A Health Equity Approach to Preventing Sexual Violence From Prevention Institute & National Sexual Violence Resource Center Why is Advancing Health Equity Critical for Sexual Violence Prevention? Health equity means that everyone has a fair and just opportunity to attain their full health potential and that no one is disadvantaged, excluded, or dismissed from achieving this potential. Prevention Institute To truly prevent sexual violence, we must address abuses of power — from the interpersonal to the societal. While sexual violence impacts people of all identities, we can trace a line between sexual violence and oppression (National Sexual Violence Resource Center [NSVRC], 2020). Multiple forms of oppression like racism, classism, sexism, homophobia, transphobia, and ableism have been built into our systems. For example, colonization, enslavement, and mass incarceration impact people directly with enduring and current effects. These and other systemic abuses of power have contributed to a culture that allows systems and people to continue to abuse their power, including through sexual violence. Sexual harassment, abuse, and assault can have short- and long-term physical, emotional, and psychological effects on a person’s well-being and impact an entire community, from the culture and connections between people to the economic toll (NSVRC, 2016). Preventing sexual violence means we all must address deep-rooted abuses of power that contribute to inequities in health, safety, and well-being. A health equity approach to preventing sexual violence means that we need to both understand and address the factors that contribute to violence and safety and factors that expose some communities — especially communities that have been historically oppressed — to higher rates of sexual violence (NSVRC, 2019). Efforts to prevent sexual violence must reach the people who are most impacted while also changing the larger systems. The Centers for Disease Control and Prevention’s Stop SV: A Technical Package to Prevent Sexual Violence outlines strategies that work on multiple levels to prevent sexual violence (Basile et al., 2016). These types of strategies have the greatest potential to address and prevent sexual violence when they reflect the specific cultural strengths and needs of a community. “Rape is fundamental to the problems we see in the world. I would put it as the highest priority for us to address because this is where the root of life breaks down and is passed on intergenerationally.” Lyla June, Indigenous environmental scientist, community organizer, and musician of Diné (Navajo), Tsétsêhéstâhese (Cheyenne) and European lineages (Farnsworth, 2019) Across the country, people are advancing health equity in their sexual violence prevention work by: Elevating community leadership and resilience, Creating spaces for healing in prevention efforts, Facilitating internal organizational change, Addressing underlying factors that contribute to violence and safety, and Partnering across fields and movements. This document dives into each of these themes and shares specific local examples that use strategies from the CDC’s technical package in different cultural and community contexts. By leading with health equity, we can work together to build collective power and create the kind of equitable, respectful communities we want to live in. Elevating Community Leadership and Resilience To truly counter oppression and achieve health equity, it is critical for community members to lead prevention work, including survivors and those most affected by sexual violence. This means ensuring that communities experiencing the heaviest burdens of oppression and sexual violence have the power, opportunities, and resources to create solutions that make sense to their community and cultures. People in the community are the ones who best understand the strengths and needs of their locale and should be the ones deciding the solutions and carrying them out. Rather than taking evidence-based programs and trying to reframe them to work with diverse communities, “a culturally-grounded approach starts with the values, beliefs, practices, and socio-historical perspectives of the cultural community” and emphasizes developing strategies from the ground up while still using research evidence to inform development (Fuije Parks et al., 2018). Starting with existing strengths and investing in those within the community can also support a prevention effort’s sustainability as residents are more likely to find value in it and commit to keeping it going. Spotlight on the New Jersey Department of Children and Families: Engaging Groups on the Margins of the Margins Related technical package strategies: Promoting social norms that protect against violence; mobilizing men and boys as allies; strengthening leadership and opportunities for girls; addressing community-level risks through environmental approaches The New Jersey Department of Children and Families’ Division on Women (NJ DOW) uses a three-pronged approach for its statewide Rape Prevention and Education (RPE) cooperative agreement. Its strategy is focused on engaging men and boys, creating protective environments for LGBTQ+ populations, and elevating opportunities for girls’ leadership. Building on publicly available data (e.g. reported rates of sexual violence) and understanding the importance of telling a broader story, the NJ DOW prioritized the need to engage communities experiencing high rates of violence and took a resident-led approach to the work, beginning with community conversations. New Jersey’s RPE initiative focuses on groups at the margins of the margins (groups that have been marginalized based on multiple factors), including LGBTQ+ youth, Black trans women, girls of color, and men of color, and in neighborhoods with concentrated disinvestment. To begin to build true partnerships with these populations, the NJ DOW/RPE staff began having community conversations in more accessible ways, by scheduling conversations outside of traditional work hours as well as by making sure the discussions were led by trusted community members and held in spaces where groups already gathered, like churches and barbershops. Through these community conversations, staff confirmed that girls’ leadership programs were not available in less affluent communities, that the bulk of resources for LGBTQ+ communities were concentrated in northern New Jersey (close to NY), and that men wanted to find ways to rewrite their narrative to show that they have compassion and should not be only characterized as perpetrators of violence. When the COVID-19 pandemic hit, NJ DOW staff hosted community conversations virtually and plans to continue engaging community members as they sharpen their prevention strategy with these underserved populations. For the DOW/RPE staff, this work is not just a funded initiative, but a movement. Spotlight on Multicultural Efforts to End Sexual Assault: Ensuring Community Ownership of Prevention Work (Asare, 2018) Related technical package strategies: Promoting social norms that protect against violence Multicultural Efforts to End Sexual Assault (MESA) is a statewide program in Indiana with the goal to establish healthier relationships, families, and communities by partnering with those who are not adequately supported by mainstream prevention efforts. MESA values community organizing with marginalized groups to develop culturally informed solutions. In Spanish, ‘mesa’ means table, and MESA builds on this meaning by emphasizing kitchen-table leadership, an approach that invites people to the table whose voices and needs are typically excluded from conversations around solutions for preventing violence. MESA believes it is important to build trust and develop genuine relationships with the community as opposed to looking at relationships as transactional or from a business perspective. They spend time attending community gatherings as a way to engage deeply with community members. Before even bringing up sexual violence prevention, MESA works to ensure that community members know that they matter and are important by providing them an opportunity to express themselves. With the goal of empowering communities to shape the agenda, MESA assesses and begins with community strengths. MESA often takes time to explain the critical importance of community outreach, so funders can better understand cultural nuances and how certain activities connect to prevention. For instance, to address barriers to sexual violence prevention — such as taboos surrounding sexuality, safer sex, and violence — MESA facilitated dialogue in communities that value oral traditions through activities like Theatre of the Oppressed (using theater as a tool for social change) or the creation of fotonovelas (graphic novels). In their various activities, MESA not only talks about sexual violence prevention, but understands that addressing related health equity concerns like food access or community safety is necessary to support their prevention work. MESA believes in the importance of acting as facilitators while the community has ownership of the various processes. They see this as the best way to ensure that the issues most affecting communities are being addressed. MESA sees its work at the intersections of preventing sexual and other forms of violence, ending racism and patriarchy, and promoting health equity. Creating Spaces For Healing in Prevention Efforts To foster health equity, it is important to recognize prevention and healing as connected. People doing prevention work may be survivors of violence, and they also may be experiencing the echoes of generations of violence and trauma. Many advocates and practitioners are integrating culturally rooted healing and accountability practices, like healing circles and listening sessions. Giving attention to community healing can support sexual violence prevention by helping to challenge norms, such as a culture of silence or a “this doesn’t happen here” culture, that contribute to sexual violence and tolerance of violence (Critical Resistance, n.d.). Through connected efforts, communities can demonstrate willingness to take action on sexual violence as a community issue and together reshape culture. The global #MeToo movement has shown the power of bringing healing and prevention together. As survivors spoke out about their experiences of sexual violence, they made this often-hidden issue more visible and increased community accountability. While RPE funding is not permitted to be used for victim advocacy or response efforts, the programs and practices described here are different because they focus on challenging larger cultures of silence and tolerance of sexual violence. To foster health equity, it is important to recognize prevention and healing as connected. Spotlight on Visioning B.E.A.R. Circle Intertribal Coalition: Rooting a Curriculum in Indigenous Values Related technical package strategies: Promoting social norms that protect against violence; teaching skills to prevent sexual violence Visioning B.E.A.R. (Balance, Equality, and Respect) Circle Intertribal Coalition, along with survivors in the community, wanted to establish their own way of rebuilding Indigenous and multicultural communities and restoring a sense of wholeness as part of preventing sexual and domestic violence. For Visioning B.E.A.R., it is important to consider the impact of colonization on the present-day structural violence impacting their communities (e.g. displacement from original lands, separation of families, etc.). This vision was the foundation for the Walking in Balance with All Our Relations curriculum, a curriculum rooted in the values of Indigenous people prior to colonization (Visioning B.E.A.R Circle Intertribal Coalition, n.d.). The Walking in Balance curriculum allows for healing at all levels, including ancestral healing, present-day healing, and the healing of future generations. Divided into 12 three-hour modules based on Indigenous values — such as true democracy, empathy, connection to the land, and courage — the curriculum is meant to serve as a way of life. The Walking in Balance Curriculum is built to show community members that they are resilient, and that the community can reform itself into love and reconciliation through recognizing, acknowledging, and healing one’s pain. One element includes using transformative justice circles to teach healing practices in the pursuit of interpersonal violence prevention. The Talking Stick Circle Process creates a safe space for people to share their experiences, pain, and harm. Visioning B.E.A.R. believes that there is no harmony or justice until every voice is heard. Spotlight on Black Women’s Blueprint: Truth-Telling and Reconciliation for Prevention and Healing Related technical package strategies: Promoting social norms that protect against violence; mobilizing men and boys as allies Black Women’s Blueprint is a national Black feminist organization that works at the grassroots and institutional levels to address gender-based violence against women and girls in Black, African American, and other communities of color. Black Women’s Blueprint launched the Black Women’s Truth and Reconciliation Commission, together with survivors of gender-based violence across the United States. They create models and systems of accountability and safety that reconcile survivors with their communities. By creating a culture supportive of gender equity and community accountability, and changing norms around violence in communities, this work sets forth conditions that can reduce the likelihood of future violence. The Truth and Reconciliation Commission has created opportunities for engagement in community settings. For instance, they have worked in churches where ministers have expressed a commitment to ending violence. This partnership has been especially important because churches and faith organizations are often the first points of contact for someone who has experienced or is committing violence; they are also culture keepers and culture translators. The Commission has also gone to barbershops to engage men in spaces where they already gather. In these spaces, men can have candid conversations about their experiences and complicity in violence against Black women and then work from a place of truth-telling to move toward solutions and restorative measures for reconciliation. The Commission recognizes the importance of meeting men where they are at, but also believes that creating a space for reconciliation means fostering an environment for men, women, and nonbinary individuals to listen to each other about what has been hurting them, hold each other accountable, and make amends. Facilitating Internal Organizational Change Many organizations, agencies, and coalitions that focus on preventing sexual violence through a health equity lens have talked about the importance of making sure their internal practices match up with their mission and goals. This work includes examining internal structures and processes, leadership and staffing, partnerships, and distribution of resources. For example, if an organization has a commitment to anti-racism and anti-oppression and wants to better support staff in speaking out against racism and other forms of oppression, they may want to begin with an all-staff conversation to discuss questions such as the following: How can we create a supportive environment where all staff can express their thoughts and concerns and be their authentic selves? What are ways we can embed anti-oppression principles to address microaggressions — a form of indirect or subtle discrimination — such as stereotyping or “othering” within our organizational culture? How can we create and uphold policies around equitable hiring, pay, and retention of diverse staff? Resource: Futures Without Violence (n.d.) has a series called Anti-Racism as Violence Prevention with stories from advocates on ways to begin dismantling racism in organizations and communities. Spotlight on the Michigan Coalition to End Domestic and Sexual Violence: Refining Internal and External Processes to Incorporate Intersectionality (Rennie & Winchell-Caldwell, 2020) Related technical package strategies: Promoting social norms that protect against violence; strengthening economic supports for women and families; establishing and consistently applying workplace policies In 2013, the Michigan Coalition to End Domestic and Sexual Violence (MCEDSV) made the decision to embed intersectionality — a framework for understanding how power structures interact across multiple identities to reinforce and sustain oppression (Crenshaw, 1991) — into all elements of their prevention work. The coalition recognized their challenges in offering appropriate services for individuals with layered marginalized identities (e.g. queer people of color). As part of this, MCEDSV looked inward to examine internal representation and began to rethink their hiring process. MCEDSV changed the language used in postings, shifted the locations of where the jobs were posted, and tried to address pay equity. With an emphasis on economic justice across their work, MCEDSV has added a wage scale that weighs life experience equally alongside education and other factors. MCEDSV revised workplace policies to include opportunities for additional flexibility, including, but not limited to, extended emergency leave, sabbaticals, and allowing children in the workplace. They have transitioned their commitment to economic justice externally and have worked on changes for paid family leave and fair living wage policies. By 2021, 18 percent of the staff were people with a disability, 51 percent were LGBTQ, and 65 percent were people of color. The Coalition also created UMOJA, which means unity and stands for “Uniting and Mobilizing Opportunities for Justice and Access.” UMOJA is an internal anti-oppression workgroup with the goal of being a space for inclusive and accountable discussions around organizational structures and processes. Members meet monthly and share decision-making, responsibility, and leadership across all levels of the organization. The Michigan Coalition to End Domestic Violence and Sexual Assault is not only making changes internally, but is also investing in leaders within the field. Each year, they select a cohort of emerging leaders that emphasizes developing skills as well as learning how to deal with secondary trauma, marginalization, and vulnerability as leaders. MCEDSV is committed to investing in intersectionality, economic justice, and representative leadership across their portfolio of work. Spotlight on Oregon Coalition Against Domestic and Sexual Violence: Making Space for Liberation in Anti-Oppression Practices (Somji, 2018) Related technical package strategies: Promoting social norms that protect against violence The Oregon Coalition Against Domestic and Sexual Violence (OCASDV) has spent time identifying how oppression against and within communities of color and other marginalized communities contributes to sexual and domestic violence. OCASDV developed Prevention Through Liberation, which serves as both a framework and grant project, after noticing that prevention models across the country often did not identify or address oppression as a root cause of sexual violence. They believe that oppression is the root of violence and see liberation from oppression as critical for stopping sexual and domestic violence and promoting sexual and relational health. Prevention Through Liberation recognizes the contributions (historical and current) of communities impacted by oppression and strives to dismantle systems of exploitation and harm. At the core of OCADSV’s anti-oppression practices is listening to communities about the impacts of oppression and better understanding underlying historical trauma. The coalition hosts various ongoing workgroups and caucuses focused on racial equity and anti-oppression in the domestic violence and sexual assault advocacy field in Oregon, including the Communities of Color Task Force, People of Color Caucus, Aspiring White Allies of Oregon, and the Queer Caucus. These workgroups and caucuses help build OCADSV’s internal capacity for anti-oppression work and builds the capacity of coalition member programs. One way that the coalition puts its values into practice is by providing mini grants for communities. The Prevention Through Liberation grant program is designed to support capacity-building focused on anti-oppression work as primary prevention of sexual violence among marginalized communities. It emphasizes work by and for communities impacted by oppression. The coalition continues to focus on helping build capacity so that communities have the power to shape their environments and relationships as part of the Prevention Through Liberation movement. Addressing Underlying Factors That Contribute to Violence and Safety Multiple forms of oppression, like racism, sexism, and ableism, impact the environments where people live, work, and exist. These community environments shape the norms and behaviors that contribute to sexual violence perpetration. For example, generations of colonialism, racism, and sexual objectification of Indigenous women and girls have created vast power inequities and contributed to poverty, lack of housing, involvement in child welfare and criminal justice systems, and higher rates of murder and sexual violence perpetration against Native women by Non-native men (MartinRogers & Pendleton, 2020; National Congress of American Indians, 2018). If we want to prevent sexual violence, we need to understand and address the underlying factors that contribute to it. Multiple forms of violence — including sexual violence, intimate partner violence, violence affecting youth, and other forms of violence — often share the same underlying factors. The Centers for Disease Control and Prevention’s Connecting the Dots publication includes research about addressing the links amongst these multiple forms of violence (Wilkins et al., 2014). Communities can work to decrease risk (by addressing risk factors) and strengthen or build resilience (by reinforcing protective factors). Because there is limited research on protective factors at the community and societal levels, the table below only shows risk factors from CDC associated with sexual and intimate partner violence — though practitioners and advocates often know from first-hand experience what might be a protective factor based on risk factors and local context. However, community connectedness is a known and researched protective factor for preventing sexual, intimate partner, and other forms of violence (Wilkins et al., 2014). Community-level risk factors for intimate partner violence and sexual violence: Poverty Lack of economic opportunities/high unemployment rates General tolerance of sexual and intimate partner violence within the community, such as viewing abuse as a private matter Weak community sanctions against those who use violence against others Societal-level risk factors for intimate partner violence and sexual violence: Societal norms that support sexual violence and intimate partner violence Weak laws and policies related to sexual and intimate partner violence and gender equity Harmful gender norms around masculinity and femininity (Dills et al., 2019) Community environments — where we live, work, and play — are places where we can push back against root causes of violence. For example, looking at where we work, we can support economic security and commit to addressing sexual violence as a workplace issue. By addressing underlying risk factors and promoting protective factors, we can influence the entire community’s experiences, exposures, and behaviors; lessen the likelihood of sexual violence; and begin to address power inequities and oppression. Spotlight on Colorado Department of Public Health: Improving Climates to Prevent Violence Related technical package strategies: Addressing community-level risk through environmental approaches; improving safety and monitoring in schools The Colorado Department of Public Health and Environment adopted hot spot mapping as part of its strategic plan to prevent sexual violence, teen dating violence, and related safety and health issues (CDPHE, n.d.). Hot spot mapping is an evidence-informed approach from the evaluated Shifting Boundaries curriculum (Stein et al., 2010) used to pinpoint areas that are “hot” and “cold” — spaces that correspond with students feeling unsafe or safe. Community members propose recommendations for change, including thinking about the impact of community and relationship-level risk and protective factors — from community disorganization to community and school connectedness to youth and adult connectedness. After participating in hot spot mapping activities, youth in multiple schools noted similar safety concerns. Unsupervised stairwells, bathrooms, locker rooms, and school buses emerged as unsafe spaces in schools around the state. For example, students noted feeling unsafe on school buses, because there were not enough seats for the number of students riding the bus. Students shared that they were being told to sit on each other’s laps or pack into rows of seating, which created opportunities for harassment, touching, and potential assault. Through hot spot mapping, students and school leaders were able to approach the transportation department and make changes to make bus routes safer, such as increased adult supervision and reduced busloads. In the community hot spot mapping example, Spanish-speaking residents noted that they did not feel safe in some public spaces because of language barriers and lack of inclusive signage and cultural understanding. Youth who led the hot spot mapping activities compiled their recommendations and presented them to city council, their mayor, the county sheriff, and chief of police. As a result, bilingual signage was added in all public offices, and conversational language classes and cultural responsiveness trainings were implemented. Despite the COVID-19 pandemic and the need for distancing and online schooling, Colorado continued to conduct hot spot mapping activities virtually with youth and community partners, including mapping social media spaces. As definitions of safety morphed during the pandemic, approaches to enhance safety and prevent violence evolved to maintain alignment with community needs. Overall, the hot spot mapping work reveals how community engagement, youth leadership, and shared decision-making are crucial to bringing about positive social change. Spotlight on The Alaska Network on Domestic Violence and Sexual Assault: Eliminating the Gender Wage Gap Related technical package strategies: Establishing and consistently applying workplace policies; strengthening economic supports for women and families; strengthening leadership and opportunities for girls (women) The Alaska Network on Domestic Violence and Sexual Assault (ANDVSA) is a statewide dual domestic violence and sexual assault coalition whose vision is to promote and sustain a collective movement to end violence and oppression through social change. After receiving funding from the CDC in 2019, ANDVSA sought to strengthen economic supports for families. They knew Alaskan women only earned 68 cents on the dollar (Hillman, 2015) in relation to men in 2017 — a disparity larger than most other states. They also knew research shows both sexual and domestic violence is more common in households where one partner has greater economic and decision-making power than another (World Health Organization [WHO], 2010). With this information on their minds, ANDVSA initiated a partnership with the YWCA of Alaska, an organization focused on social justice and economic empowerment. The YWCA of Alaska already had a program called EconEquity with the goal to eliminate the gender pay gap in Alaska by 2025. This program offered both support to employers to identify and change inequities along with education to women and girls on career choice and salary negotiation. People from many different fields have roles to play in the movement to prevent sexual harassment, abuse, and assault. The partnership between ANDVSA and YWCA sought to lift up the EconEquity approach and use ANDVSA’s statewide network to expand the program across Alaska while increasing the urgency of reaching the 2025 goal by connecting it to the epidemic of domestic and sexual violence in the state. The partnership offered hope for a new approach to sexual and domestic violence prevention in the state and provided a boost to the pay equity initiative that was gaining traction. Due to changes in executive leadership and strategic priorities at YWCA, the collaborative work stalled. ANDVSA had to reckon with its own lack of experience working in the realm of economic justice and economic supports for families, within the context of Alaska’s 2019 economic reality: three years of recession and job loss (Robinson, 2019) and an imbalanced budget due to the lowered price of oil, which accounts for 80% of state revenues (Forbes, 2021). The challenges of partnerships, state context, and the stretch of pushing domestic violence and sexual assault prevention efforts into new, unexplored realms of work sent ANDVSA back to the drawing board. Currently, Alaska is working to find new ways and continues its journey to address one of the root causes of violence: economic inequities and lack of financial support for families. Partnering Across Fields and Movements People from many different fields have roles to play in the movement to prevent sexual harassment, abuse, and assault. This is because undoing and restructuring the systems that perpetuate oppression requires us all to work together. Also, we all live dynamic lives and interact with many parts of society on a day-to-day basis — from health to education to transportation — that shape our health, safety, and well-being and affect our relationships with others. Those different fields together can address underlying factors that contribute to sexual violence, such as harmful gender norms or lack of economic opportunity — which would be difficult for one field to do alone. Partnerships driven by community leadership can include fields like public health, community development, businesses/workplaces, social justice, and sports, among others. Resource: Working with community members and across fields and social justice movements requires understanding each other’s goals, areas of expertise, resources, and more. Prevention Institute’s Collaboration Multiplier Tool can help illuminate how efforts across multiple fields can reduce sexual violence while identifying shared goals and strategies and advancing each partner’s desired outcomes (Prevention Institute, n.d.). potlight on the Bloomington Inclusion Collaborative in Indiana: Fostering Community Connectedness Related technical package strategies: Addressing community-level risk through environmental approaches Understanding that community support and connectedness are protective factors to prevent sexual violence, the Indiana Coalition Against Domestic Violence set out to increase inclusion in the City of Bloomington. They developed the Bloomington Inclusion Collaborative and partnered with people with developmental and cognitive disabilities and local government, public/private agencies, and community-service organizations. The collaborative employed participatory social mapping through PhotoVoice and geographic information systems (GIS) to identify how community environments have differential impacts on risk for violence against people with disabilities. Participants used Google Maps to show barriers in the environment which impeded their inclusion and increased their risk for experiencing violence. For example, the lack of roadway, limited sidewalk connectivity, poor road or sidewalk conditions, or lack of access into the local mall for a person who cannot open the door impeded their inclusion. From this process, the collaborative learned that roadway and sidewalk connectivity was one of the most prevalent barriers in accessing community spaces as well as social, financial, and medical resources for people with developmental and cognitive disabilities. Connectivity is a protective factor against violence because it broadens social networks — more social connections mean more people checking in with each other and calling out when things do not seem right. This can also help address social norms around privacy and silence that allow sexual violence to continue uninterrupted. By bringing together emergent leaders with disabilities and established local and state level leaders, the collaborative fostered belonging and civic engagement. People with disabilities were able to speak up about how exclusion and isolation are built into structures, which affects their ability to engage in their neighborhoods, public spaces and businesses. Through this process, they were also able to advocate for community-specific systems change. This work resulted in more people with disabilities participating in transportation advocacy forums and an increased number of connected sidewalks, curb cuts, and paved bus stop landing pads. At the Monroe County Public Library, there were also increased acoustics through environmental design for people with low vision or who are blind. Resource: The Indiana Coalition Against Domestic Violence’s Sidewalks to Sexual Violence Prevention (ICADV, 2017) is a guide to exploring social inclusion with adults with developmental and cognitive disabilities. In NSVRC’s Mapping Evaluation podcast, the coalition talks about using PhotoVoice for evaluating prevention work (2018). Spotlight on One Fair Wage: Elevating the Connection Between Tipped Wages and Sexual Harassment Related technical package strategies: Strengthening economic supports for women and families; establishing and consistently applying workplace policies One Fair Wage brings together movements for economic, racial, and gender justice to advocate for workers in the restaurant and service industries. As a national coalition, campaign, and organization, One Fair Wage raises the connection between tipped wages and sexual harassment, abuse, and assault as a social justice issue. One Fair Wage seeks to establish a living wage that is not dependent on tipping, which decreases tipped workers’ exposure to exploitation, wage theft, financial insecurity, discrimination, and sexual harassment (The Restaurant Opportunities Center United, 2018). They call attention to the fact that 70 percent of tipped workers are women, and workers dependent on tips report experiencing the highest levels of harassment from customers, colleagues, and management (One Fair Wage, 2020a). Reframing the issue of tipped wages as a sexual violence issue, rather than only using an economic angle, has significantly helped advance their work to develop better policies across the restaurant and other service industries. In 2019, 16 states introduced One Fair Wage bills, and the US House of Representatives passed the Raise the Wage Act, which includes a $15 federal minimum wage and full elimination of the subminimum wage for tipped workers, workers with disabilities, and youth (One Fair Wage, 2020b). Working Together to Create Equitable, Respectful Communities Advocates and practitioners across the country have made significant progress in advancing a health equity approach to preventing sexual violence. By elevating community leadership and resilience, creating spaces for healing in prevention efforts, facilitating internal organizational change, addressing underlying factors that contribute to violence and safety, and partnering across fields and movements, communities are building collective power and challenging longstanding power inequities. Leading with a health equity approach is complex and requires time, but taking these types of actions can help ensure that the movement to prevent and end sexual violence continues to foster equity and safety. Spotlighted Organizations Alaska Network on Domestic Violence and Sexual Assault https://andvsa.org/ Black Women’s Blueprint http://www.blackwomensblueprint.org/ Bloomington Inclusion Collaborative https://icadvinc.org/sidewalks/ Colorado Department of Public Health and Environment https://cdphe.colorado.gov/prevention-and-wellness/sexual-violence-prevention Indiana Coalition Against Domestic Violence https://icadvinc.org/ Michigan Coalition to End Domestic and Sexual Violence https://mcedsv.org/ Multicultural Efforts to End Sexual Assault https://www.asec.purdue.edu/mesa/ New Jersey Department of Children and Families’ Division on Women https://www.nj.gov/dcf/women/ One Fair Wage https://onefairwage.site/ Oregon Coalition Against Domestic and Sexual Violence https://www.ocadsv.org/ Visioning B.E.A.R. (Balance, Equality, and Respect) Circle Intertribal Coalition https://visioningbear.org/ References Asare, A. (2018). Community ownership and relationship building with multicultural communities: How Multicultural Efforts to End Sexual Assault (MESA) supports holistic prevention in Indiana. California Coalition Against Sexual Assault, PreventConnect. http://www.preventconnect.org/wp-content/uploads/2018/07/ PreventConnect-Guest-Profile-Community-Ownership.pdf?x47887 Basile, K. C., DeGue, S., Jones, K., Freire, K., Dills, J., Smith, S. G., & Raiford, J. L. (2016). STOP SV: A technical package to prevent sexual violence. U.S. Department of Health & Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/pdf/sv-prevention-technical-package.pdf Colorado Department of Public Health and Environment. (n.d.). Sexual violence prevention [Webpage]. State of Colorado. https://cdphe.colorado.gov/prevention- and-wellness/sexual-violence-prevention Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299. https://doi.org/10.2307/1229039 Critical Resistance. (n.d.). Addressing harm, accountability and healing [Webpage]. http://criticalresistance.org/resources/addressing-harm-accountability-and-healing/ Dills, J., Jones, K., & Brown, P. (2019). Continuing the dialogue: Learning from the past and looking to the future of intimate partner violence and sexual violence prevention. U.S. Department of Health & Human Services, Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/pdf/sv/Continuing- The-Dialogue-508.pdf Farnsworth, P. (Host). (2019, September). All nations rise: Undoing intergenerational trauma & healing through solidarity w/ Lyla June (208) [Audio podcast episode]. In Last Born in the Wilderness. Spotify. https://open.spotify.com/episode /7hLjTiZHXjFbxWG7etEtz1 Forbes. (2021). Best states for business 2019: Alaska [Webpage]. Forbes Media. https://www.forbes.com/places/ak/?sh=55454bfb6800 Fujie Parks, L., Piatt, A., Fulton, D., Lee, D., & Marroquin, J. (2018). Building bridges to culturally-informed prevention. California Partnership to End Domestic Violence & California Coalition Against Sexual Assault. https://www.calcasa.org/wp-content/uploads/2019/02/BuildingBridges_021119.pdf Futures Without Violence. (n.d.). Anti-racism as violence prevention [Webpage]. https://www.futureswithoutviolence.org/health/racism/ Hillman, A. (2015, August 26). YWCA is one year closer to closing the wage gap for women [Blog post]. Alaska Public Media. https://www.alaskapublic.org /2015/08/26/ywca-is-one-year-closer-to-closing-the-wage-gap-for-women/ MartinRogers, N., & Pendleton, V. (2020, December). Missing and Murdered Indigenous Women Task Force: A report to the Minnesota Legislature. Wilder Research. https://www.wilder.org/sites/default/files/imports/ MMIW_TaskForceReport_12-20.pdf National Congress of American Indians. (2018, February). Research policy update: Violence against American Indian and Alaska Native women. National Congress of American Indians Policy Research Center. https://www.ncai.org/ policy-research-center/research-data/prc-publications/VAWA_Data_Brief__FINAL_2_1_2018.pdf National Sexual Violence Resource Center. (2016). The impact of sexual violence. National Sexual Violence Resource Center. https://www.nsvrc.org/sites/default /files/2016-01/saam_2016_impact-of-sexual-violence.pdf National Sexual Violence Resource Center. (2018, April 2). Program example: Using PhotoVoice with stakeholders with developmental disabilities [Video podcast]. In Mapping Evaluation. YouTube. https://www.youtube.com/ watch?v=VWe9H96Woxs National Sexual Violence Resource Center. (2019). Risk and protective factors [Infographic]. https://www.nsvrc.org/risk-and-protective-factors National Sexual Violence Resource Center. (2020). Sexual violence and oppression. https://www.nsvrc.org/sites/default/files/publications/2020-08/OppressionFINAL508.pdf One Fair Wage. (2020a). Our work [Webpage]. https://onefairwage.site/our-work One Fair Wage. (2020b). State campaigns [Webpage]. https://onefairwage.site/state-campaign Prevention Institute. (n.d.). Collaboration multiplier. https://www.preventioninstitute.org/tools/collaboration-multiplier Rennie, S. P., & Winchell-Caldwell, L. (2020, Spring). Addressing the whole: Prevention and intervention. The Resource: The National Sexual Violence Resource Center Newsletter, 8–12. National Sexual Violence Resource Center. https://www.nsvrc.org/sites/default/ files/publications/2020-05/TheResourceSpring2020.pdf The Restaurant Opportunities Centers United. (2018, May). Take us off the menu: The impact of sexual harassment in the restaurant industry. https://rocunited.org/ wp-content/uploads/sites/7/2020/02/TakeUsOffTheMenuReport.pdf Robinson, D. (2019, February). 4 things to know in 2019. Alaska Economic Trends, 39(2), 4–9. Alaska Department of Labor and Workforce Development. https://labor.alaska.gov/trends/feb19.pdf Somji, A. (2018). Prevention through liberation: Dismantling oppression and promoting sexual and relational health in Oregon. California Coalition Against Sexual Assault, PreventConnect. http://www.preventconnect.org/wp-content/uploads/ 2018/07/PreventConnect-Guest-Profile-Prevention-Through-Liberation.pdf Stein, N., Mennemeier, K., Russ, N., & Taylor, B. (2010). Shifting boundaries: Lessons on relationships for students in middle school. Wellesley Centers for Women. http://www.wcwonline.org/proj/datingviolence/ShiftingBoundaries.pdf Thomas-Williams, C. O. (2017). Sidewalks to sexual violence protection: A guide to exploring social inclusion with adults with developmental & intellectual disabilities. Indiana Coalition Against Domestic Violence. https://icadvinc.org/wp-content/uploads/ 2019/12/new-sidewalks-to-sexual-violence-prevention.pdf Visioning B.E.A.R Circle Intertribal Coalition. (n.d.). Walking in balance with all our relations. Visioning B.E.A.R. https://visioningbear.org/walking-in- balance-curriculum/ Wilkins, N., Tsao, B., Hertz, M. F., Davis, R., & Klevens, J. (2014). Connecting the dots: An overview of the links among multiple forms of violence. U.S. Department of Health & Human Services, Centers for Disease Prevention and Control. https://www.cdc.gov/violenceprevention/pdf/connecting_the_dots-a.pdf World Health Organization, & London School of Hygiene and Tropical Medicine. (2010). Preventing intimate partner and sexual violence against women: Taking action and generating evidence. World Health Organization. https://www.who.int/ violence_injury_prevention/publications/violence/9789241564007_eng.pdf ©2021 Prevention Institute & National Sexual Violence Resource Center. All rights reserved. This publication was supported by the Grant or Cooperative Agreement Number 6 NUF2CE002510-02-04, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.