This study is the first systematic review and meta-analysis to examine changes in domestic violence incidents from pre- to post-lockdown periods; results show moderate to strong increase in domestic violence incidents

Domestic violence during the COVID-19 pandemic - Evidence from a systematic review and meta-analysis. Alex R. Piquero et al. Journal of Criminal Justice, Volume 74, May–June 2021, 101806. https://doi.org/10.1016/j.jcrimjus.2021.101806

Highlights

• Crime changed from pre- to post-COVID-19 lockdown periods.

• Limited evidence shows an increase in domestic violence.

• This study is the first systematic review and meta-analysis to examine changes in domestic violence incidents from pre- to post-lockdown periods.

• Results show moderate to strong increase in domestic violence incidents between pre- and post-lockdown periods.

Abstract

Purpose: The aim of this review was to estimate the effect of COVID-19-related restrictions (i.e., stay at home orders, lockdown orders) on reported incidents of domestic violence.

Methods: A systematic review of articles was conducted in various databases and a meta-analysis was also performed. The search was carried out based on conventional scientific standards that are outlined in the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and studies needed to meet certain criteria.

Results: Analyses were conducted with a random effects restricted maximum likelihood model. Eighteen empirical studies (and 37 estimates) that met the general inclusion criteria were used. Results showed that most study estimates were indicative of an increase in domestic violence post-lockdowns. The overall mean effect size was 0.66 (CI: 0.08–1.24). The effects were stronger when only US studies were considered.

Conclusion: Incidents of domestic violence increased in response to stay-at-home/lockdown orders, a finding that is based on several studies from different cities, states, and several countries around the world.

Keywords: Meta-analysisCOVID-19Domestic violenceLockdowns

4. Discussion

The purpose of this study was to examine whether policies implemented to reduce the spread of the coronavirus, namely stay-at-home or lockdown orders, were associated with any changes in domestic violence using administrative/official pre-post records. Our work was focused on systematically reviewing the literature on any potential changes in domestic violence after restrictions were put into place.

Following systematic review protocol, our initial research started with over 22,000 records identified through database searches as being potentially eligible for inclusion. After our eligibility criteria were imposed, we ended with 18 studies that were included in the systematic review, which is substantively similar to many such reviews in the criminological literature. These 18 studies yielded a total of 37 estimates, the results of which showed an overwhelming increase (pre-post) in reports of domestic violence. Specifically, 29 of the 37 study estimates showed a significant increase. Finally, our forest plot of the distribution of effect size estimates, based on the information necessary to perform such calculations (12 studies and 17 effect sizes), showed an overall medium effect size of 0.66. In short, the evidence is strong that incidents of domestic violence increased in response to stay-at-home/lockdown orders, a finding that is based on several studies from different cities, states, and several countries around the world.

To be sure, while our results rely on the available research that met our inclusion criteria that exists at this time, it remains a sampling of the work that is being done and not yet known. As well, much of the early work that has focused on crime changes in response to the pandemic-related lockdown orders relies on short windows of observations, a few weeks or months. But this is true of the publication process, whereby the time an article has gone through review and published many months have passed since the researchers finalized their data collection. Therefore, continued follow-ups are needed to add to and update our database going forward. Another limitation of our work is that the database relies mainly from U.S. studies, in large part because those are the studies that fit the criteria outlined in our search parameters. We know, for example, that domestic violence is a serious problem in the Americas, and in particular in Low and Middle Income Countries (LMIC) where there is a significant amount of violence, but little is noted in administrative data nor is there much help to aid victims. As a consequence, we anticipate that when researchers carry out sustained analyses of domestic violence in LMIC countries, they will likely uncover a devasting toll on women and children. Lastly, our work relies on official records, which suffer from a variety of problems. At the same time, other sources of domestic violence data, such as self-reports, have tended to show some short-term increases in domestic violence as well (Jetelina, Knell, & Molsberry, 2021). Additional work is needed to assess whether there are enough studies in that line of work to perform a similar analysis to the one carried out in this study. The same is true from the data reports from service providers (Pfitzner, Fitz-Gibbon, Meyer, & True, 2020). The more we can triangulate the data on domestic violence as a result of lockdown orders to gain a more complete picture of changes in victimization experiences, the better and more confident our penultimate conclusions can be.

5. Conclusion and policy implications

The results of this study underscore the importance of increasing the knowledge base about domestic violence, as there have been concerns raised by public health leaders, victim/survivor advocates, women's and children's groups, activists, and policymakers around the world about the potential significant spike in abuse related to the pandemic (see e.g., the Lancet Commission on Gender-Based Violence and Maltreatment of Young People, Knaul, Bustreo, & Horton, 2020). The global economic impact of COVID-19, record levels of unemployment, added stressors in the home—including the care and home schooling of children, financial instability, and illness or death caused or exacerbated by the virus—combined with the mental health toll of social distancing measures required by the epidemiological response, have undermined the decades of progress made in reducing the extent and incidence of domestic violence. In turn, the results of this systematic review call for significant attention to the policy responses and resources that are needed to attend to victims and survivors of domestic abuse that may not be getting the services they need. In particular, Galea, Merchant, and Lurie (2020) note the need to direct resources to historically marginalized groups and those likely to be disproportionately isolated during the pandemic, including older adults, women, and children with past experiences with violence and abuse, and those with ongoing mental illness and chronic health conditions—and it is certainly possible that these effects are magnified for women and children of color, immigrants or refugees, and/or households that speak a language other than English. In addition, the gendered impacts of the pandemic will be far-reaching and in need of sustained research and policy attention (Wenhma, Smith, & Morgan, 2020), especially those programs and policies that are the intersection between women and children such as income transfer programs.

It is also important for our response to domestic violence during the COVID-19 pandemic to learn from the lessons of responding to previous health crises, natural disasters, and major disruptions that may offer direction and guidance (Sánchez et al., 2020). There is strong evidence to suggest that women's physical and mental health, including the risk of first-time or escalating domestic violence, is connected to the consequences of natural disasters and epidemics, including social isolation, economic instability, and increasing relationship and family conflict (Campbell & Jones, 2016; Parkinson, 2019).

The governor of Puerto Rico recently declared a state of emergency related to gender-based violence, noting it to be a serious social and public health problem that has gotten worse as a function of the territory's economic turmoil, Hurricane Maria, and now the COVID-19 pandemic (Florido, 2021). Similar to Puerto Rico, there needs to be equally strong global, federal, and state level leadership to make these bold and decisive declarations, but also commitments to expand victims' access to health and support services and economic resources directed to families during and after the pandemic. We must look to collaborative and creative thinking, as well as to skilled and experienced victim advocates who have been providing and building upon increasingly evidence-based services for over four decades, on how to expand the availability and diversity of these services and resources, particularly transitional housing options for victims who may have contracted or been exposed to COVID-19. For those victims who report to law enforcement, there will be a need for more intensive police, social services, and victim advocacy follow-up both during and after the COVID-19 pandemic. Research will also need to explore whether the pandemic's impact on the incidence of domestic violence is sustained in the long-term.

While this systematic review provides strong evidence of increased officially reported domestic violence as a consequence of the COVID-19 stay-at-home and lockdown orders, the exact nature and context of the increase remains unknown. Increased reporting to the police, emergency rooms, and other healthcare settings may be a function of an increased number of victimizations, but also an increase in the decisions by some victims to call the police and seek criminal justice interventions. That is, changes in official reporting rates reflect both a change in extent of victimization experiences, but also the help-seeking decisions of those who were victims of domestic violence prior to and during the pandemic. The increase may include reports by a new set of domestic violence victims whose violence experiences are largely a function of the current economic impact of the pandemic, as well as the temporary isolation resulting from social distancing measures and stay-at-home orders (e.g., the abuse they experienced pre-pandemic was largely emotional in nature and circumstances surrounding the pandemic escalated that emotional control to acts of physical violence). The pandemic may have also served as the catalyst for those who were victims prior to the pandemic to report their experiences due to the increased incidence and severity of violence by their previously abusive partners.

While the findings in this study note increases in officially reported domestic violence, the direction of future research needs to include careful joint analyses of estimates from police agencies, shelter-based and clinical data, and self-report victimization data before, during, and after the COVID-19 pandemic to estimate the diverse types and context of domestic violence and also examine the ways in which the pandemic have placed women at further risk for physical violence, emotional and financial abuse, and coercive control in the long-term. Chandan et al. (2020) note that the selection bias associated with police, healthcare, and other administrative datasets consistently underestimate the extent and impact of domestic violence, a well-established finding in research before the pandemic. They conclude that without ongoing data collection and surveillance, it will not be possible to estimate the total burden of domestic violence both during and after the pandemic.

The stay-at-home measures have placed those most vulnerable to violence and abuse in close proximity to their potential abuser, and this may lead to a continued increase in the risk factors associated with domestic violence. The cause of this increase is likely to be shaped by a variety of factors that are associated with domestic violence more generally, but that have and will continue to be more prevalent during the COVID-19 pandemic. This includes social isolation and increased attempts by abusers to exert power and coercive control, unemployment, economic distress, marital conflict, and substance use and abuse. The financial stress associated with the COVID-19 pandemic has been unprecedented and is likely to disproportionately impact victims and survivors of domestic violence in the long-term. Women's economic dependence on male partners will continue to place many women at risk for new and continued domestic violence. Moreover, the disproportionate impact of the pandemic on unemployment among women, which is estimated to be four times greater for women as compared to men (Sasser Modestino, 2020; Tappe, 2020), along with their increasing responsibility for childcare and home-schooling, will exacerbate the financial challenges of women trying to navigate leaving violent relationships. Patrick et al. (2020) have identified a number of other financial stressors related to the pandemic, including increased food insecurity, decreased employer-sponsored insurance coverage for their children, and the loss of regular childcare leading to women's increasing unemployment, which in turn will lead to devastating impacts for domestic violence victims. Kashen, Glynn, and Novello (2020) point to the need for immediate and long-term action in the area of work-family policies and childcare infrastructure in order to mitigate these impacts.

Increases in domestic violence during the pandemic will also take a tremendous toll on the children living in violent homes and those directly exposed to domestic violence and abuse. As Phelps and Sperry (2020) note, for many children, schools are their only option for mental health services and trauma-informed care and support—not to mention adequate nutrition. It will therefore be important to direct research to examine the impact of the increase in domestic violence during the pandemic on children, given the well-established research on the diverse impacts of family violence on children, and the literature pointing to the intergenerational transmission of violence (Spatz-Widom, 1989). Research has already demonstrated the impact of the COVID-19 pandemic among parents and children with respect to social isolation, loneliness, and depression. Research by Patrick et al. (2020) finds that in the year since the beginning of the pandemic, a quarter of parents reported worsening mental health for themselves and a 14% worsening in the behavioral health of their children. They find that the combined impact of lack of child-care due to school closures, reduced access to healthcare due to closures and delays in visits, and declines in food security led to the most substantial declines in a family's mental and behavioral health. It is clear that these negative economic circumstances and declining mental health among parents and children, combined with the trauma of violence exposure, are likely to have substantial detrimental impacts for children long-term.

Researchers and policy makers will need to identify both the short- and long-term implications of the COVID-19 pandemic on the risk for domestic violence and subsequent consequences. This includes an understanding of the nature of domestic violence and types of victimizations that come to the attention of the police, and how police agencies may better address this changing crime problem, as well as those that do not get reported to law enforcement and how to address those situations. For those victims reporting their victimization experiences to the police, but choosing—or being forced—to remain with their abuser, there will be a need for more intensive law enforcement, social services, and victim advocacy follow-up both during and after the COVID-19 pandemic. Federal governments will need to ensure that financial stimulus packages aimed at reducing the economic impact of the pandemic on families also include targeted resources for women and children leaving violent homes, and at the same time earmark resources for victim service and healthcare providers seeing an increase in their caseloads related to domestic violence during and after the pandemic. Boserup, McKenney, and Elkbuli (2020) note the importance of making screening tools and assessments for domestic violence more readily available in diverse community, clinical, and healthcare settings, particularly via telehealth. This may also include collaboration between COVID-19 testing and vaccination sites and police agencies and domestic violence response organizations to include abuse screenings and safety planning. Finally, there will need to be creative approaches to reaching out to those women and children most at risk and often least likely to come to the attention of official agencies and victim response organizations. This includes the expansion of telehealth and remote victim services, expansion of team-based behavioral response units, and the development of innovative referral systems for any and all agencies and providers responding to calls for help from victims and survivors experiencing abuse in their home.