Delaware’s Domestic Violence Housing Crisis

Monica Beard, D.Phil., Esq. Policy Coordinator, Delaware Coalition Against Domestic Violence

Delaware’s lack of affordable housing has become a public health crisis. There are many influential factors in the causes of local homelessness – the lack of affordable housing units, particularly for extremely low income tenants,1 and many other factors, but one of the leading causes of homelessness in Delaware is domestic violence. It is not sufficient to consider housing without contemplating the complications experienced by those fleeing unsafe homes and abuse. Any solution to the housing crisis must prioritize addressing domestic violence and providing support for the populations most vulnerable to housing insecurity due to domestic violence.

WHY IS DOMESTIC VIOLENCE A HOMELESSNESS ISSUE?

Several national organizations have highlighted that domestic violence is one of the most prevalent causes of homelessness. In the most recent Center for Disease Control report on intimate partner violence, the CDC estimated that 5.5% of women (6.9 million Americans) and 1.4% of men (1.6 million) will need support services due to housing insecurity caused by intimate partner violence.2 Intimate partner violence has been found to be not only one of the leading causes of homelessness, but also of housing insecurity. Women who experience domestic violence are four times as likely to become homeless as those who are not facing an abusive relationship; even when survivors are housed, their abusive partner ensures that their housing situation is never stable.3 In their 2022 Point in Time Survey, which examines the supports provided to domestic violence survivors on one day every year, the National Network for the Elimination of Domestic Violence noted that the majority of the services requests (53%) that domestic violence providers were unable to meet were requests for housing. NNEDV noted the lack of safe and affordable housing options available to many people fleeing domestic violence.4 Ninety-two percent of homeless women report having experienced some form of sexual or domestic abuse during their lifetime and over 50% report domestic violence was the direct cause of their homelessness.5

Homelessness due to domestic violence can take several forms. Sometimes, survivors are so unsafe in their homes with family members that they are forced to leave without a stable housing plan, but it can also include examples where domestic violence has led to broader housing insecurity. Clough, et al. note that in many abusive relationships, there is financial abuse or coercion, where survivors are unable to maintain their own autonomous funds and have their financial independence sabotaged by their abuser.5 Economic abuse can mean that survivors have to deal with low credit ratings or previous evictions, which can make it difficult to find a rental when they seek to find housing without their partner, forcing them to choose between homelessness or returning to the abusive relationship. Stalking and ongoing contact from a former partner can also mean landlords or friends feel uncomfortable providing accommodation to survivors or that safety needs can make certain units inappropriate for a survivor leaving violence. These specific concerns of domestic violence survivors are exacerbated by the same issues faced by all low income Americans in finding safe, affordable, accessible housing to make it incredibly difficult for survivors to move into affordable housing.

Unfortunately, the lack of housing for domestic violence survivors within Delaware is even more extreme than in other states. The recent report from the National Low Income Housing Coalition (2023) highlights that Delaware has less housing stock than the national average, and this burden disproportionately falls on extremely low-income households. In the 2022 Housing and Homelessness study done by Housing Alliance Delaware, they noted that the number of people experiencing homelessness had doubled since 2019, but that this increase in homelessness was not the same among all groups. While homelessness among adults-only households doubled between 2019 and 2022, it tripled amongst families with children. The year 2022 documented the largest percentage of homelessness amongst children in Delaware ever recorded in an annual count. There is also great racial inequality within the homeless figures in Delaware, with Black Delawareans being five times as likely to experience homelessness as white Delawareans.1

Unfortunately, these inequalities mirror the groups which are most likely to experience family violence, economic inequality and poor health outcomes. Black women and children are more likely to experience abuse within the home than their white counterparts. Black women were also more likely to be criminalized for their responses to domestic violence, which can have considerable effects on their ability to access benefits or become economically independent from their abusers. Black women are also more likely to face serious pregnancy complications or maternal mortality, as well as the highest rates of breast cancer mortality, heart disease and HIV. This is amplified by the economic insecurity that Black women often face, with median earnings that lag far behind white men. This financial insecurity can mean that Black women are often unable to easily leave an abusive relationship and relocate into housing they can afford.6

This correlation demonstrates that, unfortunately, Black women and children in Delaware face these incredibly layered public health crises – both the effects of abuse and of insecure housing and homelessness, as well as the other effects of failures of the health systems towards Black women.

The Layered Health Effects Of Domestic Violence And Homelessness

Experiencing domestic violence leads to long term significant health consequences, both mentally and physically. One in three American women and one in seven American men who have experienced intimate partner violence have symptoms of post-traumatic stress disorder (Center for Disease Control, 2022). Domestic violence has the highest risk of repeat victimization of any type of violence crime, which means that many domestic violence survivors have to deal with repeat trauma or the extreme vulnerability of the risk of re-trauma. Domestic violence survivors also require more emergency care than the average population and are six times more likely to become dependent on drug and alcohol and are far more likely to exhibit symptoms of other mental health disorders, including depression and anxiety.7

Domestic violence survivors can have additional struggles in accessing emergency housing. Many traditional homeless shelters are intended to be in locations which can be easily reached through public transport. Traditional shelters may not meet a survivors’ need for additional security or safety; for example, they are not necessarily in undisclosed or secretive locations where abusers would be unable to find them. There can be other restrictions on domestic violence survivors when finding permanent housing, such as a history of criminal convictions, erratic behaviors due to trauma, such as substance abuse or severe mental health crises. The effects of economic abuse or coercion can often mean that survivors do not have the relevant credit score to qualify for long term leases or affordable mortgages after leaving an abusive relationship. Survivors often have very specific needs for trauma-informed housing provisions, which cannot always be met without specific in-depth training on trauma and the effects of domestic violence.8

The effects domestic violence has on long term physical and mental health is very similar to the long term physical and mental effects of homelessness, meaning that domestic violence survivors are often dealing with the complex trauma caused by both family violence and an unsafe and insecure housing situation. Empirical studies have demonstrated that those without housing have significantly worse health outcomes than those who are housed. This includes not only respiratory issues and infectious disease, but reproductive health issues such as sexually transmitted infections. Homeless women disproportionately experience these reproductive health epidemics. The life expectancy for homeless people is 20 years less than people who are housed.9

Even once rehoused, domestic violence survivors and their families will often need continual support, with specific safety and support needs and ongoing mental and other health needs. The after-effects of domestic violence and homelessness does not simply end when removed from the traumatic situations; over 25% of women continue to report ongoing mental health needs after homelessness. While it is essential for domestic violence survivors to receive access to housing, housing in itself is not sufficient to deal with these complicated traumas.10

Housing Solutions For Domestic Violence Survivors

Due to these complicated factors of both the internal health issues and practical and financial concerns of domestic violence survivors, it is essential for Delaware to develop specific policies to house families leaving abusive situations. The model which is often cited is Oregon’s Temporary Assistance for Domestic Violence Survivors program (TA-DVS). The eligibility process is far less strenuous than many assistance programs – it applies to either pregnant or parenting Oregon citizens fleeing domestic violence. It provides direct cash assistance that survivors can use to pay bills – most notably rent payments for housing or security deposits.

TA-DVS waives other requirements which would often be applicable for Temporary Assistance for Needy Families benefits. Undocumented migrant survivors and those who may have earned over the TANF income limits can be eligible for the TA-DVS program, as the program notes that it is essential to ensure that restrictions do not put survivors at risk for domestic violence. A survivor of domestic violence may earn too much income to ordinarily qualify for benefits, yet economic control by their partner means that they are unable to access the income. Strong restrictions on support systems can often mean that some survivors will be unable to access these means of financial independence.

In addition, the TA-DVS program does not put a harsh burden on survivors to demonstrate their abuse – they do not need to file a police report or obtain a protection from abuse order against their abuser in order to access TA-DVS. There are also no employment requirements to access these benefits, nor are survivors asked to seek child support from their abusers or pursue assets from their abusive partner. The TA-DVS gives survivors space to safety plan and make the decisions based on what will keep themselves and their children safe.

In order to support both survivors and employees of the Oregon Department of Human Services, the department has co-located domestic violence advocates in order to provide advice on safety planning, program effectiveness and continual training. Advocates can also provide connections for supporting services, including accessing health services and medical support.

By providing survivors with safe housing and a chance to parent and have health needs addressed without a requirement of employment, Oregon is dealing with the public health effects of homelessness. The presence of domestic violence advocates also allows the TA-DVS to adapt to meet the specific health and safety needs of individual families. The current BidenHarris administration has been urged to federalize this Oregon program in order to support domestic violence survivors across the United States.11

Delaware’s Department of Public Health (DPH) has made some steps toward providing similar supports for specific populations. In 2022, it was announced the DPH would be providing housing assistance and wraparound services for pregnant homeless women.12 Since pregnant homeless women are disproportionately likely to experience homeless violence, it is commendable that DPH is trialing this version of the TADVS. As Delaware continues to commit to creative solutions for ending the public health crisis of homelessness, DPH should continue to fund and expand housing assistance and connected support services.

Dr. Beard may be contacted at nbeard@dcadv.org

References

1. Housing Alliance Delaware. (2022). Housing and homelessness in Delaware: 2022. Housing Alliance Delaware. https://www.housingalliancede.org/_files/ ugd/9b0471_322d16c2158c4ab09743a897dc12aa6d.pdf

2. Leemis, R. W., Friar, N., Khatiwada, S., Chen, M. S., Kresnow, M., Smith, S. G., . . . Basile, K. C. (2022). The national intimate partner and sexual violence survey: 2016/2017 Report on intimate partner violence. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/pdf/nisvs/ nisvsreportonipv_2022.pdf

3. Adams, E. N., Clark, H. M., Galano, M. M., Stein, S. F., Grogan-Kaylor, A., & Graham-Bermann, S. (2021, April). Predictors of housing instability in women who have experienced intimate partner violence. Journal of Interpersonal Violence 36(7-8), 3459–3481. https://doi.org/10.1177/0886260518777001

4 National Network to End Domestic Violence (2023). 17th annual domestic violence counts report. National Network to End Domestic Violence. https://nnedv.org/resources-library/17th-annual-domestic-violencecounts-report/

5 Clough, A., Draughon, J. E. Njie-Carr, V. Rollins, C., & Glass, N. (2014, September). Having housing made everything else possible: Affordable, safe and stable housing for women survivors of violence. Qual Soc Work, 13(5), 671–688 https://doi.org/10.1177/1473325013503003

6. DuMonthier A., Childers, C., & Milli J. (2017, Jun). The status of black women in the United States. Institute for Women’s Policy Research, https://iwpr.org/wp-content/uploads/2020/08/The-Status-of-BlackWomen-6.26.17.pdf

7 Howard, L. M., Trevillion, K. & Agnew-Davies, R. (2010). Domestic violence and mental health. International Review of Psychiatry (Abingdon, England), 22(5), 525–534. https://doi.org/10.3109/09540261.2010.512283 https://doi.org/10.1016/j.avb.2010.07.005

8 Baker C. K., Billhardt, K. A., Rollins, C. W. J., & Glass, N. E. (2010). Domestic violence, housing instability and homelessness. Aggression and Violent Behavior, 15(6), 430–439.

9. Muñoz, M., Crespo, M., & Pérez-Santos, E. (2005). Homelessness effect on men’s and women’s health: A comparison between a representative homeless sample. International Journal of Mental Health 34(2), 47–61 https://doi.org/10.1080/00207411.2005.11043400

10 Vostanis, P., Tischler, V., Cumella, S., & Bellerby, T. (2001, Winter). Mental health problems and social supports among homeless mothers and children victims of domestic and community violence. The International Journal of Social Psychiatry, 47(4), 30–40 https://doi.org/10.1177/002076400104700403 https://www.futureswithoutviolence.org/wp-content/uploads/CashAssistance-Recommendations.pdf

11. Futures Without Violence. (2021, Jan). Economic security for survivors of domestic and sexual violence: Policy recommendations for cash assistance programs. Futures Without Violence.

12 Delaware Department of Health and Human Services. (2022, Mar). COVID-19 funding for vulnerable Delawareans and DHSS health care professionals at 24/7 facilities [Press release]. https://news.delaware.gov/2022/03/15/covid-19-funding-forvulnerable-delawareans-and-dhss-health-care-professionals-at-24-7facilities

From the Delaware Division of Public Health

Diabetes and obesity webinar for employers set for June 6

Delaware employers are invited to a free webinar about diabetes and obesity. The June 6, 2023 webinar runs 9:00 a.m. to 10:30 a.m. Participants will learn how addressing diabetes and obesity can improve workforce health, productivity, and retention and reduce costs. Presenters will share how to access resources to implement evidence-based programs and medical interventions.

According to 2021 data from the Division of Public Health (DPH), of Delaware adults, 12% of Delaware adults have diabetes, 12.6% have prediabetes, and 33.0% report that they are obese

The webinar is sponsored by the Delaware Diabetes Coalition, DPH, Novo Nordisk Inc., and the Greater Philadelphia Business Coalition on Health. Attendees can receive 1.25 Professional Development Credits from the Delaware Society of Human Resource Managers.

To register for the webinar, click here

21st Annual Diabetes Wellness Expo

The 21st Annual Diabetes Wellness Expo will be held on June 20, 2023 from 9:00 a.m. to 3:00 p.m. at Delaware Technical Community College’s Terry Campus, located at 100 Campus Drive in Dover. Admission is free. Attendees will find information about diabetes and prediabetes management, nutrition, and exercise, plus exhibitors, screenings, and giveaways.

The Expo is hosted by the Delaware Diabetes Coalition and the Division of Public Health’s Diabetes and Heart Disease Prevention and Control Program. To register, visit https://www.dediabetescoalition.org/ Registration is free.

DHMIC presents 2023 Kitty Esterly, MD Health Equity Champion Awards

The Delaware Healthy Mother and Infant Consortium (DHMIC) presented the 2023 Kitty Esterly, MD Health Equity Champion Awards during its 17th summit, held on April 18. Dr. Esterly, a pediatrician who specialized in neonatal care, was a visionary who worked to improve health equity.

Black Mothers in Power received the organization award for being a grassroots powerhouse for eradicating racial health disparities for Black birthing people and Black babies throughout Delaware.

Black Mothers in Power burst onto the Delaware scene in 2019 with a community listening series at the Wilmington Library and they have kept up a high level of energy and engagement ever since. With their advocate, Shane' Darby, Black Mothers in Power has consistently connected women and children in need with direct support. Members held diaper drives and other community events, did advocacy work, and worked to improve practices like doula training and reimbursement

Mona Liza Hamlin, MSN, RN, of ChristianaCare received the individual award for her personalized approach in caring for each woman and baby. She has led many initiatives that were the catalysts for statewide change and improvements.

Mona forged a partnership with the University of Delaware to develop the Birth Companion Doula program, which ensures that every mother has doula support throughout her birthing journey. She promoted a diverse lactation staff and manages Christian’s Cribs for Kid's distribution. Mona also organized a breast pump closet at ChristianaCare and designed the Twistle Program, which now has more than 3,000 enrollments and helps increase breastfeeding longevity in one of the largest birthing hospitals in our region.

Help us say thanks!

To nominate an individual or an organization for the annual Kitty Esterly, MD Health Equity Champion awards, visit dethrives.com. Nominations open once a year. Awardees ensure that access to better health is inclusive and within reach of all Delawareans.

Be smart; prepare for hurricanes

Before tropical storms and hurricanes head our way, prepare to protect lives and property from high winds and flooding. Flooding can occur from heavy rainfall and storm surge in both coastal and inland areas. Take these precautions from the Delaware Emergency Management Agency:

• Know your flooding risk. Type in your address at the Federal Emergency Management Agency’s Flood Map Service Center

• Make an emergency plan Shelters should be your last resort. Determine which friends, family, and hotels may be available to you. Individuals with functional, access, or medical needs and their pets and service animals can stay safe.

• Create an emergency kit beginning with one gallon of water per day for each person and a non-perishable three-day supply of food for all household members and pets.

• Know the latest path of hurricanes and tropical storms at the National Oceanic Atmospheric Agency’s National Hurricane Center

• Sign up for Delaware Emergency Alert Services

• Follow instructions from public safety officials to shelter-in-place or evacuate. Plan your evacuation routes using the Delaware Department of Transportation’s (DelDOT) evacuation route maps DART or Paratransit reduce their routes and may stop completely right before, during, and immediately after a disaster.

• Keep gutters clean. Prune shrubs and trees and remove dead trees and limbs.

• Take photographs of your home and contents (inside and outside). Check the coverage on your homeowner’s, rental, and business insurance policies. Consider flood insurance.

• Keep your cell phone charged and have a charged power bank.

For helpful materials, visit PrepareDE.org, www.dema.delaware.gov, or www.ready.gov

Prepare pets for emergencies

Delawareans should know how to properly prepare for a wide range of emergencies that could affect their lives. As pets are family members, make sure they are included in emergency plans.

Delaware Animal Response (DAR) is a program within the Office of Animal Welfare, located within the Delaware Department of Health and Social Services, Division of Public Health. DAR suggests that pet owners have a pet emergency kit containing:

• three days’ worth of food and water

• medical information which includes vaccination records, medicines, and a first aid kit

• collar with ID tags and extra leash

• crate or pet carrier

• a photo of the pet and pet owner together

• the pet’s favorite toys, treats, and bedding

• plastic bags, litter, and cleaning products. Before emergencies happen, plan where pets can stay Find out now if pets can stay with family, friends, or at a hotel during an evacuation. If the State of Delaware opens a community shelter, pet owners can stay there with their pets. Bring the pet emergency kit to the shelter with the pet because the vaccination records in it will be required to register the pet there. If the pet is normally housed outside, bring it inside immediately and out of danger during bad weather or a disaster

For more information about pet preparedness or how to become a DAR Volunteer Team member, send an email to the DAR Coordinator at dar@delaware.gov. To prepare families and pets for emergencies, visit www.dema.delaware.gov, www.fema.gov, or www.ready.gov

Public Health Emergency ends

The State of Delaware’s Public Health Emergency Order ended at the end of the day on May 11, 2023 Governor John Carney made the announcement on April 6 May 11 was also the end date of the federal Public Health Emergency.

On May 10, 2023, My Healthy Community reported that 646,924 Delawareans (66.9% of the state population) were fully vaccinated with a primary series of COVID-19 vaccine. Since March 11, 2020 in Delaware, there have been 333,767 total positive cases and 3,394 deaths.

Kids should not ride on lawn mowers

Aging is a dynamic time to live fully Aging is a dynamic time to enjoy independence and fulfillment. The Delaware Department of Health and Social Services Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) recommends that aging Delawareans:

• Embrace the opportunity to change. Find a new passion, go on an adventure, and push boundaries by not letting age define your limits. Invite creativity and purpose into your life by trying new activities in your community to bring in more growth, joy, and energy.

• Explore the rewards of growing older. With age comes knowledge, which provides insight and confidence to understand and experience the world more deeply. Grow that knowledge through reading, listening, classes, and creative activities.

• Stay engaged in your community. Everyone benefits when everyone is connected and involved. Stay active by volunteering, working, mentoring, and participating in social clubs and community activities such as at your local senior center.

• Form relationships. As an essential ingredient of well-being, relationships can enhance your quality of life by introducing new ideas and unique perspectives. Invest time with people to discover deeper connections with family, friends, and community members.

For more information, visit the official Older Americans Month website, and follow DSAAPD on Facebook and Instagram.

When you were a child, your family member may have given you a ride on a riding lawn mower However, it is a dangerous practice that should be avoided. Children can suffer cuts and traumatic amputations from lawn mower-related incidents. According to pediatric orthopedic surgeon Jennifer Ty of Nemours Children’s Health, lawn mowerrelated pediatric injuries include cuts to the hands and fingers, eye injuries or cuts from rocks and sticks thrown by mowing equipment, and burns. Lifechanging traumatic amputations in children are most commonly caused by lawn mowers

Prevent lawn mower injuries with these safety tips:

• Never have young children in the yard when using lawn mower equipment.

• Never let young children ride on a lawn mower.

• Children should be age 12 and older to operate a walk-behind power mower or hand mower safely.

• Children should be age 16 and older to operate a riding lawn mower safely.

• Children with cognitive or behavior issues, who are immature, or are physically unable to operate lawn mowing equipment safely should not be allowed to mow lawns.

For more safety tips, read Dr. Ty’s blog at https://blog.nemours.org/2017/06/lawn-mower-safety/