Influential Claim about Domestic Violence Against Women

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The U.S. Surgeon General’s statement in 1992 in the prestigious Journal of the American Medical Association was highly influential for proliferating false claims about domestic violence against women. That journal’s June 17, 1992, issue highlighted domestic violence against women. It included a one-page statement entitled “From the Surgeon General, US Public Health Service.” The Surgeon General’s statement began:

A Medical Response to Domestic Violence: Domestic violence is an extensive, pervading, and entrenched problem in the United States. It is an outrage to women and the entire American family. … It is a violation of our criminal laws and a callous disregard for human life.^

This statement as a whole implicitly equated domestic violence (“an outrage to women”) with domestic violence against women. Its fourth paragraph stated:

One study found violence to be the second leading cause of injuries to women, and the leading cause of injuries to women ages 15 through 44 years (Am J Epidemiol. 1991;134:59-68).

The Surgeon General’s statement, which began with an explicit scope of domestic violence (“A Medical Response to Domestic Violence: “), didn’t address violence in general. Hence a reader would reasonably assume that the reference to violence referred to domestic violence. The appended scholarly citation (“Am J Epidemiol. 1991;134:59-68”), the only scholarly citation in the Surgeon General’s statement, examined injuries treated in hospital emergency departments. The injuries of concern were all injuries from violence, not just injuries from domestic violence. The population studied was poor, urban, black women in western Philadelphia in 1987-88.^ That population is far from representative of the U.S. population as a whole. The Surgeon General’s statement concluded:

As health professionals, we must make every effort to end domestic violence. Women must be able to live their lives free from violence, both inside and outside the home. … As professionals, we can make a remarkable difference.

After the Surgeon General’s statement were the authors’ names and impressive credentials:

  • Antonia C. Novello, MD, MPH, Surgeon General, US Public Health Service
  • Mark Rosenberg, MD, PhD
  • Linda Saltzman, PhD, National Center for Environmental Health and Injury Control, Centers for Disease Control
  • John Shosky, PhD, Consultant to the Surgeon General

With the statement “From the Surgeon General,” these authors made a remarkable difference. Variants of the false claim that domestic violence is the leading cause of injury to women proliferated after its publication. Many scholarly references to that false claim have reference chains leading back to the Surgeon General’s statement in the June 17, 1992, issue of the Journal of the American Medical Association.

That journal issue also included a report that contributed to the proliferation of false claims about domestic violence against women. The report was entitled “Physicians and Domestic Violence.” It was subtitled “Ethical Considerations.” The Council on Ethical and Judicial Affairs of the American Medical Association authored it. This report’s third paragraph stated:

Women in the United States are more likely to be victimized, through assault, battery, rape, or homicide, by a current or former male partner than by all other assailants combined.{one endnote reference} The rate of injury to women from battering surpasses that of car accidents and muggings combined. {four endnote references}^

References to the Surgeon General’s misleading statement about domestic violence often include frightening comparators like “car accidents” and “muggings”. These terms do not occur in the Surgeon General’s statement. References that include these terms seem to have evolved from an intertwining and exchange of symbol material between the Surgeon General’s statement and the report of the American Medical Association’s Council on Ethical and Judicial Affairs. Despite the additional scholarly paraphernalia attached to the latter report, nationally representative injury surveys indicate that the claim about the battering injury rate for women is false by a wide margin.

The June 17, 1992, issue of The Journal of the American Medical Association also included an editorial supporting the proliferation of false claims about domestic violence against women. This editorial was entitled “Violence, Values, and Gender.” Echoing the Surgeon General’s misleading statement, that editorial noted “our findings that domestic violence was a leading cause of women’s injuries.”^ The author of the editorial was “Anne H. Flitcraft, MD.” The American Medical Association’s Council on Ethical and Judicial Affairs thanked Flitcraft for “critical review” of its report in that issue (see above). Flitcraft, along with Evan Stark, had published for the National Clearinghouse on Domestic Violence in 1981 a tendentious monograph entitled, Wife Abuse in the Medical Setting: An Introduction for Health Personnel.^ Apparently established as a domestic-violence expert, Flitcraft testified in 1985 at a Senate hearing on domestic violence and public health. She declared to the Senate:

domestic violence accounts for more injuries to women than street crimes, rapes, muggings, and motor vehicle accidents combined. It is the single largest cause of injury to women in this country.^

Flitcraft also co-authored a paper with Evan Stark for the Surgeon General’s Workshop on Violence and Public Health in 1985. As published in 1991, that paper stated that spouse abuse “results in more than three times as many injuries as auto accidents.”^ Nationally representative injury surveys indicate that these claims grotesquely exaggerate injuries from domestic violence.

The Surgeon General’s statement, in its context in the 1992 issue of the prestigious Journal of the American Medical Association, provided highly authoritative support for the claim that domestic violence is the leading cause of injury to women. That claim and its variants proliferated after 1992. That those claims are false by a wide margin mattered little. In stark contrast, scholarly studies indicating that domestic violence against men is a serious public problem have generated violent scholarly controversy and attracted little public attention. The Surgeon General’s statement on domestic violence provides a stunning example of a fundamental anti-men sex bias in public discourse.

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