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OTE Volume 15 Number 4 - Winter 2009 Barriers to Reporting
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Barriers to Reporting Sexual Assault in Rural Areas       

Image of Laura Moore, MSN, FNP-BC
By Laura Moore, MSN, FNP-BC
On The Edge - Winter 2009
This article will discuss barriers to reporting sexual assault in rural areas and the need for more research concerning sexual assault in rural areas. I will also include an overview of recent research and journal articles on the topic of sexual assault, its prevalence, and barriers to reporting.

Definition of Sexual Assault
Sexual assault is a violent sexual act committed against an individual.  Women are the most frequent target of this type of assault (Crane 2006). According to Basile & Saltzmen (2002), sexual assault can be classified into four types of aggression forced upon another individual without consent. The first type is a completed sexual act in which an object (a penis, finger, or foreign object) is forcibly placed into another individual’s mouth, vagina, or anus.  In the second type, the act is attempted but not carried out. The third type of sexual assault is a physical act of sexual touching, without the victim’s permission. Finally, the fourth act does not involve physical contact but occurs when verbal or other demonstrations of sexual innuendo are forced upon the victim by the perpetrator.  “Forcible rape, as defined in the Uniform Crime Reporting (UCR) Program, is the carnal knowledge of a female forcibly and against her will” (FBI 2007, n.p.). Forcible rape will be the focus of this study.

The revival of The Women’s Movement in the 1970’s brought more attention to these violent behaviors. However, according to researchers, even more study of these acts of sexual violence is needed (Tijaden & Thoennes 1998; Sable, Danis, Mauzy & Gallagher 2006). Research which is focused on sexual assault against rural women is even less available and needs to be conducted (Annan 2006).  Factors which affect the reporting of sexual assault in rural communities include rural beliefs, implications for rural women, and the lack of rural services will be discussed further throughout this article.

Prevalence of Sexual Assault
From 1995 to 1996, the National Institute of Justice and the Centers for Disease Control (NIJ & CDC) conducted the National Violence Against Women (NVAW) Survey (Tijaden & Thoennes 1998).  In this study, 16,000 men and women were surveyed in order to collect information on the frequency and occurrence of violent acts such as rape and physical assault.  The report primarily focused on women  almost 20% of who reported that they had been victims of sexual assault (Tijaden & Thoennes 1998).  Another study reported that almost 1 out of every 6 women has been a victim of an attempted or completed sexual assault (Basile, Lang, Bartenfield & Clinton-Sherrod 2005).  Over 300,000 women are victims of rape in the United States each year, and only 100,000 of these rapes are reported annually (Crane 2006; Sable, Danis, Mauzy & Gallagher 2006). Researchers agree that the area of unreported sexual assault warrants further investigation (Sable, Danis, Mauzy & Gallagher 2006; Johnston 2005; Rickert, Vaughan & Wiemann 2003).  Women in rural areas have a higher rate of sexual assault but a lower prevalence of reporting than urban women and these rural women face unique factors that limit their reporting abilities. (Annan 2006; Lewis & Reed 2003).

Importance of Reporting Sexual Assault
In their descriptive, exploratory study, Stermac, Dunlap & Bainbridge (2005) predicate that it is imperative that victims of sexual assault come forward and allow proper and accurate evidence collection because this directly impacts the legalities involved in prosecution and conviction of the perpetrator.  In a survey study conducted by Logan, Cole & Capillo (2007) Sexual Assault Nurse Examiners (SANEs) were proven to successfully meet the needs of sexual violence victims by way of evidence collection, timeliness of response, and coordination with other resources such as law enforcement and crisis centers. It is therefore crucial that women in both urban and rural settings have the knowledge and means to effectively report their assaults.

Assailants of Sexual Assault
A study of 1,018 sexually assaulted women revealed that half of those women were assaulted by an intimate partner or a friend; while almost twenty percent of the women knew their attacker for less than a day; and slightly more than a quarter of the women were violated by a stranger (Stermac, Dunlap & Bainbridge 2005). However, the rate of sexual assault by a stranger is significantly lower in rural areas though the exact percentage is not known (Annan 2006). Averill, Padilla & Clements (2007) speculate that this lower rate is due to the decreased level of anonymity in rural areas.

Definition of Rural
According to the United States Department of Agriculture, almost 60 million Americans live in rural areas and “rural areas comprise open country and settlements with fewer than 2,500 residents” (USDA 2003, n.p.).  Averill, Padilla & Clements (2007) define rural areas as having 7-99 residents in a square mile and as having a health facility with no more than 100 beds within an hour’s driving time. They also point out that the definition of rural can be confusing at times and should be thought of as a continuum based on facets of criteria such as geography, resources and residents’ beliefs.

Rural Beliefs
Many rural individuals view men as superior to women or “head of the household”, thus unintentionally enabling those male abusers to continue their sexual abuse without censure (Averill, Padilla & Clements 2007, p. 44).  As a result of this belief, rural women, whether the abuser’s intimate partner or otherwise, might not realize that the sexual assault act is, in fact, abuse.  In an interview of rural individuals, some participants expressed opinions that women could provoke a sexual assault by wearing enticing clothing, and half of the rural residents interviewed believed that the women should have had the ability to physically resist their attackers (Annan 2006).  Other researchers suggests that “. . . there are often informal social controls in rural areas that influence behavior, including service utilization and crime reporting, which differs from many urban areas” (Logan, Evans, Stevenson, & Jordan 2005).  These controls which are bound by rural beliefs represent another area that hinders the reporting of sexual assault.

Rural Implications for Women
Women in rural areas face unique challenges. As previously mentioned, sexual assault is, unfortunately, a common violent act that many women suffer in silence every day. This is especially true for women living in rural areas. The Violence Against Women Act of 2005 identifies some of these unique variables in stating that:

The Rural Grant Program (Rural Program) recognizes that victims of domestic violence, dating violence, sexual assault, stalking, and child abuse living in rural jurisdictions face unique barriers to receiving assistance and additional challenges rarely encountered in urban areas. The geographic isolation, economic structure, particularly strong social and cultural pressures, and lack of available services in rural jurisdictions significantly compound the problems confronted by those seeking support and services to end the violence in their lives and complicate the ability of the criminal justice system to investigate and prosecute domestic violence, dating violence, sexual assault, stalking, and child victimization cases. In addition, sociocultural, economic, and geographic barriers create difficulties for victim service providers and other social services professionals to identify and assist victims of these crimes (United States Department of Justice n.d., n.p.).

These rural women face barriers to reporting and obtaining treatment that urban women do not. Lewis (2003) contends that these barriers are not fully understood and warrant further research. Perhaps a better understanding and more conclusive research will present a solution to this dilemma. The aforementioned disparities will now be discussed further.

Lack of Rural Services
One comparative study established that there is a disparity among supportive resources when comparing rural and urban victims of sexual assault (Logan, Stevenson & Jordan 2005). Despite the higher rate of sexual abuse among rural women, rural areas have few qualified counselors. In fact, about 50 million Americans living in rural areas do not have access to a family health care provider, much less a specialist in sexual violence (Logan, Walker, Cole, Ratliff & Leukefeld 2003).  Also, rural victims are frequently uninformed about the services that are available to them so the women might feel they have no one to turn to for help (Averill, Padilla & Clements 2007).

Barriers to Reporting by Rural Women
Rural women do not report sexual assault for many reasons (Averill, Padilla & Clements 2007; Annan 2006; Lewis 2003).  According to current research, there are four main barriers to reporting sexual assault: “affordability, availability, accessibility, and acceptability” (Logan, Evans, Stevenson, & Jordan 2005).  More particular to rural women, these barriers may more specifically include stigma, self-blame, no anonymity, fear of the attacker, lack of financial support, no police support, no telephone, no transportation, and lack of trust in law enforcement. The researchers point out that more investigation is needed to understand these unique barriers experienced by rural women. Because of the cycle of non-reporting and barriers to reporting, it is difficult to distinguish victims and their reasons for remaining silent. This further provides evidence as to the importance of further research in this area so that we, as a society and as caregivers, may more adequately help these rural victims.

Implications for Nursing Practice
Nurses and primary care providers have a unique opportunity to educate rural women in order to possibly decrease the rate of rural sexual assault and increase the rate of reporting sexual assault.  In fact, researchers point out that “. . .physical and sexual assault are prevalent among rural women and linked to health status and service use. . .the health sector that serves rural women may have opportunities to be involved in addressing and preventing assault” (Thurston, Patten & Lagendyk 2006, p. 266).  With more understanding on the subject, nurses and primary health care providers, who possibly are the victim’s only information source on sexual assault, can greatly help these rural women.  More research in this area is needed for this to be fully possible.

Sexual assault is, regrettably, a common act committed against women each and every day. It is statistically prevalent in the United States in both rural and urban areas. However, the aforementioned research indicates a higher prevalence of sexual assault and lower rates of reporting among victims of rural areas as compared to urban areas. Because of the unique barriers that rural women face, it is unknown how underreported sexual assault is in rural areas. It is important that these factors be thoroughly understood in order to help rural victims in overcoming these barriers to reporting sexual assault.

Laura Moore is a registered nurse at the University of Tennessee Medical Center in Knoxville, TN. She is also a senior-level nurse practitioner student at Carson-Newman College in Jefferson City, TN where she will graduate with a MSN degree May, 2009. She hopes to work in a rural area specializing in women’s health after graduation. In her free time, she enjoys reading, hiking and traveling. She currently lives in East Tennessee with her husband, Phillip and their schnoodle, Mary.

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