Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, United States of America.
Program on Global Health Justice and Governance, Columbia University Mailman School of Public Health, New York, New York, United States of America.
PLoS One. 2022 Feb 16;17(2):e0263970. doi: 10.1371/journal.pone.0263970. eCollection 2022.
Gender-based violence (GBV) policies and services in the United States (U.S.) have historically been underfunded and siloed from other health services. Soon after the onset of the COVID-19 pandemic, reports emerged noting increases in GBV and disruption of health services but few studies have empirically investigated these impacts. This study examines how the existing GBV funding and policy landscape, COVID-19, and resulting state policies in the first six months of the pandemic affect GBV health service provision in the U.S.
This is a mixed method study consisting of 1) an analysis of state-by-state emergency response policies review; 2) a quantitative analysis of a survey of U.S.-based GBV service providers (N = 77); and 3) a qualitative analysis of in-depth interviews with U.S.-based GBV service providers (N = 11). Respondents spanned a range of organization types, populations served, and states.
Twenty-one states enacted protections for GBV survivors and five states included explicit exemptions from non-essential business closures for GBV service providers. Through the surveys and interviews, GBV service providers note three major themes on COVID-19's impact on GBV services: reductions in GBV service provision and quality and increased workload, shifts in service utilization, and funding impacts. Findings also indicate GBV inequities were exacerbated for historically underserved groups.
The noted disruptions on GBV services from the COVID-19 pandemic overlaid long-term policy and funding limitations that left service providers unprepared for the challenges posed by the pandemic. Future policies, in emergency and non-emergency contexts, should recognize GBV as essential care and ensure comprehensive services for clients, particularly members of historically underserved groups.
美国（U.S.）的基于性别的暴力（GBV）政策和服务历来资金不足且与其他卫生服务相隔离。在 COVID-19 大流行开始后不久，有报道指出 GBV 有所增加且卫生服务受到干扰，但很少有研究对这些影响进行实证研究。本研究考察了现有的 GBV 资金和政策情况、COVID-19 以及大流行前六个月的相关州政策如何影响美国的 GBV 卫生服务提供。
这是一项混合方法研究，包括 1）对各州紧急情况应对政策的审查分析；2）对美国基于 GBV 服务提供者的调查进行定量分析（N = 77）；3）对美国基于 GBV 服务提供者的深入访谈进行定性分析（N = 11）。受访者涵盖了各种组织类型、服务人群和州。
21 个州为 GBV 幸存者制定了保护措施，5 个州明确豁免了非必要业务关闭对 GBV 服务提供者的限制。通过调查和访谈，GBV 服务提供者提到了 COVID-19 对 GBV 服务的影响的三个主要主题：GBV 服务的提供和质量下降以及工作量增加、服务利用的转变以及资金影响。研究结果还表明，历史上服务不足的群体的 GBV 不平等现象加剧。
COVID-19 大流行对 GBV 服务造成的破坏，叠加了长期存在的政策和资金限制，使服务提供者对大流行带来的挑战毫无准备。未来的政策，无论是在紧急情况还是非紧急情况下，都应将 GBV 视为基本护理，并确保为客户，特别是历史上服务不足群体的成员，提供全面的服务。
