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November 13, 2006: 

Congressional Committees: 

Subject: Prevalence of Domestic Violence, Sexual Assault, Dating 
Violence, and Stalking: 

In hearings conducted between 1990 and 1994, Congress noted that 
violence against women was a problem of national scope and that the 
majority of crimes associated with domestic violence, sexual assault, 
and stalking were perpetrated against women. These hearings culminated 
in the enactment of the Violence Against Women Act (VAWA) in 1994 to 
address these issues on a national level.[Footnote 1] VAWA established 
grant programs within the Departments of Justice (DOJ) and Health and 
Human Services (HHS) for state, local, and Indian tribal governments 
and communities. These grants have various purposes, such as providing 
services to victims and training for law enforcement officers and 
prosecutors. The 2006 reauthorization of VAWA expanded existing grant 
programs and added new programs addressing, among other things, young 
victims, the housing and economic needs of victims, and the health care 
system's response to domestic violence, dating violence, sexual 
assault, and stalking.[Footnote 2] The total fiscal year 2006 
appropriation level for violence against women programs is about $560 
million--approximately $382 million for programs administered by DOJ 
and about $178 million for programs administered by HHS.[Footnote 3] 

Although criminal justice, health, and domestic violence experts 
believe that valid and reliable estimates have the potential to be of 
use to policy makers, service providers, and researchers, there are 
concerns that current crime statistics do not provide a full assessment 
of the problem. The Violence Against Women and DOJ Reauthorization Act 
of 2005, enacted January 5, 2006, requires GAO to conduct a study and 
report on data indicating the prevalence of domestic violence, dating 
violence, sexual assault, and stalking among men, women, youth, and 
children, as well as services available to these victims.[Footnote 4] 
We developed two objectives to respond to this mandate. 

1. To what extent do national data collection efforts report prevalence 
of men, women, youth, and children who are victims of domestic 
violence, sexual assault, dating violence, and stalking? 

2. What support services (e.g., counseling, medical, legal, etc.) are 
available to victims of these categories of crime and what are the 
number and characteristics of victims receiving these services by type 
of service? 

This report addresses the first objective. Our work on the second 
objective is ongoing. 

To assess the extent to which national data collection efforts report 
prevalence of victims of domestic violence, sexual assault, dating 
violence, and stalking, we obtained information from and interviewed 
officials at DOJ's Office of Justice Programs' Bureau of Justice 
Statistics, National Institute of Justice, and Office of Juvenile 
Justice and Delinquency Prevention, Office on Violence Against Women, 
and Federal Bureau of Investigation's Criminal Justice Information 
Services Division. We also obtained information and interviewed 
officials at HHS's National Institutes of Health and Centers for 
Disease Control and Prevention's National Center for Injury Prevention 
and Control--Division of Violence Prevention. Further, we gathered 
information from research and advocacy organizations related to the 
crimes under study, including the National Academy of Sciences' 
National Research Council; Respecting Accuracy in Domestic Abuse 
Reporting; Men's Health Network; Rape, Abuse, and Incest National 
Network; National Center for Victims of Crime; National Domestic 
Violence Hotline; and Stalking Resource Center. We reviewed pertinent 
federal laws and conducted literature searches, focusing on reporting 
systems and surveys from which results were issued or reported since 
2001.[Footnote 5] However, we did not independently evaluate the 
methodology used in any of these studies and we are not making any 
assessments regarding their overall merit. 

In October 2006, we briefed your offices on the results of our work or 
provided a copy of our briefing slides to your staff. This report 
conveys the information provided during those discussions. 

We conducted our work from April through October 2006 in accordance 
with generally accepted government auditing standards. 

Results: 

Since 2001, the amount of national research that has been conducted on 
the prevalence of domestic violence and sexual assault has been 
limited, and even less research has been conducted on dating violence 
and stalking. No single, comprehensive effort currently exists that 
provides nationwide statistics on the prevalence of these four 
categories of crime among men, women, youth, and children. Rather, 
various national efforts address certain subsets of these crime 
categories among some segments of the population. For example, the 
Centers for Disease Control and Prevention's (CDC) National Violent 
Death Reporting System, which collects incident-based data from 
multiple sources, such as coroner/medical examiner reports, gathers 
information on violent deaths, including those resulting from domestic 
violence and sexual assaults. This system and the other national data 
collection efforts were not intended to provide comprehensive estimates 
on the prevalence associated with domestic violence, sexual assault, 
dating violence, and stalking. Some of these national data collection 
efforts focus largely on incidence--the number of separate times a 
crime is committed against individuals during a specific time period-- 
rather than prevalence--the unique number of individuals who were 
victimized during a specific time period.[Footnote 6] Obtaining both 
incidence and prevalence data is important for determining services to 
provide to victims of crimes. In addition, HHS noted that both types of 
data are important for determining the impact of violence and 
strategies to prevent it from occurring. Table 1 in the attached 
briefing slides (see enc. II, p. 29) shows the 11 national efforts we 
identified that have reported data since 2001 on certain aspects of 
domestic violence, sexual assault, dating violence, and stalking. More 
detailed information about these efforts is contained at the end of 
enclosure II. 

The national data collection efforts we reviewed cannot provide a basis 
for combining their results to compute valid and reliable nationwide 
prevalence estimates because the efforts use varying definitions. For 
example, CDC's Youth Risk Behavior Surveillance System's definition of 
dating violence included the intentional physical harm inflicted upon a 
survey respondent by a boyfriend or girlfriend. In contrast, the 
Victimization of Children and Youth Survey's definition did not address 
whether the physical harm was intentional. Officials from the National 
Institute of Justice (NIJ) and Bureau of Justice Statistics (BJS) 
acknowledge that estimating prevalence in the absence of widely 
accepted and used uniform definitions is a challenge. 

Certain agencies have taken steps to build consistency in some of their 
collection efforts. For example, CDC, in collaboration with the Office 
of Justice Programs (OJP) and others, established uniform definitions 
for certain forms of domestic violence in 1999 and for sexual assault 
in 2002, with the intent of promoting and improving consistency among 
the research community. CDC and OJP encourage but do not require 
grantees to use these definitions as part of their research efforts and 
cannot always use these definitions in their own work. Although CDC and 
OJP acknowledge that using standard definitions of these offenses may 
be advantageous, they believe there are circumstances that preclude 
such use. For example, CDC officials said that some of the current data 
collection efforts, such as the Youth Risk Behavior Surveillance 
System, were developed before CDC established the uniform definitions. 
They also said it would be difficult to alter the definitions used in 
these efforts because the efforts continue to be used to provide 
comparable data to measure trends over time in the United States. 
However, in 2004, the National Academy of Sciences' National Research 
Council reported that top priority should be given to developing clear 
definitions and cautioned that without consistency in the use of terms 
across studies, accurate prevalence estimates will remain elusive. 

Further, the national data collection efforts we reviewed cannot 
provide a basis for combining their results to compute valid and 
reliable nationwide prevalence estimates because the efforts have 
varying scopes in terms of the incidents and categories of victims that 
are included. For example, the National Child Abuse and Neglect Data 
System includes only reported sexual assaults against children, not 
unreported incidents. Furthermore, as noted earlier, CDC's Youth Risk 
Behavior Surveillance System definition of dating violence includes 
intentional physical harm inflicted upon a survey respondent, but 
excludes youth who are not in grades 9-12 and those who do not attend 
school. In contrast, the Victimization of Children and Youth Survey was 
addressed to youth ages 12 and older, or those who were at least in the 
sixth grade. 

Although perfect data may never exist because of the sensitivity of 
these crimes and the likelihood that not all occurrences will be 
disclosed, initiatives are under way to provide additional information 
related to the prevalence of these issues. For example: 

 Domestic violence, sexual assault, and stalking initiatives: CDC, 
NIJ, and the Department of Defense are collaborating on a National 
Intimate Partner and Sexual Violence Survey to address certain forms of 
domestic violence, sexual assault, and stalking. CDC reported that it 
expects the survey to be fully administered by 2008. Although the 
survey will gather information regarding experiences that occurred 
during an individual's life span, it will not be administered to people 
under age 18. 

 Other stalking initiatives: The Office on Violence Against Women and 
BJS told us that they collaborated to conduct the National Crime 
Victimization Survey--Stalking Supplement and expect to report results 
in the summer of 2007. According to BJS, this survey will obtain 
information about the identity of the stalker, nature of the stalking 
incidents, consequences to the victim, and actions the victim took 
about the incident, including whether it was reported to the police. 
However, while this supplement will gather data on stalking incidents 
involving adult victims, it will not collect information on stalking 
associated with youth ages 12-17. 

 Other domestic violence and sexual assault initiatives: CDC began 
collecting data through a telephone survey on intimate partner violence 
and sexual violence as part of its ongoing Behavioral Risk Factor 
Surveillance System. In 2005, CDC administered the intimate partner 
violence module to approximately 77,000 people in 16 states and 
administered the sexual violence module to about 115,000 people in 26 
states. 

In addition to these efforts, under an Office of Juvenile Justice and 
Delinquency Prevention (OJJDP) grant, the University of New Hampshire 
is planning to conduct the National Study on Children's Exposure to 
Violence. DOJ officials told us the data will be collected from 
September 2007 to June 2008, and OJJDP officials said that the study 
will assess variations in incidence and lifetime prevalence of 
children's exposure to a broad array of violence and abuse. 
Furthermore, NIJ recently sponsored two seminars aimed at identifying 
key issues related to measuring the prevalence of dating violence, 
domestic violence, and sexual assault against women, improving 
interagency coordination on these issues, and highlighting the results 
of the latest efforts on domestic violence and sexual assault. 

If these efforts are completed as planned, CDC and DOJ will make 
progress in collecting information needed to determine the extent to 
which men, women, youth, and children are victims of domestic violence, 
sexual assault, dating violence, and stalking. However, some 
information gaps will remain, particularly in the areas of dating 
violence among victims age 12 and older and stalking among victims 
under age 18. 

To cost-effectively address information gaps, it is important to 
consider additional costs that would be incurred in collecting new or 
different data as well as the usefulness of such data. It is equally 
important to consider the benefits resulting from the use of these data 
(different allocations of resources) and the availability of funds to 
collect such data (a cost-benefit analysis). According to DOJ 
officials, a cost-benefit analysis should precede any future large- 
scale effort aimed at national prevalence estimates. 

Conclusions: 

Current national data collection efforts cover portions of domestic 
violence, sexual assault, dating violence, and stalking among different 
segments of the population. Because the efforts use different 
definitions and vary in scope, they cannot be combined and leveraged to 
determine the nationwide prevalence of these categories of crime. The 
absence of comprehensive nationwide prevalence information somewhat 
limits the ability to make informed policy and resource allocation 
decisions about the statutory requirements and programs created to help 
address these four categories of crime and victims. Although 
policymakers may never have perfect data, DOJ and HHS have collaborated 
to obtain more uniformity across research efforts and have initiatives 
in the early stages that could be used to collect information regarding 
the prevalence of certain crimes for some segments of the population. 
However, some information gaps will remain. DOJ and HHS have not yet 
determined to what extent they can cost-effectively revise current 
efforts or design new initiatives so as to collect more consistent data 
that can be combined to better build nationwide estimates. To decide on 
the cost-effectiveness of obtaining better data, policymakers would 
need to consider the marginal costs to collect more or different data, 
the utility of obtaining better data, benefits to be derived from the 
use of better data (different allocations of resources), and 
availability of funds to gather better data. 

Recommendations for Executive Action: 

To provide Congress and agency decision makers with more comprehensive 
information on the prevalence of domestic violence, sexual assault, 
dating violence, and stalking to assist them in making policy decisions 
on grants and other issues associated with these four categories of 
crime, we are recommending that the Attorney General and the Secretary 
of Health and Human Services collaboratively take the following four 
actions: 

 determine the extent to which initiatives being planned or under way 
can be designed or modified to address existing information gaps; 

 identify and evaluate alternatives for addressing any remaining gaps; 

 incorporate such alternatives deemed cost-effective in future budget 
requests; and: 

 to the extent possible, require the use of common definitions when 
conducting or providing grants for federal research to leverage 
individual collection efforts so that the results of such efforts can 
be readily combined to achieve nationwide prevalence estimates. 

Agency Comments: 

We provided a draft copy of this report with the attached briefing 
slides to HHS and DOJ for comment. HHS provided formal written comments 
on a draft of this report on October 25, 2006, which are presented in 
enclosure III. In commenting on the draft report, HHS concurred with 
the recommendations and stated that it will continue to expand its 
collaborations with DOJ to improve data collection and monitoring of 
violence. HHS also provided technical comments, which we have 
incorporated as appropriate. 

DOJ declined to provide formal written comments on a draft of this 
report. However, DOJ provided technical comments on the draft briefing 
slides, which we incorporated as appropriate. In its technical 
comments, DOJ expressed concern regarding the potential costs 
associated with implementing our proposed recommendations and suggested 
that a cost-benefit analysis be conducted. We agree that performing a 
cost-benefit analysis is a critical step, as acknowledged by our 
recommendation that DOJ and HHS incorporate alternatives for addressing 
information gaps deemed cost-effective in future budget requests. DOJ 
officials also expressed concern that our work was primarily focused on 
issues associated with prevalence data. As discussed in this report and 
the attached briefing slides, we believe obtaining information on both 
prevalence and incidence data is important for determining services to 
provide to victims of crime. However, we did not conduct a detailed 
analysis of incidence data because doing so was outside the scope of 
our review. 

We are sending copies to the Senate Committee on Homeland Security and 
Governmental Affairs, the House Committee on Government Reform, the 
Secretary of Health and Human Services, the Attorney General, the 
Director of the Office of Management and Budget, and other interested 
parties. We will also make copies available to others on request. 

In addition, the report will be available on GAO's Web site at 
[Hyperlink, http://www.gao.gov]. 

If your office or staff have any questions concerning this report, 
please contact me at (202) 512-8777 or by e-mail at Larencee@gao.gov. 
Other GAO contacts and key contributors to this report are listed in 
enclosure IV. 

Signed by: 

Eileen Regan Larence, Director: 
Homeland Security and Justice Issues: 

Enclosures (4): 

Enclosure I: List of Committees: 

The Honorable Arlen Specter: 
Chairman: 
The Honorable Patrick J. Leahy: 
Ranking Minority Member: 
Committee on the Judiciary: 
United States Senate: 

The Honorable Michael B. Enzi: 
Chairman: 
The Honorable Edward M. Kennedy: 
Ranking Minority Member: 
Committee on Health, Education, Labor, and Pensions: 
United States Senate: 

The Honorable F. James Sensenbrenner, Jr. 
Chairman: 
The Honorable John Conyers, Jr. 
Ranking Minority Member: 
Committee on the Judiciary: 
House of Representatives: 

The Honorable Joe Barton: 
Chairman: 
The Honorable John D. Dingell: 
Ranking Minority Member: 
Committee on Energy and Commerce: 
House of Representatives: 

Enclosure II: Briefing to Congressional Committees: 

Prevalence of Domestic Violence, Sexual Assault, Dating Violence, and 
Stalking: 

Briefing to Congressional Committees: 

Introduction: 

In hearings conducted between 1990 and 1994, Congress noted that 
violence against women was a problem of national scope and that the 
majority of crimes associated with domestic violence, sexual assault, 
and stalking were perpetrated against women. These hearings culminated 
in the enactment of the Violence Against Women Act (VAWA) in 1994 to 
address these issues on a national level.[Footnote 7] 

VAWA established grant programs within the Departments of Justice (DOJ) 
and Health and Human Services (HHS) for state, local, and Indian tribal 
governments and communities. These grants have various purposes, such 
as providing services to victims and training for law enforcement 
officers and prosecutors. The total fiscal year 2006 appropriation 
level for violence against women programs is about $560 million- 
approximately $382 million for programs administered by DOJ and about 
$178 million for programs administered by HHS.[Footnote 8] 

Although the Bureau of Justice Statistics (BJS) reported a decline in 
family violence[Footnote 9] between 1993 and 2002, some service 
providers and advocacy groups do not believe current crime statistics 
provide a full assessment of the problem. 

* For example, National Domestic Violence Hotline officials cautioned 
that statistical reports must be used carefully because they do not 
account for all cases of violence, such as those that are 
unreported.[Footnote 10] 

Criminal justice, health, and domestic violence experts believe that 
valid and reliable estimates have the potential to be of use to 
policymakers, service providers, researchers, and others in determining 
the success of programs to combat domestic violence, sexual assault, 
dating violence, and stalking and the need for changes or additions to 
these programs. 

* The Violence Against Women and Department of Justice Reauthorization 
Act of 2005, enacted January 5, 2006, requires GAO to conduct a study 
and report on data indicating the prevalence of domestic violence, 
dating violence, sexual assault, and stalking among men, women, youth, 
and children, as well as the services available to these 
victims.[Footnote 11] 

Objectives: 

In responding to this mandate, we outlined two objectives. We assessed: 

1. to what extent national data collection efforts report prevalence of 
men, women, youth, and children who are victims of domestic violence, 
sexual assault, dating violence, and stalking and: 

2. the support services (e.g., counseling, medical, legal, etc.) 
available to victims of these categories of crime and the numbers and 
characteristics of victims receiving these services by type of service. 

This briefing addresses the first objective. Our work on the second 
objective is ongoing. 

Scope and Methodology: 

To address the first objective, we obtained information from and 
interviewed officials of the following key federal entities because 
they are involved in ongoing efforts to (1) collect and maintain 
information or (2) conduct or fund research to address certain aspects 
of domestic violence, sexual assault, dating violence, and stalking: 

* DOJ: 

- Office of Justice Programs' BJS, National Institute of Justice (NIJ), 
Office of Juvenile Justice and Delinquency Prevention (OJJDP): 

- Office on Violence Against Women (OVW): 

- Federal Bureau of Investigation's (FBI) Criminal Justice Information 
Services Division: 

* HHS: 

- National Institutes of Health: 

- Centers for Disease Control and Prevention's (CDC) National Center 
for Injury Prevention and Control-Division of Violence Prevention: 

Through research efforts, we also identified the following research or 
advocacy organizations and contacted them to obtain information related 
to the prevalence of these categories of crime: 

* National Academy of Sciences' National Research Council: 

* Respecting Accuracy in Domestic Abuse Reporting: 

* Men's Health Network: 

* Rape, Abuse, and Incest National Network: 

* National Center for Victims of Crime: 

* National Domestic Violence Hotline: 

* Stalking Resource Center: 

We reviewed pertinent federal laws related to domestic violence, sexual 
assault, dating violence and stalking. 

We conducted literature searches of DOJ publications, HHS publications, 
prior GAO report Congressional Research Service reports., and the 
Internet. As assault we reviewed information on pertinet national 
health and crime reporting systems and surveys that are ongoing, 
episodic and onetimeffrts from federal and non-federal sources. To 
obtain recent information, we focused on reporting systems and surveys 
from which results were issued or re ported since 2001.[Footnote 12] We 
did not independently evaluate the methodology used in any of these 
studies. 

We attended an NIJ workshop that gathered representatives from various 
program and research funding agencies to discuss the results of recent 
research and data collection efforts. 

We conducted our work from April through October 2006 in accordance 
with generally accepted government auditing standards. 

Results in Brief: 

No single, comprehensive effort currently exists that provides 
nationwide statistics on the prevalence of these four categories of 
crime for men, women, youth, and children. Designing a single effort 
would be costly given the resources required to collect such data and 
may be duplicative of some existing efforts. 

Available national data collection efforts contain information on 
various subsets of domestic violence, sexual assault, dating violence, 
and stalking among certain segments of the population and were not 
intended to provide comprehensive estimates. 

Some of these efforts collect data on incidence rather than prevalence. 
Both are important for appropriately determining resources needed to 
provide services to victims of crimes. 

* Incidence refers to the number of separate times a crime is committed 
against individuals during a specific time period. 

* Prevalence is the unique number of individuals who were victimized 
during a specific time period. 

We cannot combine the results of the various collection efforts to 
estimate the prevalence of these four categories of crime nationwide 
among all segments of the population because the efforts: 

* use different definitions to measure the various offenses, and: 

* have varying scopes such as including different categories of victims 
and not always including estimates of unreported incidents. 

Several initiatives are under way that could help address some 
information gaps if they are completed as planned, but other gaps will 
remain, such as in the area of dating violence. 

To provide Congress with more comprehensive information on the 
prevalence of domestic violence, sexual assault, dating violence, and 
stalking to assist in carrying out its legislative and oversight 
agenda, we are recommending that DOJ and HHS: 

* determine the extent to which initiatives being planned or under way 
can be designed to address existing gaps in information on domestic 
violence, sexual assault, dating violence, and stalking, 

* identify and evaluate alternatives to address any remaining gaps, 

* incorporate alternatives deemed cost-effective in future budget 
requests, and: 

* to the extent possible, require the use of common definitions when 
conducting or providing grants for federal research to leverage 
individual collection efforts so that the results of such efforts can 
be readily combined to achieve nationwide prevalence estimates. 

Background: 

Domestic violence, sexual assault, dating violence, and stalking are 
complex subjects. They can include many forms of violence, such as 
verbal threats, physical assaults, murder, and rape and a wide range of 
victims (e.g., spouses, intimate partners, children, and other family 
members). 

Some of these forms of violence have not always been considered crimes. 

The offenses involved in these forms of violence, like most violent 
crimes, generally are prosecuted at the state and local levels. 

VAWA created a number of grant programs to address domestic violence, 
sexual assault, and stalking as well as authorized additional funding 
for domestic violence shelters.[Footnote 13] 

In 2000, during the reauthorization of VAWA, language was added to the 
law to provide greater emphasis on dating violence in efforts to 
address violence against women. 

The 2006 reauthorization of VAWA expanded existing grant programs and 
added new programs addressing, among other things, young victims, the 
housing and economic needs of victims, and the health care system's 
response to domestic violence, dating violence, sexual assault, and 
stalking.[Footnote 14]

Limited National Data Are Available to Estimate Prevalence: 

Since 2001, the amount of national research that has been conducted on 
the prevalence of domestic violence and sexual assault has been 
limited, and even less research has been conducted on dating violence 
and stalking. 

No single, comprehensive data collection effort has been conducted to 
determine the prevalence of these four categories of crime among men, 
women, youth, and children. Rather, various national efforts address 
certain subsets of these categories of crime among some segments of the 
population and were not intended to provide comprehensive estimates. 

Designing a single, comprehensive data collection effort to address 
these four categories of crime among all segments of the population 
independent of existing efforts would be costly, given the resources 
required to collect such data. Furthermore, it would be inefficient to 
duplicate some existing efforts that already collect data for certain 
aspects of these categories of crime. 

Some of these efforts focus largely on incidence rather than 
prevalence. 

* Incidence refers to the number of separate times a crime is committed 
against individuals during a specific time period. 

* Prevalence is the unique number of individuals who were victimized 
during a specific time period. 

The following hypothetical statements illustrate incidence and 
prevalence: 

* 4,110 separate occurrences of domestic violence against women were 
reported during 1938 (incidence), whereas: 

* 2,500 women were victims of these 4,110 occurrences (prevalence). 

Obtaining both incidence and prevalence data is important for 
determining services to provide to victims of crimes. In addition, HHS 
noted that both types of data are important for determining the impact 
of violence and strategies to prevent it from occurring. 

The National Violence Against Women Prevention Research Center reported 
that to effectively measure rape, it is important to determine how many 
rape cases have occurred (incidence) and how many women have ever been 
raped (prevalence) to determine the level of services that the state 
will need to provide to victims.[Footnote 15] 

As reflected in table 1, we identified 11 national efforts that have 
reported data on certain aspects of these categories of crime. These 
efforts provide a mixture of prevalence and incidence data. Additional 
information on these efforts is provided in appendix I. 

Table 1: National Data Collection Efforts with Results Reported or 
Issued since 2001 Relevant to Domestic Violence, Sexual Assault, Dating 
Violence, and Stalking. 

Data collection effort: Summary Uniform Crime Reporting Program; 
categories of crime: Sexual Assault; 
Prevalence data: No; 
Incidence data: Yes. 

Data collection effort: National Incident-based Reporting System; 
categories of crime: Domestic violence, Sexual assault, stalking; 
Prevalence data: No; 
Incidence data: Yes. 

Data collection effort: national crime Victimization Survey; 
categories of crime: Domestic violence, sexual assault; 
Prevalence data: Potentially[A]; 
Incidence data: Yes. 

Data collection effort: National Violent Death Reporting System[B]; 
categories of crime: Domestic violence, sexual assault; 
Prevalence data: Yes; 
Incidence data: Yes. 

Data collection effort: Youth Risk Behavior Surveillance System; 
categories of crime: Sexual assault, dating violence; 
Prevalence data: Yes; 
Incidence data: no. 

Data collection effort: National Child Abuse and Neglect Data System; 
categories of crime: Sexual Assault; 
Prevalence data: Yes; 
Incidence data: No. 

Data collection effort: National Electronic Injury Surveillance System- 
All injury program; 
categories of crime: Domestic violence, sexual assault; 
Prevalence data: No; 
Incidence data: Yes. 

Data collection effort: Extent, nature, and Consequences of Rape 
Victimization: Findings from the National Violence Against Women 
Survey; 
categories of crime: Sexual Assault; 
Prevalence data: Yes; 
Incidence data: Yes. 

Data collection effort: The Harris Poll #50; 
categories of crime: Domestic violence, sexual assault; 
Prevalence data: yes; 
Incidence data: No. 

Data collection effort: The Victimization of Children and Youth; 
categories of crime: Sexual assault, dating violence; 
Prevalence data: Yes; 
Incidence data: Yes. 

Data collection effort: Injury Control and Risk Survey-2; 
categories of crime: Stalking; 
Prevalence data: Yes; 
Incidence data: Yes. 

[A] Although BJS collects data that could be used to determine 
prevalence related to domestic violence and sexual assault, BJS has 
declined to produce prevalence estimates because of the difficulties 
and complexities associated with the task. 

[B] This system contains data only on fatalities, thus, an individual 
is entered into the system one time upon death. Therefore, the 
prevalence and incidence rates for data in this system would be the 
same. 

Source: GAO's analysis of national data collection efforts. 

[End of table] 

Varying Definitions and Scope Make It Difficult to Combine Results for 
Nationwide Estimates: 

In 2004, the National Academy of Sciences' National Research Council 
reported that currently available information on prevalence was 
inadequate because it had been derived from efforts with varying 
definitions and scope. 

The national data collection efforts we reviewed cannot provide a basis 
for combining their results to compute valid and reliable nationwide 
prevalence estimates because the efforts use varying definitions and 
have varying scopes. 

National data collection efforts currently available use different 
definitions to measure these various forms of violence. 

* For example, CDC's Youth Risk Behavior Surveillance System's 
definition of dating violence included the intentional physical harm 
inflicted upon a survey respondent by a boyfriend or girlfriend. In 
contrast, the Victimization of Children and Youth Survey's definition 
did not address whether the physical harm was intentional. 

NIJ and BJS officials acknowledge that estimating prevalence in the 
absence of widely accepted and used uniform definitions is a challenge. 

Agencies have taken steps to build consistency into some of their 
collection efforts. 

* For example, CDC, in collaboration with OJP and others, established 
uniform definitions for certain forms of domestic violence in 1999 and 
for sexual assault in 2002, with the intent of promoting and improving 
consistency among the research community. CDC and OJP encourage but do 
not require grantees to use these definitions as part of their research 
efforts and report they cannot always use these definitions in their 
own work when these efforts began before the definitions were 
developed. 

Although CDC and OJP acknowledge that using standard definitions of 
these offenses may be advantageous, they believe there are 
circumstances that preclude such use. 

* For example, CDC officials said that some of the current data 
collection efforts, such as the Youth Risk Behavior Surveillance 
System, were developed before CDC established the uniform definitions. 
They also said it would be difficult to alter the definitions used in 
these efforts because the efforts continue to be utilized to provide 
comparable data to measure trends over time in the United States. 

In 2004, the National Academy of Sciences' National Research Council 
reported that top priority should be given to developing clear 
definitions and cautioned that without consistency in the use of terms 
across studies, accurate prevalence estimates will remain elusive. 

Varying Scopes Make It Difficult to Combine Results for Nationwide 
Estimates: 

National data collection efforts also have varying scopes in terms of 
the incidents and categories of victims and that are included. 

* For example, the National Child Abuse and Neglect Data System 
includes only reported sexual assaults against children, not unreported 
incidents. 

* Furthermore, as noted earlier, CDC's Youth Risk Behavior Surveillance 
System's definition of dating violence includes intentional physical 
harm inflicted upon a survey respondent in grades 9-12. In contrast, 
the question on dating violence included in the Victimization of 
Children and Youth Survey was addressed to youth a ages 12 and older, 
or those who were at least in the sixth grade, but its definition of 
dating violence did not address if the physical harm was intentional. 

Without comparable information, including both reported and unreported 
incidents, it is not possible to combine prevalence estimates from 
national data collection efforts, and these efforts likely 
underestimate the prevalence of these categories of crime. 

Recent Initiatives May Address Some Information Gaps: 

Perfect data may never exist because of the sensitive nature of these 
issues and the likelihood that all occurrences related to domestic 
violence, sexual assault, dating violence, and stalking will not be 
disclosed. However, initiatives are under way to provide additional 
information related to the prevalence of these issues. 

If these efforts are completed as planned, CDC and DOJ will make 
progress in collecting information needed to determine the extent to 
which men, women, youth, and children are victims of these four 
categories of crime. However, some information gaps will remain, 
particularly in the areas of dating violence among victims ages 12 and 
older and stalking among victims under age 18. 

To cost-effectively address information gaps, it is important to 
consider additional costs that would be incurred in collecting new or 
different data as well as the usefulness of such data. It is equally 
important to consider the benefits resulting from the use of these data 
(different allocations of resources) and the availability of funds to 
collect such data (a cost-benefit analysis). 

According to DOJ officials, no cost-benefit analysis has been 
performed, and such an analysis should precede any future large-scale 
effort aimed at national prevalence estimates. 

Domestic violence, sexual assault, and stalking initiatives: 

CDC, NIJ, and the Department of Defense are collaborating on a National 
Intimate Partner and Sexual Violence Survey to address certain forms of 
domestic violence, sexual assault, and stalking. CDC reported that it 
expects the survey to be fully administered by 2008. Although the 
survey will gather information regarding experiences that occurred 
during an individual's life span, it will not be administered to 
victims under age 18. 

Other stalking initiatives: 

OVW and BJS told us that the collaborated to conduct the National Crime 
Victimization Survey-Stalking Supplement and expect to report results 
in the summer of 2007. 

* According to BJS, this survey will obtain information about the 
identity of the stalker, nature of the stalking incidents, consequences 
to the victim, and actions the victim took about the incident including 
whether it was reported to the police. 

* However, while this supplement will gather data on stalking incidents 
involving adult victims, it will not collect information on stalking 
associated with Youth ages 12-17. 

Other domestic violence and sexual assault initiatives: 

CDC began collecting data through a telephone survey on intimate 
partner violence and sexual violence as part of its ongoing Behavioral 
Risk Factor Surveillance System. In 2005, CDC administered the intimate 
partner violence module to approximately 77,000 people in 16 states and 
administered the sexual violence module to about 115,000 people in 26 
states. 

Under an OJJDP grant, the University of New Hampshire is planning to 
conduct the National Study on Children's Exposure to Violence. DOJ 
officials told us the data will be collected from September 2007 to 
June 2008. 

* OJJDP officials said that the study will assess variations in 
incidence and lifetime prevalence of children's exposure to a broad 
array of violence and abuse. 

NIJ recently sponsored two seminars aimed at identifying key issues 
related to measuring the prevalence of dating violence, domestic 
violence, and sexual assault against women, improving interagency 
coordination on these issues, and highlighting the results of the 
latest efforts on domestic violence and sexual assault. 

* In July 2006, NIJ sponsored an interagency seminar to discuss 
challenges associated with measuring the prevalence of dating violence. 

* In August 2006, NIJ sponsored a Violence Against Women seminar for 
program and research funding agencies to present the results of recent 
prevalence studies and to discuss unresolved questions that may guide 
future research efforts. 

Conclusions: 

Current national data collection efforts cover portions of these four 
categories of crime among different segments of the victim population. 
Because the efforts use different definitions and vary in scope, they 
cannot be combined and leveraged to determine the nationwide prevalence 
of these categories of crime. 

The absence of comprehensive nationwide prevalence information somewhat 
limits the ability to make informed policy and resource allocation 
decisions about the statutory requirements and programs created to help 
address these four categories of crime and victims. 

Although policymakers may never have perfect data, DOJ and HHS have 
collaborated to obtain more uniformity across research efforts and have 
initiatives in the early stages that could be used to collect 
information regarding the prevalence of certain crimes for some 
segments of the population. However, some information gaps will remain. 

DOJ and HHS must determine to what extent they can cost-effectively 
revise current efforts or design new initiatives so as to collect more 
consistent data that can be combined to better build nationwide 
estimates. 

Policymakers need to decide whether it is worth the cost to obtain 
better data. This decision should be based on judgments about the: 

* marginal costs to collect more or different data, 

* utility of obtaining better data, 

* benefits to be derived from the use of better data (different 
allocations of resources), and: 

* availability of funds to gather better data. 

Recommendations for Executive Action: 

To provide Congress and agency decision makers with more comprehensive 
information on the prevalence of domestic violence, sexual assault, 
dating violence, and stalking to assist them in making policy decisions 
on grants and other issues associated with these four categories of 
crime, we are recommending that the Attorney General and the Secretary 
of Health and Human Services collaboratively take the following four 
actions: 

* determine the extent to which initiatives being planned or under way 
can be designed or modified to address existing information gaps, 

* identify and evaluate alternatives for addressing any remaining gaps, 

* incorporate such alternatives deemed cost-effective in future budget 
requests, and: 

* to the extent possible, require the use of common definitions when 
conducting or providing grants for federal research to leverage 
individual collection efforts so that the results of such efforts can 
be readily combined to achieve nationwide prevalence estimates. 

Agency Comments and Our Evaluation: 

We provided draft copies of these briefing slides to HHS and DOJ for 
comment. 

HHS concurred with the recommendations and stated that it will continue 
to expand its collaborations with DOJ to improve data collection and 
monitoring of violence. 

HHS and DOJ provided technical comments, which we have incorporated as 
appropriate. 

In its technical comments, DOJ expressed concern regarding the 
potential costs associated with implementing our proposed 
recommendations and suggested that a cost-benefit analysis be 
conducted. We agree that performing a cost-benefit analysis is a 
critical step, as acknowledged by our proposed recommendation that DOJ 
and HHS incorporate alternatives for addressing information gaps deemed 
cost-effective in future budget requests. 

DOJ officials also expressed concern that our briefing was primarily 
focused on issues associated with prevalence data. As discussed in the 
briefing, we believe obtaining information on both prevalence and 
incidence data is important for determining services to provide to 
victims of crime. 

Appendix I: National Data Collection Efforts with Results Reported or 
Issued since 2001: 

We identified 11 national data collection efforts that address various 
aspects of domestic violence, sexual assault, dating violence, and 
stalking from which results were reported or issued since 2001. The 
national data collection efforts are discussed in table 2 and include 
information on (1) the agency or sponsor responsible for conducting the 
effort; (2) whether domestic violence, sexual assault, dating violence, 
or stalking was included in the scope of the effort; (3) the frequency 
in which the effort is conducted; and (4) the data limitations 
associated with the determination of reliable prevalence estimates 
related to domestic violence, sexual assault, dating violence, and 
stalking on a national basis. These efforts provide a mixture of 
prevalence and incidence data. 

Table 1: National Data Collection Efforts with Results Reported or 
Issued since 2001 Relevant to Domestic Violence, Sexual Assault, Dating 
Violence, and Stalking: 

Data collection efforts: Summary Uniform Crime Reporting Program (UCR); 
[Hyperlink, http://www.fbi.gov/ucr/ucr.htm], [Hyperlink, 
http://www.fbi.gov/ucr/05cius/]; 
Agency/sponsor: Federal Bureau of Investigation; 
Description: Summary UCR is a DOJ statistical program designed to 
measure the magnitude, nature, and impact of certain crimes in the 
United States. More than 17,000 law enforcement agencies nationwide 
(about 94 percent of the total population in 2005) voluntarily report 
crime data brought to their attention to the Federal Bureau of 
Investigation, and findings are published in a detailed annual report; 
Categories of crime: Sexual assault; 
Data Collection Frequency: Ongoing; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include crimes that are not reported to the police; 
* This effort does not include the full range of sexual assaults (i.e., 
male rapes, forcible groping); 
* Does not include data on prevalence. 

Data collection efforts: National Incident-Based Reporting System 
(NIBRS); [Hyperlink, http://www.fbi.gov/ucr/ucr.htm], [Hyperlink, 
http://www.fbi.gov/filelink.html?file=/ucr/cius_03/pdf/03sec5.pdf]; See 
PDF file page 5 (report page 341) under center column heading labeled 
"DATA"; 
Agency/ sponsor: Federal Bureau of Investigation; 
Description: NIBRS is an incident-based reporting system designed to 
collect more detailed information than is reported under the 
traditional Summary UCR program. According to DOJ, to date about 33 
percent of the 17,000 law enforcement agencies nationwide report crime 
information to the FBI using NIBRS; 
Categories of crime: Domestic violence, sexual assault, stalking; 
Data Collection Frequency: Ongoing; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include crimes that are not reported to the police; 
* Currently, 30 states as well as the District of Columbia are NIBRS 
certified. Of these, 10 have participation from all law enforcement 
agencies in their state; 
* Does not include data on prevalence. 

Data collection efforts: National Crime Victimization Survey (NCVS); 
[Hyperlink, http://www.ojp.usdoj.gov/bjs/cvict.htm], [Hyperlink, 
http://www.ojp.usdoj.gov/bjs/abstract/cv05.htm]; 
Agency/sponsor: Bureau of Justice Statistics; 
Description: NCVS is a DOJ statistical program designed to measure the 
magnitude, nature, and impact of certain crimes in the United States, 
including crimes reported and not reported to the police. Twice a year, 
the U.S. Census Bureau interviews household members ages 12 and over in 
a nationally representative sample of approximately 42,000 households 
(about 75,000 people); 
Categories of crime: Domestic violence, sexual assault; 
Data Collection Frequency: Ongoing; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include individuals under age 12; 
* Does not include individuals not living in a household; 
* Does not include homicides; 
* Although BJS collects data that could be used to determine prevalence 
related to domestic violence and sexual assault, BJS has declined to 
produce prevalence estimates because of the difficulties and 
complexities associated with the task. 

Data collection efforts: National Violent Death Reporting System 
(NVDRS); [Hyperlink, 
http://www.cdc.gov/ncipc/profiles/nvdrs/facts.htm], [hyperlink, 
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5415a1.htm]; 
Agency/sponsor: Centers for Disease Control and Prevention; 
Description: NVDRS collects incident-based data from multiple sources, 
such as death certificates, coroner/medical examiner reports, and 
police reports. Information is collected about the relationship between 
victims and suspects as well as circumstances preceding the death, such 
as whether intimate partner violence was involved; 
Categories of crime: Domestic; Violence, sexual assault; 
Data Collection Frequency: Ongoing; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include incidents other than violent deaths; 
* NVDRS is used in 17 states. 

Data collection efforts: Youth Risk Behavior Surveillance System 
(YRBSS); [Hyperlink, 
http://www.cdc.gov/healthyyouth/yrbs/overview.htm], [Hyperlink, 
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5519a3.htm]; 
Agency/sponsor: Centers for Disease Control and Prevention; 
Description: YRBSS collects data through a nationally representative 
school-based survey of students in grades 9-12 that monitors priority 
health risk behaviors that contribute to the leading causes of death, 
disability, and social problems among youth and adults in the United 
States. Students are asked to complete a self-administered 
questionnaire covering a variety of health risk behaviors and topics; 
Categories of crime: Sexual assault, dating; violence; 
Data Collection Frequency: Biennial; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include individuals who do not attend school; 
* Excludes students in grades other than 9-12; 
* Respondents are asked only one question on physical dating violence 
and only one question on sexual assault. 

Data collection efforts: National Child Abuse and Neglect Data System 
(NCANDS); [Hyperlink, http://www.acf.hhs.gov/programs/cb/systems/], 
[Hyperlink, 
http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can]; 
Agency/ sponsor: Children's Bureau, Administration on Children, Youth 
and Families, Administration for Children and Families; 
Description: NCANDS is a voluntary system that currently collects 
annual case-level child abuse and neglect data from almost all states 
(48 states and the District of Columbia for fiscal year 2005) as well 
as key aggregated child abuse and neglect statistics from all states' 
child protective services agencies; 
Categories of crime: Sexual; assault; 
Data Collection Frequency: Ongoing; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Excludes data on abused children not reported to child protective 
service agencies. 

Data collection efforts: National Electronic Injury Surveillance System-
All Injury Program (NEISS-AIP); [Hyperlink, 
http://www.cpsc.gov/cpscpub/pubs/3002.html], [Hyperlink, 
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5121a3.htm]; 
Agency/sponsor: Centers for Disease Control and Prevention and the 
Consumer Product Safety Commission; 
Description: NEISS-AIP collects data about all types and external 
causes of nonfatal injuries and poisonings treated in emergency 
departments in a subset of a nationally representative sample of 100 
U.S. hospitals. The system collects data about the relationship of the 
perpetrator to the victim (e.g., spouse, parent), as well as the 
context of the crime (e.g., sexual assault); 
Categories of crime: Domestic violence, sexual assault; 
Data Collection Frequency: Ongoing; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include injuries that are not reported to an emergency room; 
* Does not include data on prevalence. 

Data collection efforts: Extent, Nature, and Consequences of Rape 
Victimization: Findings from the National Violence Against Women Survey 
(January 2006); [Hyperlink, http://www.ojp.usdoj.gov/nij/pubs-
sum/210346.htm]; 
Agency/sponsor: Centers for Disease Control and Prevention and National 
Institute of Justice; 
Description: This report was prepared using data collected in a 
telephone survey administered to a sample of 8,000 women and 8,005 men. 
Although this report was issued in 2006, the data were originally 
collected from November 1995 to May 1996 to obtain information about 
lifetime experiences with various types of violence; 
Categories of crime: Sexual assault; 
Data Collection Frequency: Onetime; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include individuals that do not live in a residential 
household; 
* Does not include individuals under age 18; 
* Data are over 10 years old; * Does not include individuals without a 
telephone. 

Data collection efforts: The Harris Poll[] #50 (June 2006); 
[hyperlink, 
http://www.harrisinteractive.com/harris_poll/index.asp?PID=677]; 
Agency/ sponsor: Harris Interactive; 
Description: An online survey of 2,377 adult respondents ages 18 and 
older was conducted to gauge the magnitude of domestic violence in the 
United States; 
Categories of crime: Domestic violence, sexual assault; 
Data Collection Frequency: Onetime; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include individuals under age 18; 
* Does not include individuals without a computer or Internet access; 
* Non-probability sample. 

Data collection efforts: The Victimization of Children and Youth: A 
Comprehensive, National Survey (February 2005); [Hyperlink, 
http://www.unh.edu/ccrc/pdf/CV74.pdf]; 
Agency/sponsor: University of New Hampshire and University of North 
Carolina at Chapel Hill; 
Description: This survey examined a large spectrum of violence, crime, 
and victimization experiences in a nationally representative sample of 
about 2,000 children and youth ages 2 to 17 years in the contiguous 
United States. Telephone interviews were conducted with 1,000 children 
age 10 to 17 years and the caregivers for 1,030 children age 2 to 9 
years; 
Categories of crime: Sexual assault, dating violence; 
Data Collection Frequency: Onetime; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include individuals over age 17; 
* Does not include individuals without a telephone. 

Data collection efforts: Injury Control and Risk Survey-2 (2006); 
[Hyperlink, 
http://www.ajpmonline.net/article/PIIS074937970600167X/abstract]; 
Agency/sponsor: Centers for Disease Control and Prevention; 
Description: The first survey, conducted in 1994, involved a nationally 
representative telephone survey of 5,238 individuals aged 18 and older, 
and the results were reported in 1999. The second national telephone 
survey, conducted from 2001 to 2003, collected data from a nationally 
representative sample of 9,684 respondents (4,877 women and 4,807 men); 
Categories of crime: Stalking; 
Data Collection Frequency: Episodic; 
Data limitations associated with the determination of reliable 
nationwide prevalence estimates: 
* Does not include individuals under age 18; 
* Does not include individuals without a telephone. 

Source: GAO analysis of national data collection efforts. 

[End of table] 

Enclosure III: Comments from the Department of Health and Human 
Services: 

Office of the Assistant Secretary for Legislation:  
Department Of Health & Human Services: 
Washington, D.C. 20201: 

OCT 25 2006: 

Eileen R Larence: 
Director, Homeland Security And Justice Issues: 
U.S. Government Accountability Office: 
Washington, DC 20548: 

Dear Ms. Larence: 

The Department of Health and Human Services has reviewed the U.S. 
Government Accountability Office's (GAO) draft report entitled, 
"Prevalence of Domestic Violence, Sexual Assault, Dating Violence, and 
Stalking"(GAO 07-148R). 

HHS concurs with the draft Recommendations for Executive Action, and 
will continue and expand its collaborations with the Department of 
Justice to improve data collection and monitoring of violence. However, 
in addition to requiring the use of common definitions, it may be 
beneficial to include measurement. Although definitions may be similar, 
if different operationalizations and measures are used, the result 
could be that survey questions will be different and, if so, prevalence 
estimates could not be combined across those studies. 

The Department provided several technical comments directly to your 
staff. 

The Department appreciates the opportunity to comment on this draft 
report before its publication. 

Sincerely, 

Signed by: 

Vincent J. Ventimilgia: 
Assistant Secretary for Legislation: 

Enclosure IV: GAO Contact and Staff Acknowledgments: 

GAO Contact:Eileen R. Larence, (202) 512-8777: 

Acknowledgments: 

In addition to the contact named above, Debra B. Sebastian, Assistant 
Director; David P. Alexander; Frances Cook; Katherine M. Davis; Melissa 
Hermes; Varflay C. Kesselly; Deborah Ortega; and Clarence Tull made key 
contributions to this report. 

(440497): 

FOOTNOTES 

[1] Pub. L. No. 103-322,  40001-703, 108 Stat. 1796, 1902-55 (1994). 

[2] Pub. L. No. 109-162, tits. I-VII, 119 Stat. 2960, 2972-3053 (2006). 

[3] These amounts reflect the across-the-board rescission reductions of 
1 percent for fiscal year 2006 discretionary appropriations. 

[4] Pub. L. No. 109-162,  119, 119 Stat. 2960, 2989-90 (2006). 

[5] Some of these systems and surveys obtain information about 
incidents not reported to police or other authorities. 

[6] The following hypothetical statement illustrates incidence and 
prevalence: 4,110 separate occurrences of domestic violence against 
women were reported during 1938 (incidence); whereas 2,500 women were 
victims of these 4,100 occurrences (prevalence). 

[7] Pub. L. No. 103-322,  40001-703, 108 Stat. 1796, 1902-55 (1994). 

[8] These amounts reflect the across the board rescission reductions of 
1 percent for fiscal year 2006 discretionary appropriations. 

[9] The Bureau of Justice Statistics defines "family violence" as all 
types of violent crime committed by an offender 3 who is related to the 
victim either biologically or legally, through marriage or adoption. 

[10] While some data collection efforts, such as the National Crime 
Victimization Survey, obtain information from survey participants about 
crimes not reported to the police, some survey participants may not 
disclose all incidents of crime during the survey. 

[11] Pub. L. No. 109-162,  119, 119 Stat. 2960, 2989-90 (2006). 

[12] Some of these systems and surveys obtain information about 
incidents not reported to police or other authorities. 

[13] Pub. L. No. 103-322,  40121, 40151-52, 40231, 40241, 40295, 
40602, 108 Stat. 1796,1910-16,1920-21, 1932-35, 1940-42, 1951. 

[14] Pub. L. No. 109-162, tits. I-VII, 119 Stat. 2960, 2972-3053 
(2006). 

[15] National Violence Against Women Prevention Research Center, "Rape 
in South Carolina: A Report to the State," 20 April 9, 2003.