Introduction
Located in Cambria County, Pennsylvania, Johnstown previously had the distinction of being an iron, coal and steel producer during the late 1800’s which quickly made it into one of America’s “steel towns”, often equaling or surpassing the production levels of Pittsburg and Cleveland. Unfortunately by the mid 1900’s the production capacity of the town waned as a result of domestic and foreign competition as well as the fact that its distance from the source of the iron ore used in the smelting process was far away from the processing plant which added additional costs to the production process.
Today, steel production is no longer a thriving industry in the city however with the area being located 70 miles east of Pittsburgh and along the “Health Belt” (American Midwest to New England where there has been a massive growth in health related services) of the U.S. the result has made Johnstown a medical and communications center with the University of Pittsburgh at Johnstown and the Pennsylvania Highlands Community College annually attracting thousands of students which helps to support the local economy. The primary location to be used in this study will be downtown Johnstown with the zip code 15901. The total population from the latest U.S. census estimate shows that there are roughly 5,539 people living within this area with 54.9% of them being female and remaining 45.1% being male (U.S. Census Bureau, 2009).
The median age for this part of the city is 45.6 years old with a large percentage of the population 80.8% (4,473) being comprised of individuals 18 years old and over (U.S. Census Bureau, 2009). The remaining population sets show that individuals 65 years old and above comprise 27.3% (1,513) of the population with 5.4% (297) comprising children under five years of age. Population demographics show that 15901 is a predominantly white neighborhood with a population of 4,096 comprising 73.9% of the total population (U.S. Census Bureau, 2009). The second largest demographic is that of African Americans number 1,210 or 21.8% of the population (U.S. Census Bureau, 2009).
The remaining 24.3% of the Johnstown population is comprised of various ethnicities ranging from Asian, Native Americans, and various other races. Based on the data above it can be seen that the population demographic is rather similar to that of most East Coast and Mid-Western towns which usually have a predominant white population with African Americans and other races comprising the remainder of the population in varying degrees (City Data, 2010).
Epidemiological Factors in the Johnstown 15901 Area
Data collected from 2008 shows that the entire Johnstown area comprised of zip codes 15901, 15902, 15904, 15905, 15906, 15907, 15909, 15915 has had the following rates of crime from 2004 to 2008:
(Note: Data average is unusually high due to the significantly smaller population of Johnstown compared to the average U.S. population bases that have 100,000 or more residents within a given area)
(Note: Assaults in this section refer to physical rather than sexual assaults with the statistic on rapes used as the data for sexual assault)
Salutogenic Factor
An examination of the Johnstown area reveals that the area possesses remarkable potential in health care services and possibly retailing due to the presence of various colleges in the local area. The advantage of the Johnstown area lies in the fact that due to the location of area which is in the “Health Belt” of the U.S. jobs in relation to the health services sector for women continue to be in demand. Careers such as nursing, care giving and various other health related services are on the rise which makes the area a good staging point for women interested in careers related to this particular type of industry.
Another point to consider is that based on the demographic information of Johnstown it can be seen that a large percentage of the female population is actually within the ideal age to start college degree with the various colleges and universities roughly two miles away. Based on this data it can be seen that the Johnstown area is an ideal location for various women to start a health services career or a college education due to the convenience of the location and the fact that the area has a higher female to male ratio as compared to other cities.
Pathogenic Viewpoint
Economic scarcity has been shown by many studies as leading to the development of criminal behavior such as domestic violence, rape, murder, robberies and other forms of crime. For domestic violence in particular, situations involving scarce economic resources have led to behavioral changes in individuals heightening cases of anxiety, stress and nervousness which often lead to cases of physical abuse as a method of release for various individuals. An examination of the 15901 area code reveals that 42.6% of the people living there are below the poverty line with 19.8% at income levels 50% below the poverty line (City Data, 2010).
The reason behind this lies behind two distinct factors: the focus of various members of the male population on manufacturing jobs and the disproportionally low level of college degrees among the population despite several colleges being located nearby. As a result of the recent financial crisis various businesses, shops and factories closed down as a result of either low consumer consumption of their products or the fact that various banks within the country became rather stringent on loans resulting in much needed capital drying up.
This lead to workers in the manufacturing, construction and services sector losing their jobs as a result of the economic recession that followed the financial crisis. What this meant for the population of employed workers at Johnstown, Pennsylvania was that their already meager source of income disappeared which resulted in an even harsher financial situation for them. Various studies examining the effects of job loss and economic recessions on national and local communities show that there is a distinct correlation between the health of the local economy and the rate of crime within a particular area (Wen et al.,2003).
These studies showed that as economic situations worsen in a particular area this creates an adverse reaction in the local populace wherein various members of the community increasingly turn to crime as a way in which to survive in this new situation they find themselves in (Wen et al., 2003). These studies are based off the cyclical cycle of economic recessions and growth wherein during periods of economic growth the crime rate in certain areas tends to go down, on the other hand in periods of economic recession where people tend to lose their jobs and become desperate the rate of crime goes up (Wen et al., 2003). This particular situation can be seen in Johnstown wherein due to the effects of the financial crisis various individuals within the community have lost their jobs which creates the potential for crime to be that much greater (Orsagh & Witte, 1981).
Another factor to consider is that while Johnstown may be located within the so called “Medical Belt” of the U.S. where there is a distinct growth in healthcare services most of these jobs are primarily isolated to individuals who have college degrees in the specific medical field required. In the case of the residents at 15901 many of them barely finished one year of college resulting in most of the population being unable to gain entry into more advanced careers beyond that of manufacturing, retail and construction.
One interesting study involving crime and demography by South and Messner show that in most cases involving the development of criminal behavior in people a majority of the respondents indicated that their criminal behavior started at around the age of 16 to 20(South and Messner, 2000). Several other studies examining criminal demography also back up these claims, they also happen to indicate that while criminal behavior for the majority starts at that particular age it also happens to taper off at around the age of 28 to 30. An examination of the demography of the population of Johnstown shows that a majority of the population is between the ages of 18 to 25, which is within the indicated age of the start of criminal behavior as stated by South and Messner.
Rating on determinants of health
It must be noted that one of primary reasons behind criminal behavior is a lack of available opportunities within the local area. As a result many people turn towards becoming criminals because it is in their belief that this is the only method for them to survive. As such based on the age demographic situation in the Johnstown area combined with the economic difficulties various residents face it can be stated that the area can be labeled as a potentially high risk location for the start and development of criminal behavior.
Analysis
Low Income Threshold Leads to the Possibility of Violent Crime
Current studies investigating the reasons and origins of violent crime state that areas with low income thresholds actually are more prone to cases of violent crime, robberies and property theft as compared to higher income neighborhoods. The reason behind this is simple, as incomes continue to decrease people become increasingly desperate leading to a situation that encourages the propensity for crime (Orsagh & Witte, 1981).
An examination of the data from the Johnstown area, specifically from the 15901 area code reveals that 42.6% of the residents live below the poverty line in this particular neighborhood with 19.8% of that particular population achieving incomes 50% below the poverty line. In conjunction with data statistics of the crime rate in the Johnstown area shows that as of 2008 there were 42 instances of robberies, 212 burglaries, 501 thefts and 43 cases of auto thefts.
While such numbers are largely insignificant compared to a major metropolitan city such as Chicago, L.A., Austin or Las Vegas where there are millions of residents it must be noted that the population of Johnstown, PA is composed of 5,539 individuals. The current U.S. crime index average is set at 319.2, a comparison to the crime index of Johnstown shows the following crime index averages from 2004 to 2008:
While the data reveals a continuous drop in the overall crime rate in Johnstown over the past four years what it does show is that the crime index attributed to the city only just recently fell below the average crime index of 319.2 with its highest point reaching 406.8. Not only that, the U.S. crime index average is set for populations exceeding 100,000; in the case of zip code 15901 in Johnstown the population barely exceeds 5,000 with the total Johnstown population just slight going beyond 20,000 as such this shows that the crime rate in Johnstown is far higher than the national norm.
As mentioned earlier, there is a distinct connection between income rate and the propensity for crime, an analysis of statistical data on the city reveals that its current labor force (16 years old and older) is set at 1,807 people or 39.1% of the current population yet most of these jobs are primarily isolated in the manufacturing or services sector. Statistics showing the most popular industries for men within Johnstown reveal that the manufacturing industry takes up 17% of the labor force, 12% goes to the retail industry, 11% for construction, 11% for health care and social assistance, 7% in the transportation and warehouse industry, and 6% in the food services sector (City data, 2010).
For women on the other hand the most popular industries are composed of health care and social assistance sector which takes up 33% of the female population, 12% are in retail, 10% are in the hotel and food services industry, 7% are in public administration, another 7% are in waste management services, 5% are in the education services sector and 5% are in the finance and insurance industry (City data, 2010). What this set of statistics reveals is that male jobs are isolated towards sectors that are considered vulnerable to economic upheavals and changes such as the recent financial crisis which devastated the markets in the U.S. For example, jobs related to retail, manufacturing and construction are all dependent on consumer demand which drastically fell at the start of the 2008 global financial crisis.
News of layoffs, closures and bankruptcy were practically a daily state of affairs with crime statistics showing a sudden increase in the amount of crimes in the years during and after the financial crisis. As such, this distinct concentration of the male half of the population on a particular set of volatile industries creates the potential for a sustained rate of crime within Johnstown due to the fact that various studies show that males are more likely to turn to crime as compared to females especially in areas with low income thresholds (Crouch et al., 2000).
Domestic Violence
One of the primary reasons behind issues related to domestic violence cases comes in the form of job loss for men. In the case of Johnstown, several cases of domestic violence can actually be related to the prevalence of the healthcare industry in the city itself wherein 33% of the women within the city are employed by that particular industry. As a result of the recent financial crisis various men lost their manufacturing and retail jobs due to a distinct lack of consumer buying behavior.
On the other hand various women within the city itself were able to retain most of their healthcare jobs due to the need for well trained healthcare professionals. While most individuals may think that this particular state of affairs is perfectly fine since at least one spouse has a job the fact remains that it is in situations such as this that the prevalence of domestic violence cases increases. Studies investigating issues directly related to domestic violence show that men often create a sense of identity around the role of the “provider”, it becomes an indelible part of their psychological profile and an actual part of how they perceive their identities to be (Allen & Wozniak, 2011).
In cases where the husband in the family loses his job yet the woman retains hers the result has been described as a “loss of identity” wherein an integral part of their character profile no longer exists (Allen & Wozniak, 2011). While there are various mechanisms behind this behavior and their inherent result the most common are sudden bouts of depression brought on by the shame of being jobless and the fact that the wife is now the primary provider of the family (Allen & Wozniak, 2011).
Without intervention this behavior continues to escalate till it reaches a point where the depression becomes resentment and this in turn causes cases of domestic violence wherein the husband lashes out as a result of a combination of pride, anger and resentment (Simmons et al., 2008). Such cases have actually become quite common in various states throughout the U.S and continue to grow as a result of the global economic recession which has yet to fully abate (Simmons et al., 2008).
Another factor to consider is the fact that income, as mentioned earlier, plays a vital role in interactions within various households (Simmons et al., 2008). Even in cases where the husband is the primary breadwinner and his wife does not have a job there are still instances of domestic violence due to the lack of income acting as a trigger to the violence. It must be noted that not all cases of domestic violence are isolated to being caused by men, nearly 40% of all domestic violence cases actually have the man as the victim with the woman lashing out with physical force often seriously injuring their spouse in the process (Domestic Violence and the State, 2007).
Various studies investigating the relation of income to case of domestic violence within households reveals that one of the primary stresses placed on most families are cost of living expenses such as utilities, food, clothing etc., and how the family is to pay for them (Domestic Violence and the State, 2007). What is indicated in such cases is that the direct amount of domestic violence to be expected from a certain household is in direct relation to the stability of finances (Domestic Violence and the State, 2007).
While there are various other reasons behind cases of domestic violence and battery the situation at Johnstown clearly shows a higher propensity towards this type of behavior when taking into account the low income level of various individuals and households within the area and the fact that the economic recession has yet to truly abate. Another factor that must be taken into consideration is the fact that domestic violence is not isolated to adults but extends to children as well with various cases showing a distinct amount of physical violence direct against children by their parents (Crouch et al., 2000).
The inherent problem with domestic abuse cases is at times they do not stop merely at physical abuse but actually go so far as to actually cause the death of the victim (Davis, 2010). In 2008 alone nearly 125 people died within Pennsylvania as a result of domestic violence with nearly 2,300 victims served in a single day on September by the Pennsylvania Coalition Against Domestic Violence (Davis, 2010). Based on this data it can be seen that the problem of domestic violence is a growing public health problem that needs to be resolved or reduced in order to protect society from its prevalence.
Prevalence of Sexual Assault
An examination of the data reveals that Johnstown has actually had a declining rate of sexual assault within the past couple of years with the number of rapes going down from a total of seven in 2005 to just three in 2008. An examination of the national statistical average also indicates that Johnstown actually has a declining rate of sexual assault as compared to the national average. An examination of various studies fails to reveal any actual connection between economic recessions and sexual assault rather what they do reveal is that demographics within a specific area actually play a key role in creating problems in association to sexual assault (Hetling & Zhang, 2010).
Demographically speaking Johnstown is a predominantly white community however a in terms of population size the town is a rather unique case in that it has a larger female to male ratio in the population with a large percentage of the population being within the age range of 18 to 28 (Services Provided, 2007). This is important to take note of since various studies indicate that the prevalence for cases related to sexual assault actually occur in ages ranged from 18 to 28.
Another factor to consider is the fact that Johnstown is located near several college and University campuses and as such the propensity for cases of rape and sexual assault do go up as a result of various negative behaviors associated with college living. It must be noted that studies examining the occurrence of various forms of sexual assault in colleges reveal that on average a college campus within the U.S. will have a few cases of sexual assault (Services Provided, 2007).
This can come in the form of forced intercourse between students in a relationship, students raped as a result of uncontrolled alcohol binging, cases of violent physical altercations between various members of the opposite sex and other such similar behavior that this study will not go into detail about. Suffice it to say most incidents go unreported but for the few that do they are usually included into the crime statistic for that particular town resulting in the town being attributed for the negative behavior of various students.
The Problem – Domestic Violence
Studies show that the population demographic in Johnstown, PA is conducive towards the development of cases of domestic violence which is a growing public health problem that needs to be resolved or reduced in order to protect society from its prevalence
Planning, Implementation and Evaluation
Schneider states in her book “Introduction to Public Health”, that in order to design an intervention program to a particular problem it is necessary to think of it as the result of a chain of causation with a particular, agent, cause or environmental reaction bringing about the incident in the first place (Schneider, 2010). She states that preventing the problem takes the form of interrupting the chain of progression in such a way that the causation is prevented at each step of the process. In the case of domestic violence, this takes the form of preventing the causes behind it and rendering it inert.
One of the methods employed by other states and even in the state of Pennsylvania have been the creation of various advocacy groups that aim to assist people experiencing cases of domestic abuse such as the Pennsylvania Coalition against Domestic Violence (Postmus & Hahn, 2007). What these groups do is help victims of domestic violence escape their spouses or families and give them a form of half way house in order to help them stay away from their family member or spouse (Postmus & Hahn, 2007).
They also provide various forms of psychiatric services which are in place to help mitigate the emotional damage done by a case of domestic abuse. What this does for women is that it gives them the ability to “breath” so to speak, to understand that they are being abused and to give them the necessary mental strength to do what needs to be done (Postmus & Hahn, 2007). The aim of such coalitions is to help enhance the safety for various families and communities by helping to enact sufficient laws and systems of social change in order to prevent the occurrence of domestic violence (Postmus & Hahn, 2007). Such methods have actually resulted in enabling thousands of victims throughout the years deal with problems in relation to battery from domestic violence cases. Unfortunately the inherent problem advocacy solutions such as this face is that unlike other cases of violent crimes a majority of domestic abuse cases often go unreported for years or even for a lifetime (Defina & Wetherbee, 1997).
This is due to the fact that most women in such cases often think of what might happen to them financially should their husband all of a sudden wind up in jail. Other cases involving domestic violence where it is the wife that is working often show that the wife is often unwilling or will not report cases in relation to battery due to a sense of obligation to their spouse (Defina & Wetherbee, 1997). The problem with these unreported cases is that they have the propensity to increase over time resulting in possibly serious injury or even death in some cases (Suresh & Vito, 2009). In 2009 nearly 126 cases of deaths associated with domestic assault were recorded with many of them happening to women.
Based on this it can be stated that another solution needs to be undertaken where women are encouraged to report cases of domestic violence in order to prevent them from getting worse in the future. Another method employed in various populations has been the use of various information and marketing campaigns through television programs and the internet which specifically target women as victims of sexual assault. Such programs aim to encourage various women to come forward and report such cases in order to prevent their spouses from causing more problems in relation to domestic violence in the future.
While such programs have been largely successful in encouraging reports of domestic violence various studies investigating the causes behind the reluctance of some women to report that they are being abused is in direct relation to the apparent social shame involved in being someone that is being abused (Hetling & Zhang, 2010).
The apparent reluctance stemming from social shame is due to the fact that the women in such cases feel that being physically abused by their husbands constitutes a certain degree of shame that they do not want to reveal to the general public. Apparently being a victim in this case, in their words, makes a person seem weak willed and pathetic as such they would be willing to let the abuse continue rather than have outsiders know about what is going on. Based on this it can be seen that drastic improvements need to be put into place in order to find a better way to prevent cases of domestic assault that encourage women to report what is happening to them rather than let it go on.
Resolving the Problem
Anonymous Online Reporting – Social Marketing
One of the problems mentioned earlier was that women were at times too ashamed to report that they were being abused as such one method to resolve this would be to create a method wherein they can anonymously report incidences of domestic violence. On method used to prevent incidences of rape and crime was the creation of the Ushahidi online application tool that enabled communities to track where incidences of crime were occurring based on anonymous user input onto the site that helped to track where cases of rape were occurring regularly (Greenwald, 2010).
This method can be utilized by the community at Johnstown to determine which areas in their community are more prone to cases of domestic violence and focus their social advocacy campaigns in those specific areas. It can be assumed that through constant lecturing over the problems associated with domestic violence women in those particular areas would be encouraged to report cases where they were abused by their spouse or the spouses themselves would gain a sense of shame over their actions. The advantage of this method is that it is anonymous, easily accessed by anyone and can be implemented free of charge. As such this would make its implementation rather easy to be accomplished and viable as a method of resolving issues related to domestic violence (Talbot, 2008).
Level of Prevention: Tertiary
In this particular case the level of prevention deals with putting into place methods of prevention after the incident has occurred. What must be taken into consideration is the fact that the proposed online prevention system utilizes anonymous reports after an incident has occurred. As such, its goal is to prevent future occurrences from happening in the same area through community stewardship in creating various programs aimed at targeting specific populations that are determined to be at risk for domestic abuse cases.
Community Related Advocacy Programs – Community Organizing
The inherent problem with state wide anti domestic violence advocacy programs is that they do not offer support on the community level (Lepistö et al., 2011). The strength of community level support must not be underestimated since it provides an immediate and easily accessible means of strength and support in cases of domestic violence (Lepistö et al., 2011). The creation of various community level groups designed to act as a support system for individuals suffering from cases of domestic violence not only enabled them to immediately confront the problem on a personal level but it allows action on a community level in order to prevent the offending spouse from doing it again in the future.
Similar programs in the Philippines and Africa show that cases of domestic violence were significantly lessened when the perpetrators were informed of community level action should they attempt the action again in the future. As such this presents itself as a viable and effective means of ensuring the prevention of issues related to domestic violence in the community level due to concerted action (Services Provided, 2007).
Level of Prevention: Secondary
The goal of this particular strategy is education and prevention in cases where it is possible that domestic abuse may occur. It has already been established by this paper that areas with the potential for domestic abuse can actually be predetermined based on the factors related to income and economic status. Based on this, community related advocacy programs initiated in “at-risk” areas would go a long way towards providing some level of prevention. On the other hand should domestic abuse cases already be present within a given area it can be assumed that these particular programs should be able to mitigate some of the effects of domestic abuse by acting as support programs.
Financial Assistance to Women suffering from Domestic Violence
Earlier it was mentioned that one of the problems women receiving physical abuse due to domestic violence encounter is the possibility of losing their source of income should their spouse be taken to jail. Based on various studies involving abused women in domestic violence cases they always state that their greatest fear is to be without a source of income and as a result usually stay quiet in cases of domestic abuse. This is due to the fact that many women in domestic abuse cases are usually homemakers without jobs themselves and have come to adopt the attitude of relying on their husband as a source of income for the family (LeCouteur & Oxlad, 2011).
This reliance is at the root of the reluctance in reporting cases of domestic abuse and as such should it be resolved the number of cases reported to the local polices would invariably rise (LeCouteur & Oxlad, 2011).
On method of doing so would be to create a specific piece of legislation that allows women who are victims of domestic abuse cases to receive a government stipend that would allow them to live in a modicum of comfort till such a time that they will be able to support themselves by getting a job (Services Provided, 2007). This particular solution would get rid of the reluctance women would feel about reporting their husbands to the police since they would not be left without a means to support themselves should their husband be sent to jail. While research into this particular method domestic violence prevention has yielded little results it can be expected that since it gets rid of the factor that creates the reluctance to report there is a distinct possibility of success in this particular method of domestic violence reduction.
Level of Prevention: Tertiary
In this particular case the goal of prevention is to establish a sense of security for the spouse that is currently being affected by a domestic abuse case. As it was mentioned earlier one the primary reasons behind why most women do not report cases of domestic abuse is in direct relation to their assumption that they will have no financial means to support themselves. As such in this case the level of prevention is at the tertiary level since it provides a means of support after the incident has occurred in order to encourage women to report cases of domestic abuse.
Preventive Measures in Relation to Economic Problems
Based on findings of this paper it can be seen that one of the main causes behind domestic violence are issues relating to income. It has already been shown that in areas with lower income rate the propensity for cases of domestic violence grows as a result of spouses arguing over adequate funds needed to maintain at least the very minimum of living standards. Studies examining this particular issue reveal that income levels are directly proportionate to the rate of domestic abuse cases wherein lower income families have higher chances of cases related to domestic abuse (Trevillion et al., 2011). In cases similar to that of Johnstown it can be seen that in instances where income levels suddenly drop as a result of job loss cases related to domestic violence actually increase (Trevillion et al., 2011).
As such what is needed in cases such as these is to enact measures to prevent domestic abuse from starting in the first place. Community related support groups for husbands without jobs would go a long way towards preventing cases of abuse within various households. Various studies investigating the psychological reasons behind domestic abuse show that most men turn to domestic abuse as an outlet for their own personal frustrations that they keep bottled inside (Trevillion et al., 2011). Community led support groups that help to psychologically ease individuals who have recently been affected by job loss would act as an outlet for their pent up frustration leading to better domestic relationships at home.
Level of Prevention: Primary
The goal of this particular strategy is prevention, as it was mentioned earlier job loss and low income statuses have a tendencies to encourage the development of domestic abuse cases especially in men. As such in order to prevent them from occurring the use of various community led support groups targeting recently unemployed men should act as an appropriate enough mitigating factor in order to prevent the behaviors associated with domestic abuse from cropping up.
Measuring Outcomes
In order to determine the outcomes of the strategies described what must first be done is to examine the data within a two to three year period from the local police department. The reason a two to three time period has been implemented is due to the fact that a certain amount of time must be given in order for the suggested strategies to go into effect. In this case it has been determined that two to three years should be a sufficient enough time.
A request for police records in the number of domestic violence cases within a period of three years from the time of implementation all the way to period examination should reveal whether the proposes strategies were a success. Another factor that can be used to determine the effectiveness of the strategies is to see how many of the programs are still in effect after the three year time period as well. Programs that are still in effect instead of being relegated to obscurity indicate that they are actually being used. While this neither confirms nor denies that the strategies were actually effective the fact that they continue to be used shows that at least some people are being helped by the proposed strategies.
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