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When the state of Pennsylvania locked down for the coronavirus in March, K found herself stranded with an abusive husband and four children. She knew she couldn’t stay.

The 30-year-old mother gathered her kids, got them in a car, and drove away from her rental home. Luckily, she didn’t have far to go, because her windshield was broken.

K (who asked us not to use her name) found help at the Crisis Shelter of Lawrence County, Pennsylvania. Located in New Castle, a city of 22,000 about 50 miles north of Pittsburgh, the Crisis Shelter is the only domestic violence shelter serving Lawrence County.

K’s situation is not unique, advocates say. As lockdown orders spread across the country this spring and summer, authorities worried what would happen to victims of domestic violence. 

Trapped alone with their abusers, women faced the prospect of higher tension, lower income, and increased substance use – triggers for domestic violence.At the same time, it was harder for women to reach out for help because of barriers like lack of transportation and independent income. 

At the Crisis Shelter of Lawrence County K and her children  found refuge. They stayed in one room together until being moved into a transitional apartment. 

“It was hard on the baby sleeping all night due to the noise of us all in the same room,” K said. 

Preliminary research from radiologists and anecdotal information from those who work with domestic violence victims show that across the board, incidents of domestic violence in rural America are up. 

At the Crisis Shelter of Lawrence County, the first months of lockdown saw a big drop in requests for services, followed by a surge in victims seeking help, said Nicole Amabile, chief operations officer at the shelter.

“Once we started getting into May and June, we definitely saw a huge upswing in people who were reaching out via our hotline,” Amabile said. “Our emergency shelter is always full. But in May and June we saw a huge uptick in the number of people who were looking at emergency shelter housing options as a way to get out of their homes where domestic violence was occurring.” 

Most of the individuals coming to the shelter come from New Castle. Those in more rural areas of the Lawrence County, Amabile said, tended not to come in even before the pandemic. 

“We do not see a lot of individuals in our county who live in the most rural parts of the county seeking services.” She theorized that more conservative cultural and religious norms there may reduce women’s willingness to seek help.

But that doesn’t mean the need isn’t there. 

Researchers at the Southwest Rural Health Education Research Center found that the prevalence of domestic violence-related emergency department visits among women in rural settings was higher than in non-rural settings in all regions of the country except the Midwest. 

The study looked at women between 15 and 64 who visited an emergency room between 2009 and 2014, and found that 15.5 rural women out of every 100,000 were in the hospital because of a domestic violence incident compared to 11.9 out of every 100,000. 

Research at the Southwest Rural Health Education Research Center found that emergency visits related to domestic violence were higher in rural settings between 2009 and 2014. (Source: Southwest Rural Health Research Center)

In the summer of 2020, researchers found a significant year-over-year jump in intimate partner violence cases during the first few weeks of the pandemic. The study, published in the journal “Radiology,” found that twice as many patients were coming to emergency departments with domestic violence injuries. 

“This data confirms what we suspected,” said study co-author Mardi Chadwick Balcom. “Being confined to home for a period of time would increase the possibility for violence between intimate partners.”

Looking at radiology scans at Brigham and Women’s Hospital in Boston, the researchers found that of the 62 patients who received x-rays between the weeks of March 11 and May 3, 26 of them had injuries consistent with intimate partner violence (IPV), or nearly 42%.

In 2019, during the same period, 104 patients got x-rays and only 20 of them had injuries consistent with IPV, the researchers found, or 19%. In 2018, only 7 of the 106 x-ray patients had IPV injuries (6%) and in 2017, only 15 of the 146 x-ray patients had IPV injuries (10.2%). 

One thing that may be keeping rural women away from shelters, Abamile said, is transportation. 

“When you think about rural poverty and how that overlaps with domestic violence in the rural communities, we have a lot of individuals who simply lack the resources, transportation being a huge one, to be able to get out of their homes and to seek domestic violence assistance.” 

Nora Montalvo-Liendo, RN, Ph.D., an Assistant Professor in the College of Nursing at Texas A & M who researches domestic violence and works with victims, said where she is in Brownsville, Texas near the border of Mexico, saw a huge increase in calls seeking services.

From March to April, there were 279 calls to the shelter. From April to May, she said, it increased to 291. But in June, calls went up to 416. 

And during this time, she said, the shelter had to reduce its capacity to 35% because of social distancing requirements. 

“So that made it complex for not only the shelter but of course for the families that were trying to find a safe place away from an abuser,” Montalvo-Liendo said. 

Other issues brought by Covid-19 and social distancing exacerbated existing barriers, she said. 

“With Covid, it just makes it more complex,” she said. “There was one lady (who) had already been at the shelter and had already exited the shelter (into transitional housing). And the perpetrator found her… She tried to call the police. But the police said they weren’t coming because of the social distancing. They just said, ‘Well, we can take the report over the phone,’ and the guy was literally there, beating her and her son up.”

Although the abuser did eventually leave, and the police did eventually come to, there was no room at the shelter for her to go back to. That meant the shelter had to find space for her somewhere else so her abuser couldn’t come back, she said. 

Another issue facing domestic violence victims in rural areas, she said, was access to a phone. 

“They couldn’t go to work, so their only lifeline is the phone. And when they can’t work and pay for their phone, their phones were disconnected,” she said. “Many times, you know, whether they’re living with the abuser or they’re post-abuse, they have to have that phone to call someone for help.” 

Montalvo-Liendo said the more long-term problem she sees is the impact this will have on children. 

“The sad thing is the children that are exposed, that’s the topic that it’s so important to talk about because yes, the victim, of course, is hurt during the abuse, but so are the children,” she said.

“Before Covid, the children were at school and if the mother was being abused…many times the children maybe didn’t see all of what was going on. They saw it before school or after school. Right now, it’s an ongoing thing. So, you can only imagine what this is like.”

The real numbers, she said, probably wouldn’t be known for at least a year. 

Even then, she said, a lack of mental health care providers and budget cuts at the state and local levels because of Covid-19 could mean a lack of access for those in rural areas to the services they need to heal.