Problem
Violence affects millions of individuals each year, with women being particularly vulnerable. According to the WHO, around one-third of women worldwide have suffered physical trauma from either intimate partners or strangers. In the US alone, the CDC estimates that over 10 million women and men experience intimate partner violence each year. Common injuries resulting from violence include bruises and other soft tissue trauma, affecting individuals from children to the elderly. The documentation and assessment of these injuries play a crucial role in survivors’ health and legal outcomes. Undetected injuries can lead to untreated or undiagnosed conditions, potentially resulting in severe consequences, such as in the case of strangulation or chronic abuse. Conversely, when injuries are documented, survivors are more likely to feel validated and empowered.
Racial minorities experience a higher rate of intimate partner violence (IPV) than non-Hispanic Whites, indicating a need for greater attention to address potential differences in how their injuries are assessed. Bruising, caused by blunt or crushing force trauma, occurs when blood vessels are damaged, leading to the escape of red blood cells into the skin. However, identifying bruises on dark skin tones is challenging due to the skin’s structure and higher melanin levels. Melanin is a brown pigment deposited in the epidermis. Its presence in high concentrations can obscure bruises, which primarily form in the dermis layer. This complexity makes detecting bruises difficult, especially on dark skin or when bruises are faint or old. Unlike surface skin lesions like melanoma, bruises are harder to detect due to their deeper location.
US Legislation
National coverage of these early advancements drew the attention of director and humanitarian Angelina Jolie. During the 2022 Congressional hearings on the reauthorization of the Violence Against Women Act (VAWA), Ms. Jolie and Ruth Glenn referred to our work as an example of what can be done to address inequities in health and legal outcomes associated with injury detection. As a result, the legislation specifically expands funding for “technology that better detects bruising across skin tones” (VAWA Reauthorization Act of 2022, S.3623, 117th Cong., 2022).
Patents
Scafide, K., Lattanzi, D., & Wojtusiak, J. (2023, September). Systems and processes for automated detection and characterization of skin features using machine learning (Provisional US Patent Application 18/478,466). U.S. Patent and Trademark Office.