For Some Breast Cancer Survivors, October Is the Cruelest Month

This special report was underwritten in part with a grant from the University of Southern California's Annenberg Center for Health Journalism and its 2021 Domestic Violence Impact Reporting Fund

CINCINNATI – From its start, the coronavirus pandemic worsened^[1] the public health crisis of domestic violence.

Beyond the immediate suffering, though, domestic violence and its generational legacy of trauma has a deep root in families and in the community, shows an analysis by the Cincinnati Enquirer, part of the USA TODAY Network.

In April 2020, 161 men and women in Ohio's Hamilton County were charged with misdemeanor domestic violence against 165 others. The Enquirer found that of those 326 people, nearly a quarter of the offenders and of the survivors knew in childhood or their teen years a relative, often a parent, who had been arrested for domestic violence.

Of the 161 offenders in the Enquirer analysis, 71 had previous arrests. Yet 86% of the cases were dismissed because the survivor did not appear in court to testify against the offender. Twenty-one were arrested on new domestic violence charges after April 2020.

From Gabby Petito to Tyga to 'MAID': Domestic violence seems to be everywhere. Now what?^[2]

Hamilton County Municipal Court Judge Heather Russell presides over a variety of cases, including domestic violence, aggravated menacing and telephone harassment, on Aug. 23, 2021. Liz Dufour/The Enquirer

Overwhelmed criminal justice

Judge Heather Russell of the Hamilton County Municipal Court said she was not surprised by the dismissal rate.

She's been on the bench for 20 years, and for nearly 20 before that, she was the county's domestic violence prosecutor. Russell has seen the power of the cycle. For a survivor, fear of the offender can surpass the fear of a subpoena. 

When a case before her does end in a conviction, “I really try to and break through, to explain all this. ‘Do you want your son to learn this tradition from you? Is this what you want for yourself?’

"I really feel sometimes that it’s the first time someone ever asked them that," Russell said.

Adverse childhood experiences? Seeing domestic violence is one of them^[3]

April 2020 wasn't a breakthrough month for domestic violence in the county. The 161 cases were on par with the monthly average from April 2019 until April 2021. But between March and September of this year, four months saw more case counts than April 2020 and domestic violence arrests touched a two-year high in July at 205

Still, the number of court cases underestimates the incidence. The U.S. Justice Department estimates that only about 56% of domestic violence is reported to the police^[4].

Sometimes, domestic violence jumps over the misdemeanor to murder. In April 2020, six women were murdered^[5] in Cincinnati, more than all of 2019. Eighteen months later, on Oct. 5, the nonprofit Ohio Domestic Violence Network reported that homicides jumped 62% ^[6]during the pandemic.

Officials at advocacy agencies say record numbers of survivors have sought help^[7] during the pandemic, busting the budget of the shelter-providing YWCA of Greater Cincinnati and straining other resources. 

The marker where Patricia Woods, 24, is buried in Cincinnati as it looked on Sept. 30, 2021. Woods was killed on April 17, 2020 in what police believe was a domestic violence situation. Her boyfriend, Marcus Reed, is charged with aggravated murder. Woods' two children, Kayden, then 5, and Kay-Lia, then 14 months, were at the house at the time. Kayden fled to neighbors to get help. Liz Dufour/The Enquirer

Kristin Shrimplin

If COVID-19 taught us anything, it is that we have to address gender-based violence.

Advocates say an already overwhelmed criminal justice system and an underfunded social safety net alone cannot bring down the pandemic spike in cases, much less the overall social problem. They say what's needed are solutions that are smart about the health effects of the trauma.

One small step on that road is a partnership between Cincinnati police and the advocacy group Women Helping Women that dispatches an advocate to the scene of a domestic violence call to assist the survivor. 

“If COVID-19 taught us anything, it is that we have to address gender-based violence,"  said Kristin Shrimplin, president and CEO of Women Helping Women. Without a more widespread awareness of the impact of trauma caused by domestic violence, the abuse rises, arrests go up, and the community deals with the consequences, she said. "That is heartbreaking for all of us."

Generations of trauma

The generational legacy of domestic violence in The Enquirer's findings echoes an August 2020 report by the nonprofit Health Policy Institute of Ohio. In that survey, more than a quarter of Ohioans ^[8]said they had been exposed to domestic violence as children.

The institute has been concentrating research on events, such as domestic violence, that the U.S. Centers for Disease Control and Prevention, among others, call adverse childhood experiences. Scientists are learning how psychological trauma in childhood shapes an adult's behavior and health^[9], in body and mind. 

Repeated trauma from adverse childhood experiences can induce toxic stress, overriding a child's ability to regulate reactions to other people and environments. That stress can travel into adulthood.

“What happens in childhood does not stay in childhood,” said Dr. Andrew Garner, a Cleveland pediatrician ^[10]and early development expert. “We will not be able to ‘punish’ our way out of these intergenerational cycles. We need restorative practices to help parents and caregivers in order to help their kids … and the next generation of parents and caregivers.”

Tracey Jones visits her daughter's grave in Cincinnati on Sept. 26, 2021. Patricia Woods, 24, was killed April 17, 2020 in what police believe was a domestic violence situation. Liz Dufour/The Enquirer

Childhood trauma is pervasive in Ohio. More than 61% of residents reported that they had endured abuse or neglect or divorce as children, the Health Policy Institute found. 

The more adverse experiences a child has, the greater the risk that the traumatized adult makes poor health choices as a way to soothe trauma. For example, the institute found nearly one-third of Ohio smokers^[11] had at least two adverse childhood experiences. Then consider that lung cancer is the No. 1 cancer killer in Ohio and Kentucky.

Today, scientists see the effects of trauma on the brain and the body’s building blocks. One 2018 review of studies^[12] found indications that trauma can change the expression of a gene that plays a role in mental health. Another study on women who were pregnant when exposed to the Sept. 11, 2001, terror attacks^[13] suggests the children inherited lower levels of the stress hormone cortisol.

A 2018 study at Cincinnati Children's Hospital Medical Center says a parent's adverse childhood experience can delay development in a child before age 2.^[14]

"Does that mean that all kids who witness intimate partner violence will be perpetrators and/ or victims themselves? Certainly not," said Garner. "But having that experience may make it more likely that they themselves will have issues with emotional regulation and result in any of a number of dysfunctions," such as doing poorly in school or on the job, having problems sustaining friendships and picking up bad health habits.

Michael Nyerges, Cincinnati Enquirer

The Health Policy Institute of Ohio estimated that avoiding even 10% of costs^[15] like medical bills and lost work that arise from adverse childhood experiences could save Ohio more than $1 billion a year.

Reem Aly, the institute’s vice president, said the organization’s long study of the overall poor health of Ohioans^[16] showed that at the foundation lay adverse childhood experiences and their generational legacy.

“Health doesn’t just happen,” Aly said. “It’s over the life course, and it compounds over time. There are issues older Ohioans faced as children that could have been prevented or managed. … Using (adverse childhood experiences) as a measure, we rank very poorly compared to other states.”

The intergenerational legacy of domestic violence landed heavily in April 2020 when six women were murdered in the city of Cincinnati, more than in all of 2019. In three of the murders, the men charged with the crime were current or former intimate partners. One is Marcus Reed, 30, due to go on trial next month for the murder of Patricia Woods, 24, a mother of two.

Kayden Allen, 7, and his sister, Kay-Lia McCree, are the children of Patricia Woods. They were visiting her grave on Sept. 26, 2021 in Cincinnati. Woods, 24, was killed April 17, 2020 in what police believe was a domestic violence situation. The children were present at the time of her death. Kayden went to a neighbor for help. Her boyfriend, Marcus Reed, is charged with aggravated murder. His trial is scheduled for November. Liz Dufour/The Enquirer

Before he was 13, Reed's father had been to prison twice. By early 2020, when Reed, 30, met and briefly dated Woods, his own criminal record included two domestic violence arrests, both dismissed.

But Woods "did not feel threatened by this guy whatsoever,” said Tracey Jones, her mother. “I would have laid down my life on that because I know my daughter, and I know how she feels about her own kids. She would never put herself or them in any type of danger like that. She did not see this coming for herself at all.”

On the morning of April 17, 2020, the Woods children heard a loud boom in their apartment. Her 5-year-old son found Woods' body at the front door. Jones said the boy “actually spoke to the Marcus Reed guy before he left and said 'can you please get help for my mommy'. And he said no.”

Jones now cares for her grandchildren. “Even more so now, we’re trying to do things as a family because we know, honey, how that saying goes, tomorrow isn’t promised to anyone.”

The toll of domestic violence

Liz Dufour, Cincinnati Enquirer

Survivor advocates under financial stress 

Survivor advocates say they regularly see handed-down trauma in their work. They believe trauma has deepened because the pandemic weakened the thin layer of services for survivors and their children, as well as complicating the police response to domestic violence.

Debbie Brooks, executive vice president of the YWCA of Greater Cincinnati,^[17] said the pandemic “put more stress on an already stressed family dynamic, with people losing jobs, and being isolated, and being fearful to leave violent situations to come into a shelter where they might contract a deadly disease.”

Richard Byes, a YWCA facilitator, conducts a class for men who have been court-appointed to participate in a 20-week transformation class for domestic violence offenders, on Aug. 26, 2021. Liz Dufour/The Enquirer

In 2018, a key source of federal money went dry with the lapsing of the Violence Against Women Act, and Ohio lost $7.7 million. The legislature recently resupplied $7.5 million to the statewide Ohio Domestic Violence Network for two years, and, "while we greatly appreciate it," said network Policy Director Micaela Deming, "it doesn’t cover the loss over the last couple of years."

The YWCA is the only agency in Hamilton County providing housing for survivors of domestic violence. With shelters closed under the public health orders, the YWCA has paid for survivors to stay in hotels, adding an extra $65,000 a month to shelter expenses, Brooks said.

The YWCA served nearly double the number of survivors it had projected for 2020, and Brooks said the number of people seeking help has continued to rise in 2021. Economic pressures meant most survivors arrived with no income and a long list of overdue bills, she said, and the average stay went from 30 to 56 days.

Financial stress also has hit those researching the causes of domestic violence. Dr. Robert Shapiro, a pediatrician at Cincinnati Children's Hospital Medical Center, is a founder of Joining Forces for Children^[18], a decade-old network of about 30 nonprofits that are studying the impact of adverse childhood experiences^[19]. “The pandemic has eaten into a lot of our funding” to the point of nearly shutting it off, he said.

When a man took the life of an officer

The scene on March 20, 2020, when Terry Blankenship was fleeing police and he purposely rammed his vehicle into Springdale, Ohio, police officer Kaia Grant, killing her at the scene. In April 2021, Blankenship was sentenced to life in prison with the possibility for parole after 30 years. Fox19

One case from the Enquirer's study month of April 2020 illustrates that a generational legacy of domestic violence is not confined to a home. The community pays a price when family trauma metastasizes. It's with that knowledge that police officers brace themselves when answering a domestic violence call.

On the night of March 20, 2020, Terry Blankenship broke into his ex-wife’s home, assaulted her boyfriend then fled in his truck with a gun. Blankenship had three previous arrests for domestic violence, all dismissed. He also had the legacy of his father, convicted in Ohio in 1999 for strangling his third wife. The elder Blankenship skipped court-ordered anger-management classes, moved to Kentucky and remarried. He died in 2020.

Officer Kaia Grant Springdale Police Department

As night fell March 21, Terry Blankenship turned up in a Cincinnati suburb. Police pursued him onto the highway. Springdale police Officer Kaia Grant, 37, finished setting up a barricade.

Grant crouched behind her cruiser as Blankenship came out of the darkness. He then aimed his truck at Grant, struck and killed her. His truck stopped at last, Blankenship attempted suicide, but was treated for his injuries and recovered. In April 2020, he was charged with aggravated murder. A year later, he pleaded guilty and was sentenced to prison for 30 years.

The trauma of Grant's death endures. Her mother declined an interview. 

The Springdale police chief said Grant distinguished herself on the one call that every officer dreads.

The temperature in those domestic violence situations can run pretty high, and Grant was so calm and diplomatic, she always found a way to bring it down.

Members of the Springdale Police Department lift fellow officer, Kaia Grant's casket from the hearse prior to her funeral service on Sunday, March 29, 2020. Amanda Rossmann/The Enquirer

Contributing: Quinlan Bentley and Liz Dufour, Cincinnati Enquirer

ACE Test: Rate your risk factors

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A landmark study from 1995-1997 study found 10 umbrella events^[20] that most often cause trauma in childhood. Four or more adverse childhood experiences can lead to toxic stress, which can raise risk factors for disease and early death in adulthood.

 

• Emotional abuse: A parent, stepparent or adult living in a home swore at, insulted or acted in a way that made a child afraid of physical hurt.
 
• Physical abuse: A parent, stepparent or adult living in the home pushed, grabbed, slapped, threw something at a child or hit a child so hard to leave marks or injury.
 
• Sexual abuse: An adult, relative family friend or stranger at least five years older touched or fondled the child's body in a sexual way, made the child touch his or her body in a sexual way or attempted to have sexual intercourse with the child.
 
• Mother treated violently: The mother or stepmother was pushed, grabbed, slapped, had something thrown at her, kicked, bitten, hit with a fist, hit with something hard, repeatedly hit for over at least a few minutes, or threatened or hurt by a knife or gun by the father or stepfather or mother’s boyfriend.
 
• Substance abuse: A household member abused alcohol or used street drugs.
 
• Mental illness: A household member was depressed or mentally ill, or a household member attempted suicide.
 
• Separation or divorce: Parents were ever separated or divorced.
 
• Incarceration: A household member went to prison.
 
• Emotional neglect: A child did not experience feeling important or special, or felt loved, or that the family looked out for each other and felt close, or felt that the family was a source of strength and support.
 
• Physical neglect: A child had no one to take care of and protect the child, or no one to take the child to the doctor when needed, or that there wasn't enough to eat or clean clothes, the parents were too drunk or too high to provide care.

References

1. ^{^} worsened (bit.ly)
2. ^{^} Domestic violence seems to be everywhere. Now what? (www.usatoday.com)
3. ^{^} Seeing domestic violence is one of them (www.cincinnati.com)
4. ^{^} 56% of domestic violence is reported to the police (bjs.ojp.gov)
5. ^{^} were murdered (www.cincinnati.com)
6. ^{^} jumped 62% (www.cincinnati.com)
7. ^{^} have sought help (www.cincinnati.com)
8. ^{^} more than a quarter of Ohioans (https://ift.tt/3nke08y)
9. ^{^} shapes an adult's behavior and health (www.ncbi.nlm.nih.gov)
10. ^{^} Cleveland pediatrician (www.uhhospitals.org)
11. ^{^} found nearly one-third of Ohio smokers (https://ift.tt/3nke08y)
12. ^{^} 2018 review of studies (www.ncbi.nlm.nih.gov)
13. ^{^} exposed to the Sept. 11, 2001, terror attacks (academic.oup.com)
14. ^{^} can delay development in a child before age 2. (https://ift.tt/3AsEvNS)
15. ^{^} avoiding even 10% of costs (https://ift.tt/3nke08y)
16. ^{^} overall poor health of Ohioans (https://ift.tt/3b8o92c)
17. ^{^} YWCA of Greater Cincinnati, (www.ywcacincinnati.org)
18. ^{^} Joining Forces for Children (https://ift.tt/3b0VeNE)
19. ^{^} studying the impact of adverse childhood experiences (publichealth.gwu.edu)
20. ^{^} 10 umbrella events (www.cdc.gov)

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