The recent debate about alcohol-fuelled violence by men has offered a rare opportunity to lift the lid on the scores of hidden victims of alcohol-fuelled assaults in private dwellings whose tragedies rarely reach the public eye, let alone rouse the community and spur political action.
What role does alcohol play in partner violence at home?
This question is complex and contested.
In New South Wales, 82.1 per cent of domestic violence offenders are male, according to the NSW Bureau of Crime Statistics and Research. Male violence against their intimate partners is endemic in all societies - including those where drinking alcohol to excess is not as much a part of the national psyche as it is in Australia.
Not all acts of violence by men - against their partners or others - involve alcohol. Many men drink and drink heavily but do not go on to abuse their partners. Many will drink heavily in public but only hit out when they get home.
However, alcohol misuse is a constant feature in a high proportion of domestic violence incidents recorded by police. In NSW, between 2001-2010, alcohol was present in 41 per cent of police-recorded domestic assaults; in one year alone, this figure was up to two-thirds in the remote Far West region. And not all domestic violence offences are reported to police.
A 2004 national survey found one in three recent domestic violence incidents were alcohol-related.
A study investigating alcohol's harm to others in Australia estimated that alcohol contributes to half of all kinds of partner violence, and 73 per cent of partner physical assaults.
Decades of work has shown a consistent association between heavy or binge drinking and physical violence against a female partner. Despite the lack of consensus about the role alcohol plays in intimate partner violence, evidence shows that it emerges as a consistent risk factor across cultures and results in more severe injuries; aggression is also more severe when one or both partners were drinking. Studies also show women experience a heightened risk of partner violence on days that men have been drinking.
So while we cannot draw a neat causal line between drinking and violence, we know enough to show that alcohol has enough of an influence on behaviour to increase both the risk of experiencing an assault from a violent partner, and how severe that assault will be.
The policy and prevention gap
Despite the issue of violence against women in the home being placed firmly in the public eye by the Women's movement several decades ago, we are still no closer to finding effective interventions. Domestic violence is a complex 'wicked' problem with systemic gender disparity at the core of women's experience of violence. There is no good evidence yet about how to intervene directly to reduce the rates of partner violence, therefore it is timely to look at opportunities that may exist through indirect influences.
Alcohol is one factor amenable to change and while it is neither the cause nor the solution, changing alcohol misuse may have the effect of changing if not the incidence, then at least the severity of assaults against women whose experience of violence is worse when their partner is under the influence of alcohol.
Recently, the World Health Organization identified action on alcohol misuse as one (of several) levers for preventing violence against women: 'The strong association between alcohol and intimate partner violence and sexual violence suggests that primary prevention interventions to reduce the harm caused by alcohol could potentially be effective.'
While both partner violence and alcohol misuse are each significant public health issues in their own right with a high rate of co-occurrence, neither the research nor policy agendas are co-ordinated. There has been a resistance to focus on men's drinking in the context of his perpetration of violence for fear that it will diminish their responsibility for violent behaviour.
Within the alcohol policy field, violence prevention strategies have focussed on drinking in public settings. A persistent challenge for public health interventions is how to influence behaviour that takes place within private settings.
Opportunities for intervention
While the proposals to be implemented by the NSW Government are designed to reduce alcohol-fuelled violence from public drinking, they could provide an opportunity to see how and whether these measure might have an impact on alcohol-related domestic violence.
Specifically we need to investigate how alcohol policy interventions can influence rates of alcohol-related partner violence. Pricing and taxation strategies that increase the cost of alcohol have been shown to be effective at influencing problematic alcohol consumption and harm, yet these are largely untested when it comes to intimate partner violence.
A growing body of research is drawing links between the numbers and density of alcohol outlets and domestic violence, giving strength to the notion that alcohol consumption associated with domestic violence is also affected by its physical availability.
A Melbourne study using liquor licence data and police-recorded domestic violence found positive associations between liquor outlets and domestic violence and a particularly strong link with packaged liquor (takeaway) outlets; an increase in one packaged liquor outlet resulted in a 28.6 per cent increase in the domestic violence rate.
We need to follow these leads and particularly target intervention studies on alcohol-related partner violence in young adulthood - a key risk period for both high risk drinking and partner violence. In the NSW data mentioned above, 50 per cent of perpetrators of partner violence were males aged 18–39 years in 2010.
Surveys of alcohol use consistently show that young males also drink frequently at risky levels. Interventions that target binge drinking in young people may present opportunities to prevent and reduce alcohol-related intimate partner violence in later life.
While not diminishing the important focus on alcohol-fuelled violence in public settings, it is time to shine the research and policy spotlight more widely - not just on what's beneath the lamp-post, but into those hidden dark spots where we know that mostly women and children are suffering tremendous fear and harm due to a male family member's drinking and aggression.
Combining prevention efforts from both the alcohol policy and intimate partner violence prevention fields provides an opportunity to enhance the safety of families enduring alcohol-related violence in the home.
First published on The Drum on 31 January 2014.
Image: Gianni Testore