with an object, threaten to hit with fi st, hit with a closed fi st); Somewhat severe (slap, hit with an object, threaten with a knife, threaten to M. kill); Moderately Severe (threaten to kill himself, threaten with a gun, forced to have sex); Severe (squeeze or pinch, choke, burn, broke bone, stab); Very Severe (attempt to kill) (continued)41 Intimate Partner Violence in Immigrant and Refugee Communities

A recent analysis of the Behavioral Risk Factor Surveillance System (BRFSS) Survey in 16 states and two territories reported the following estimates of lifetime physical and/or sexual IPV: 20.5 percent for Hispanic women; 9.7 percent for Asian women; 29.2 percent for Black women; and 26.8 percent for White women.26 These studies indicate somewhat or considerably lower IPV rates for Latina and Asian women when compared to other racial/ethnic groups. Virtually no population-based prevalence estimates are available for immigrant/refugee population groups other than Latina and Asian.

Other national population-based studies have reported somewhat inconsistent findings, with some reporting a higher rate of IPV in the previous year among Latinas/Hispanics than Whites,27-29 and others, a lower past-year rate in Latinas/Hispanics.30, 31 For rates of IPV ever experienced, different studies have found both higher32 and lower33 rates for Latina/Hispanics than for White women, with others reporting comparable rates for the two groups.34

Although studies using aggregated racial groups have found higher rates of domestic violence among non-Whites35 and Mexican Americans27 than Whites, studies that disaggregated subgroups often uncovered differences among ethnic subgroups and/or across generational positions within an ethnic group. For example, the National Alcohol and Family Violence Survey found a higher rate of domestic violence among Puerto Rican Americans than among Cuban Americans, and also found that the rate was significantly lower among first-generation Mexican immigrants than among their U.S.-born Mexican American counterparts.36

These findings clearly underscore the importance of considering within-group differences among immigrant populations and warn against aggregation. It should also be noted that when other factors, such as socioeconomic status and partners' substance abuse, are taken into consideration in multivariate analyses, differences by race/ethnicity tend to disappear or decrease.36, 37 Thus, available data appear to indicate that IPV is not more prevalent, and in fact, is probably less prevalent, among immigrant/refugee population groups compared to other groups.

Immigrants (foreign-born individuals) of Hispanic and Asian/other descent are at a higher risk of homicide in general (not limited to IPV-related homicide) than U.S.-born persons.38 And although no population-based studies have provided rates of IPV-related homicide by immigration status, homicide reviews and analyses of reported homicide cases have consistently documented an overrepresentation of immigrant/refugee women among victims. For example, 31 percent (16 out of 51 cases) of women killed in domestic violence-related deaths from 1993 to 1997 in California's Santa Clara County were Asian, although Asians comprised only 17.5 percent of the county's population.39 Of women and children killed in IPV-related homicides in Massachusetts in 1991, 13 percent were Asian, although Asians represented only 2.4 percent of the state's population.40 In domestic violence-related homicides in 2000 in Hawaii five of the seven women killed were of Filipina descent41 (staff of the Domestic Violence Clearinghouse and Legal Hotline, Honolulu, HI, personal communication, April 3, 2002; also see the Fact Sheet on Domestic Violence in Asian Communities compiled by the Asian & Pacific Islander Institute on Domestic Violencei). This is a disproportionately high rate given that Filipinos represent only 12.3 percent of the total population of Hawaii. The Washington State fatality reviews also found a higher rate of IPV-related homicides among immigrants.42

i www.apiahf.org/apidvinstitute/PDF/Fact_Sheet.pdf42 Intimate Partner Violence in Immigrant and Refugee Communities

For Latinas, some studies found a higher rate of physical IPV among U.S.-born Mexican Americans36, 43 or U.S.-born Latinas44 than among foreign-born counterparts. Findings concerning the relationship between acculturation levels and IPV risk are inconsistent. Some studies designated three to five levels of acculturation and found the "highest acculturation group" to be at higher risk of IPV,45 and others found the "medium acculturation group" 46 or both the middle and high acculturation groups to be at higher risk.47 In other studies, no significant association was found between acculturation levels and IPV risk.48

For Asian/Pacific Islanders, Yoshihama's study of Japanese women in Los Angeles found no significant generational differences in the risk of experiencing physical/sexual IPV.49 ,50 Raj and Silverman (2002) also found no association between the respondent's experience of IPV and country of birth, citizenship status, or level of acculturation.51

Thus, the relationship between immigration status or acculturation levels and the likelihood of experiencing IPV is, at best, inconclusive. This challenges a widely held assumption that IPV is more prevalent among (recent) "un-acculturated" immigrants compared to U.S.-born individuals or those immigrants who have been in the United States longer (thus "acculturated").

Exclusion:¦¦ The language(s) used in data collection can lead to the exclusion of large segments of immigrant/refugee populations. Studies have often been conducted only in English, excluding non-English-speaking individuals (e.g., recent immigrants). Although recent national surveys have used both English- and Spanish-speaking interviewers, immigrants who speak other languages remain excluded from study participation.

Inattention:¦¦ Even if studies include substantial numbers of immigrants/refugees in their samples (e.g., Latina or Asian individuals), researchers might not conduct analyses by race/ethnicity or report study results by race/ethnicity.

Aggregation:¦¦ A large proportion of researchers aggregate various ethnic groups. For example, lumping API ethnic groups (e.g., Chinese, Filipino, Indian, Japanese, Korean, Tongan, Vietnamese) together as one group. Aggregation may also take the form of not differentiating immigration status or generational position within a particular ethnic group.

Lack of attention to sociocultural context:¦¦ Despite a vast volume of literature documenting the various ways in which sociocultural factors affect the manifestations 43 Intimate Partner Violence in Immigrant and Refugee Communities

of IPV, the majority of studies employ a standardized instrument that has been developed and normed based on the experiences of mainstream population groups. Although the use of standardized instruments can assist with the comparability of findings, the lack of an instrument's validity with a particular group may ultimately compromise the quality of the data. Yoshihama's study (2001) documented that the inclusion of socioculturally relevant items resulted in higher reported rates of IPV, which suggests that the use of standardized instruments is likely to result in underestimation of the prevalence of IPV.52

Limited comparability:¦¦ In addition, studies vary considerably with respect to such methodological aspects as sampling criteria (e.g., age, marital status), measures/instruments, data collection methods, and study framework (e.g., whether the study is introduced as focused on IPV, safety, health, stress, or conflict). Such variations challenge the comparability of study findings. Furthermore, the effects of sampling and self-selection bias, as well as the degrees to which respondents are willing to disclose their experience of IPV, remain unknown.

Although IPV cuts across racial, ethnic, and sociocultural boundaries, there are certain socioculturally rooted ways in which IPV manifests itself. One notable aspect of IPV against immigrant women is the partner's use of a woman's immigration status, a vulnerability exacerbated by current U.S. immigration policies. In a provision of the Immigration Marriage Fraud Amendments of 1986 (8 U.S.C. § 1186a), a foreign spouse of a U.S. citizen is granted conditional residency status for two years, requiring the U.S. citizen to petition on behalf of his/her foreign spouse in order for the latter to obtain permanent residency. This policy provides partners (who may have a propensity toward intimidation) a virtual license to abuse.53, 54 Studies have documented numerous examples of how abusive partners use women's immigration status to instill fear in them and control them. For example, a partner may threaten to divorce his wife, or not petition for her permanent residency. Fear of losing legal status or of facing deportation could prevent a woman in this situation from seeking outside help.55-61 And undocumented immigrant women face the heightened fear of being reported to the immigration authority.55, 62 The Immigrant Power & Control Wheeliiprovides a good overview of multiple ways in which immigration status can be used as part of a system of power and control.

ii www.endingviolence.org/files/uploads/ImmigrantWomenPCwheel.pdf44 Intimate Partner Violence in Immigrant and Refugee Communities

Marriages to U.S. military personnel: Women who immigrate to the United States ¦¦through their marriage or engagement to U.S. military personnel.63

Marriages through international marriage brokers or dating services: An increasing ¦¦number of men in the United States utilize picture/mail-order bride services from such parts of the world as Asia and Eastern Europe.53, 59, 64-66

International marriages, typically arranged by family networks, where women residing ¦¦in their country of origin marry men (usually of the same ethnic background) who have been living in the United States: Within many immigrant and refugee communities, a practice of marrying foreign-born women of the same ethnic and/or cultural background is common. Bachelors (and sometimes married men, as well) often return to their country of origin for the specific purpose of finding a bride.67-70

A number of sociodemographic characteristics have been identified as risk factors, although findings vary depending on whether the outcome variable is based on lifetime or past-year experience of IPV. For example, while young age is frequently found as a risk factor in studies of past-year IPV,31, 44, 71, 72 older age is found to be associated with increased risk of lifetime IPV.43, 73 This is not surprising because the older the woman, the longer she is exposed to the risk.

With respect to socioeconomic status, while some studies have found low income or financial strain to be associated with a higher risk of IPV,27, 31, 74, 75 others have not found a significant association between IPV risk and socioeconomic status. Other risk factors identified include being separated or divorced43, 44 and urban residence.27, 31, 71

Frequently, partners' use of substances, especially heavy alcohol consumption, has been identified as a risk factor for IPV.44, 76-80 Relatively fewer protective factors have been identified; several studies have found the availability of social support to be a protective factor.33, 71

While understanding risk and protective factors is important, because risk factors are not necessarily causes, addressing these correlational factors alone in prevention programs is unlikely to help prevent IPV. 45 Intimate Partner Violence in Immigrant and Refugee Communities

In contrast to a wide and extensive body of research that exists on the health and social consequences of IPV in the general U.S. female population over the last two decades, a far smaller number of studies have examined these consequences in immigrants/refugees. The literature on the effects of IPV on immigrants/refugees has begun to emerge and expand only recently. Studies of the health status of immigrant/refugee battered women indicates the general negative impact of IPV on physical health;81, 82 mental health, such as depression, posttraumatic stress, and anxiety symptoms and disorders;49, 50, 82-88 substance abuse;89 and reproductive/sexual health, such as miscarriage and unwanted pregnancies.60, 82, 90

A number of studies have found a dose-response relationship between IPV severity and the severity of health problems.49, 86, 91 Torres and Han (2000) found that the experience of forced sex (not physical abuse, nonphysical abuse, life changes, acculturation, or social support) was the only factor significantly associated with Posttraumatic Stress Disorder (PTSD) scores.83 In another study, Yoshihama and Horrocks found that forced sex perpetrated by a partner did not independently contribute to increased posttraumatic stress symptom counts in the presence of other types of victimization. In this study, it was IPV-related injuries and fear for their lives that were associated with women's increased posttraumatic stress symptoms.49

Due to methodological variations across studies, it is difficult to ascertain whether the prevalence of health problems among immigrant/refugee women is comparable to that of the general female population when both experience IPV. One study that compared rates of mental health problems found that abused Latina women were less likely than abused White women to be diagnosed with PTSD or an anxiety disorder.83 Another study documented a higher rate of unmet mental health needs among Hispanic battered women.92 In addition to prevalence, symptom manifestations may vary by race/ethnicity, immigration status, and generational position.86 More research is needed to enhance our understanding of health consequences and other effects of IPV among immigrants/refugees.

In general, community-based studies, as well as review articles, have found a lack, or low level, of awareness about IPV among immigrants/refugees (e.g., IPV is not seen as a problem in their community;59, 93, 94 IPV is recognized, but only as a family/private issue;95, 96 or community members condone IPV and/or do not consider various abusive or controlling acts to be IPV.93, 97, 98 In a study conducted by the Family Violence Prevention Fund utilizing a random sample of men and women, Asian-American men and women and Latino men were less likely to define a husband's shoving or face-smacking as domestic violence when compared to Caucasian men and women.99 However, other studies found that some immigrant/refugee groups were more likely to recognize IPV and/or less likely to approve of IPV. For example, a study of multi-ethnic populations in California found that foreign-born individuals of Latino/a descent, and Korean, Vietnamese and other Asian descent saw various acts depicted in a vignette as wrong more frequently than native-born respondents100 (e.g., "A husband told his wife that he did not want her to visit her family that night and that he would not allow it. Then he slapped her."). A study by Kantor and colleagues36 found a wide variation by race/ethnicity in the proportion of respondents approving of a husband slapping his wife: Puerto Rican (18.8%); Mexican born in Mexico (7.7%); U.S.-born Mexican American (5.4%); Cuban (2.1%); and Anglo (13.6%). Given inconsistent findings, it is 46 Intimate Partner Violence in Immigrant and Refugee Communities

A number of studies have identified types of behavior exhibited by community members as exerting a strong influence on battered women's coping and help-seeking behaviors (e.g., gossiping and making fun of victims;24, 96 blame, hostility, and criticism for exposing IPV to those outside the family/ethnic community70). A recent study of Ethiopian women in Seattle describes: 70

As an ecological framework suggests, there are dynamic and interactive influences among factors on individual, interpersonal, familial, organizational, community and policy levels.101,102 Thus, the attitudes and behaviors of an immigrant/refugee batterer, survivor, or community bystander are continuously shaping, and being shaped by, sociocultural and sociopolitical contexts. In order to organize many intersecting factors, this report will discuss them in a rather linear fashion (e.g., cultural practices, values, and norms in one section, and the impact of racism and xenophobia in a separate section). Nevertheless, these factors interact with, are influenced by, and reinforce each other. For example, the immigration and refugee settlement process and the experience of racism and other forms of discrimination are likely to reinforce certain cultural values and practices among immigrants and refugees.

The majority of the literature on IPV among immigrants/refugees discusses cultural values and practices that are unique and/or salient to particular ethnic/cultural groups. The ways these values and practices impact how IPV manifests itself, and how individuals, families, community members, and organizations respond to it are also analyzed. Caution must be exercised, however, not to essentialize culture as a (or the) cause of IPV. Rather, it is critical to view selected cultural values and practices as one of the factors that may influence various aspects of IPV in immigrant/refugee communities (e.g., manifestations, consequences and individual and community reactions). 47 Intimate Partner Violence in Immigrant and Refugee Communities

Hierarchical and patriarchal family structure. It is important to recognize that patriarchal values and practices are found in almost all societies and cultures, including the contemporary United States. For immigrants and refugees, patriarchal aspects of family relationships may be intensified for various reasons (see the Cultural Freezing and Community Denial Section for more details). There is a large volume of literature that points to the hierarchical and patriarchal nature of families in many immigrant/refugee population groups, where roles and powers are ascribed based primarily on gender and age; in general, the man is regarded as the head of the household, and women are expected to defer to men.59, 67, 69, 95, 96, 103-125 These rigid gender-role expectations are likely to contribute to the justification of men's violence against women who do not conform to such expectations.

The literature on IPV among Latina populations makes frequent reference to machismo, the man's role as the head of the household who is expected to care for and protect the family unit.112, 126 Although the term is often associated with a stereotype of Latino families as highly patriarchal, as many authors caution, machismo also connotes ideas of honor, pride, courage, and responsibility to the family.127 It is important not to essentialize cultures and mistake them for explanations of IPV.

Although domestic violence is typically conceptualized in the United States as violence perpetrated by one intimate partner against the other, it is important to take into account the important role that extended family members play in the lives of immigrants/refugees when designing intervention and prevention programs. Extended families play an important role in many immigrant/refugee families. It is not uncommon for a couple to live with the husband's or sometimes the wife's parents and other family members. The presence of extended family can provide resources and support of various kinds (e.g., help with childcare), diffuse tension between the couple, and offer comfort and advice in times of need. However, extended family members can also contribute to or exacerbate the husband's controlling and abusive behavior. Studies of API populations reveal that it is not uncommon for parents-in-law (and other extended family members) to perpetrate violence against their daughters-in-law directly or indirectly.96, 113, 125, 128-131

Family, face saving, faith, and fate. In many immigrant/refugee population groups, the family is regarded as the unit of central importance.67, 106, 108, 112, 114, 115, 117, 119, 132-134 There is strong pressure to keep the family together,59, 67, 96, 109, 114, 119 and this strong sense of familialism can hinder battered women's willingness to escape from, disclose, or report their partners' abuse.

Another factor that has been identified as guiding the behavior of many immigrants and refugees is the value of saving face. There is strong pressure to avoid shaming the family, which is likely to hinder women's efforts to seek outside help for "family" problems.95, 96, 108, 113, 119, 121 Ayyub's work with South Asian women illustrates the shame that divorce brings not only to women but also to families: 67

Also, belief in fate has been identified as playing a significant role in immigrant/refugee women's reactions to IPV.132, 135, 136 Women may accept their partners' violence as fate and believe (or be led to believe) that they have little control over it.48 Intimate Partner Violence in Immigrant and Refugee Communities

Religion and faith are also important to many immigrants and refugees. For example, Marianismo (i.e., belief in the Virgin Mary) emphasizes certain ideals of femininity and motherhood, such as purity, humility, modesty, acceptance of fate, and self-sacrifice.132 These expectations may lead women to believe that they should endure partners' violence, and accept and/or forgive their behavior.

Immigration is associated with many changes and stressors, including disruption in the social support system, language barriers, and a lack of familiarity with the U.S. social system, which in turn are likely to intensify a sense of isolation and loneliness. Studies of IPV in immigrants/refugees have consistently documented a sense of isolation;61, 96 a smaller social network and/or a shift from extended family to a nuclear family structure;61, 70, 119, 137 and a lower level of social support satisfaction than others.49, 50 It is important to note that isolation due to immigration/migration is often intensified by abusive partners' tactics of control, surveillance, and threat.

It is not uncommon for refugee women to have experienced sexual assault and other forms of violence against women during their journeys on land and at sea, as well as within refugee camps.138 Some immigrant women also have faced a range of sexual assault, harassment, and exploitation during border-crossing.55 The experience of trauma by many refugees from war-torn countries before and during their escape may desensitize them to suffering, and some, or many, may not consider IPV serious in comparison to their war-related ordeals.70, 96 The impact of torture, maltreatment in political camps, and trauma during refugee/immigration processes on the perpetration and experience of IPV is a neglected area of research.

Impact of policies. Ongoing experiences with racist and discriminatory practices contribute to stress for many immigrant/refugee families. Although these stressors do not cause men to abuse their partners, they are likely to affect how the perpetrator, the survivor, their families, and community members respond to IPV. On an individual level, experiences with racism and discrimination affect the willingness of survivors to seek assistance from outside agencies. Many immigrant/refugee battered women are reluctant to report their partners' violence to the authorities because they are afraid that they and/or their partners will be treated with insensitivity, hostility, and/or discrimination.

There are many policies that have profound impacts on the vulnerability of immigrant/refugee women. (See Appendix A for a discussion of legal structures relating to U.S. immigrants and refugees.) The impact of U.S. immigration policies and welfare policies deserves a brief mention. As discussed in the Immigration Status and Systems as Tools of Control Section, certain provisions of U.S. immigration policies, such as the Immigration Marriage Fraud Amendments of 1986 (8 U.S.C. § 1186a), place immigrant women at risk of exploitation by U.S. citizens or permanent residents. The Personal 49 Intimate Partner Violence in Immigrant and Refugee Communities

Political activism on behalf of battered immigrant/refugee women. Due in large part to strong grassroots lobbying efforts, the Immigration Act of 1990 (Pub.L. 101-649) and the Violence Against Women Act (Title IV of the Violent Crime Control and Law Enforcement Act of 1994, Pub.L. 103-322, AKA Crime Bill) were enacted, which provided a number of avenues of legal recourse for battered immigrant women, including a waiver for failure to meet the requirements for permanent residency status and right to self-petition for residency status.139 The reauthorizations of the Violence Against Women Act (VAWA) in 2000 and 2005 expanded the scope of individuals eligible for relief, eased the evidentiary requirements, and expanded access to public benefits.140, 141 As of 2006 a total of 42,000 self-petitions had been approved since the program began, and 10,000 had been denied, according to a staff member of Citizenship and Immigration Services of the U.S. Department of Homeland Security. This number alone is a testament not only to the previously unmet needs of battered immigrant women, but also to the effectiveness of the advocates who have worked tirelessly to bring about legal reform.

The experiences of immigration and resettlement may trigger or exacerbate what is known as cultural freezing, the development and imposition of rigid values and normative behavioral expectations from one's country of origin, such as the affirmation of male control as head of the household and the expectation of submissiveness in women.109 As such, the images of values and normative behaviors of the country of origin are often distorted, idealized, romanticized, and/or stereotyped. It is important to recognize that this process of distortion and/or idealization does not happen in isolation from other social forces, such as racism, xenophobia, and anti-immigrant/refugee sentiments.

Although both men and women engage in such idealization, because men are the ones who generally used to enjoy higher status and more privileges in their country of origin, they have more to lose, and thus have a vested interest in keeping the idealized family structure where they assume authority, power, and control. Of course, whereas the desire to be in control may affect men in general, the process of immigration/refugee 50 Intimate Partner Violence in Immigrant and Refugee Communities

Historically and contemporarily, immigrants and refugees have experienced overt and covert discrimination, exploitation, violence, and harassment. Such experiences may desensitize community members to the seriousness of IPV in their own community.121, 142 In the face of historical and contemporary discrimination against immigrant/refugee groups, the survival of the community is often considered the priority; coupled with patriarchal ideology, women's suffering is not seen as a serious and urgent problem.143 Because acknowledging IPV as a problem is viewed as detrimental to the collective survival of the community, there is strong pressure to maintain a positive image of their community and remain silent about the problem of IPV.59, 121, 142, 144, 145 Those who violate these expectations may experience silencing, criticism, and sometimes even death threats. Nilda Rimonte, a founding director of the Center for the Pacific Asian Family-the nation's first shelter for API battered women-describes one such reaction of community members: 118

After Newsweek quoted me as stating that there was a problem of wife-abuse in the Asian community, I received many irate phone calls from Asians angered by my exposure of the community's "underbelly." (p. 1313)

Consistent with the literature on help-seeking among the general U.S. female population, studies have consistently found that only a small proportion of battered immigrant/refugee women seek assistance from outside agencies.51, 61, 113, 121, 137, 138, 146, 147 In a study of Latina battered women by Santiago and Morash, only 12 percent of respondents said that they would seek help from people within institutional settings, while 73 percent said it was appropriate to seek the help of family members.146 Dutton and colleagues documented that less than 10 percent of Latina battered women sought help from domestic violence programs.61 Although a somewhat larger proportion of battered immigrant/refugee women seek health care, not all of them disclose their experience of IPV to health care workers.61, 148

In light of this, a finding of a more frequent use of the police among Latina and African-American women in some studies is somewhat contradictory.147, 149, 150 However, other studies did not find a higher use of police among Latinas.151, 152 Studies have not 51 Intimate Partner Violence in Immigrant and Refugee Communities

As previously discussed, immigration and resettlement are often associated with disruptions in immigrants' and refugees' social support networks. Over 90 percent of Vietnamese women interviewed in Tran's study had only zero to two people as sources of support.119 In Yoshihama's study, which examined four generations of women of Japanese descent in Los Angeles, first-generation respondents (immigrants from Japan) had the smallest number of individuals who provided social support, and they were the least satisfied with the available social support.49 South Asian women in Boston had fewer family members residing in the area, and South Asian and Hispanic women in a northeastern city had fewer family members residing in the United States compared with African-American women.137 Despite limited availability, abused immigrant/refugee women rely heavily on the individuals in their social network for support.61, 75, 130, 137, 146, 147, 153

Seeking help does not necessarily result in receiving the help that is desired.61, 121, 134, 137 Individuals to whom a battered immigrant/refugee woman has turned to for help may be well-meaning; however, they may impose their values and beliefs, deny or minimize her suffering, or worse, blame her rather than hold her abusive partner accountable. In addition, mainstream organizations may lack sociocultural understanding and/or may have discriminatory or insensitive attitudes toward immigrants/refugees.

In a study of Latina women in the Washington, D.C. area, only 20 percent said that the first person to whom they spoke about IPV told them that "what happened to them [partners' perpetration of violence] was wrong."61 In the same study, only 13.7 percent said they were offered shelter, and another 11.6 percent were helped to find shelter/legal services. Only half of the women who sought help from either formal or informal sources found the assistance they received to be helpful.146

The importance of clergy has been discussed in a number of studies as well; 25, 134, 147 however, studies tend to find a low usage of clergy and faith-based assistance. For example, in one study only 3.3 percent to 5.7 percent of battered Latina women had used religious-based assistance;61 in another study, 9.6 percent.75 Studies point to women's fears of not being understood or of not receiving the support desired, and instead, being blamed or encouraged to endure abuse by clergy and faith-based organizations.25, 134

One of the scarcest areas of the literature on IPV in immigrant/refugee communities is that on intervention and prevention programs. This is not to say that immigrant/refugee communities are devoid of programs addressing IPV. On the contrary, immigrant/refugee women's groups and community-based organizations have developed and implemented 52 Intimate Partner Violence in Immigrant and Refugee Communities