Welcome to TEDMED conversations. I’m Kelly Thomas. I’m joined today by April Zeoli.

April is an associate professor of health management and policy at the School of Public Health at the University of Michigan and director of policy core at the Institute for Firearm Injury Prevention, also at the University of Michigan. Her research focuses on the prevention of firearm violence, intimate partner violence, and homicide through the use of policy and law. April, thank you so much for joining us today to have this conversation.

Yeah. Thank you for having me.

Before we dive into your research, I think it’s important to understand some of the nuances of intimate partner violence. So can you describe that for us?

Sure. Intimate partner violence is a dynamic where one partner tries to control the other partner.

And they do this through a series of strategies and a pattern of behaviors.

And those patterns of behaviors and strategies could include physical violence. Often it does. It could include sexual violence, emotional abuse, psychological abuse, financial abuse, and, you know, many other types of abuse.

But what the perpetrator is doing is making it so that their partner relies on them, obeys them, and often, you know, they’re reducing the external supports, family supports, friend supports that their partner, the victim, has.

How has this type of violence changed and evolved over time?

Intimate partner violence has likely always been around. You know, we see examples of it in Shakespeare’s The Taming of the Shrew, for example, but it hasn’t always been deadly.

And if we look at the United States in its founding period in the eighteen hundreds, there aren’t many intimate partner homicides.

It’s only when we get to the nineteen hundreds and, you know, further that we see intimate partner homicide really pick up. And some of that is due to the availability of firearms.

Firearms were not widely available, you know, before eight the eighteen thirties. There were no mass produced handguns before the eighteen thirties.

And we also see not only are firearms changing the landscape, but the household unit isn’t the same as it used to be.

Previously, there were these strict gender roles where the men would do one thing and the women would do another thing, and both parties needed the other to function. The woman needed the husband to bring in money. The husband needed the wife to raise the kids and run the household.

That isn’t the case anymore. People can manage on their own. So intimate partner homicides have become more common as people are determining that they don’t need to keep the other person alive.

And, in fact, they decide they want to kill the other person.

It’s devastating.

I know that you’ve been researching all of these policies and laws and work on helping to understand which are the best ones. What do you see as the best policy and laws that are in place now that can help people and protect people who are in these types of relationships and and feel these threats?

The law that has the most support in the research for preventing intimate partner homicides are domestic violence protective order firearm restrictions.

Now this law is in place at the federal level, and most states have some kind of law around this that says that if you’re under a certain kind of domestic violence protective order, you can’t purchase or possess a firearm.

And those laws are associated with reductions in intimate partner homicide at the state level.

And we do know that the laws aren’t created equally between states. You know, they differ between states, and there are some elements of the law that may make them more effective.

For example, covering dating partners as people who can get the firearm restriction is probably really important.

And when you think about it, it makes sense. Our average age at marriage today in twenty twenty four is much higher than it was fifty years ago. You know, fifty years ago, people were getting married in their late teens and early twenties, and that was common even, you know, possibly the average age.

Today, we’re getting married in our late twenties and early thirties. So people are spending a whole lot more time dating and being exposed to dating partners.

Intimate partner violence hasn’t changed, though.

It’s just that now it’s the dating relationship in which these homicides occur instead of the marital relationship.

And in fact, over half of intimate partner homicides today are committed by dating partners.

Are more states starting to adopt that policy of including dating partners with these statistics coming out? Yes. More states are adopting that policy.

We just saw in twenty twenty two, the federal government add dating partners to its list of people who can be prohibited from having a gun if convicted under a misdemeanor crime of domestic violence.

However, the federal government hasn’t added dating partners to their domestic violence protective order firearm restriction yet.

Now are these the same as the extreme risk protection orders or the red flag laws, or is that something different?

Extreme risk protection orders or red flag laws are different. Domestic violence protective orders, while they can include firearm prohibitions, they also include a lot of other safety measures to protect, you know, intimate partners and their children. For example, they can include stay away orders saying that the person under the order can’t get within x number of feet of you or can’t call you and harass you or it might have, a provision for temporary custody.

Extremist protection orders are just about the firearm.

So what those do is prohibit the purchase and possession of guns by someone who is at extreme risk of harming themselves or others in the near future for a temporary period, generally about a year.

And then after it expires, that person gets their firearm rights back. And I should mention a person gets their firearm rights back when a domestic violence protective order expires as well.

How effective have these red flag laws been in in actually reducing further violence even after maybe somebody might get their firearm back?

So extremist protection orders have not been around for very long.

Connecticut had the first of these laws in nineteen ninety nine and then Indiana in the mid two thousands.

The majority of states with these laws adopted them after the mass shooting at Marjorie Stillman Douglas High School in twenty eighteen.

So, you know, they’re pretty new.

There has been some research on the Connecticut Indiana laws that have found that they’re associated or there’s a suggestion that they reduce suicide.

There haven’t been associational studies that have shown a reduction in interpersonal violence, and that’s mostly because there just haven’t been these associational studies yet. I’m conducting a study of extremist protection orders in six states, California, Colorado, Connecticut, Florida, Maryland, and Washington.

And we looked at over six thousand six hundred extremist protection order case files.

And of those case files, about ten percent were for threats of mass shootings, threats to shoot and kill more than three people or at least three people.

And most of those petitions were granted. And when I say most, I mean that there are two phases in an extremist protection order. And at the first phase, over ninety percent of them were granted.

Of those that made it to the second phase, which was, you know, over eighty five percent of them, then over eighty percent of those were granted.

So the vast majority of cases of threats to shoot and kill at least three people were found to be credible by a judge who evaluated the evidence.

We also know that they’re being used in cases of intimate partner violence risk.

In this study, we found that twenty percent of these petitions were filed due to intimate partner violence, and that’s a threat of violence against an intimate partner or the use of violence against an intimate partner.

And some of these included firearm threats and firearm uses.

So we do see intimate partner violence being addressed by extremist protection orders in addition to domestic violence protective orders. We’re grateful that you are focused on this type of research and intimate partner violence and firearm violence. Thank you so much for chatting with TEDNA today. We really appreciate it. Thank you.