The Centers for Disease Control and Prevention runs the largest sustained federal effort on relationship violence prevention in the United States. The Division of Violence Prevention, created within the National Center for Injury Prevention and Control in 1993, has produced surveillance systems, technical packages, multi-site trials, and a body of evidence that no other actor in the field could have produced. It has also accumulated the characteristic limitations of a federal scientific agency operating in a politically contested space: caution about messaging, dependence on congressional appropriation, and a tendency to declare success on intermediate outcomes when terminal outcomes are slow to move.
The CDC's contribution is best understood in three layers. The first is surveillance. The National Intimate Partner and Sexual Violence Survey (NISVS), launched in 2010, gives the country its only ongoing national estimate of prevalence and incidence. Before NISVS, the field relied on the National Violence Against Women Survey, which ran twice and stopped. With NISVS, trends became visible at five-year intervals, subgroup differences could be tracked, and policy debates could be grounded in numbers that did not depend on which advocacy group commissioned them. The work is unglamorous, expensive, and indispensable.
The second layer is the technical package. The CDC's Preventing Intimate Partner Violence Across the Lifespan, published in 2017 and updated since, distills decades of evaluation evidence into six strategies—teaching safe relationship skills, engaging influential adults, disrupting developmental pathways, creating protective environments, strengthening economic supports, and supporting survivors. The package does not pretend each strategy is equally proven; it grades the evidence. For policymakers and program designers, the package is a Law 4 artifact: a plan that tells you what works, what is promising, and what is being tested.
The third layer is the trials. Dating Matters, the multi-component teen dating violence prevention program tested in Chicago, Baltimore, Fort Lauderdale, and Oakland, showed roughly fifteen percent reductions in perpetration in middle schools that received the full program compared with schools that received a single standard curriculum. The trial took ten years and tens of millions of dollars. It is the most rigorous evidence the field has for primary prevention at population scale. Its limits are also instructive: the effects, while real, are modest, and replication outside the trial cities is harder than the cities make it look.
The Law 2 dimension is the CDC's insistence on definitions, measurement, and replicable evidence. The agency has been criticized for moving slowly. The criticism is partly right and partly the price of doing the work properly. A federal agency that endorses an intervention before the evidence supports it will lose credibility when the intervention fails. The criticism is also partly wrong: the agency's slowness is not always methodological caution; sometimes it is political caution, particularly around topics like firearms in domestic violence cases, where congressional restrictions have repeatedly constrained research.
The Law 3 dimension is connection across violence types. The CDC's Connecting the Dots framework explicitly treats intimate partner violence, child maltreatment, youth violence, sexual violence, and suicide as related phenomena with shared risk factors. The framework has shaped funding so that prevention programs increasingly address multiple outcomes rather than competing for attention. The romantic lens benefits from this connection. A teen who grows up watching her father beat her mother is at elevated risk for everything in the list. A program that reduces childhood exposure to violence has effects she will feel decades later in her own relationships.
The Law 5 dimension—revise—is where the agency's record is mixed. Some programs have been retired when evaluation showed they did not work. Others have persisted on momentum. The agency's external evaluations, including by the Institute of Medicine and the Government Accountability Office, have repeatedly noted that dissemination of effective programs lags discovery by years or decades. The frame produces the evidence; the system does not always act on it.
The collective question is whether the CDC's contribution justifies its cost. The agency's violence prevention budget is small relative to its disease-control budget and tiny relative to criminal justice spending on the same problem. Per dollar, the evidence base it produces is one of the higher-leverage investments in the system. The frustration is that the evidence sits in technical packages while frontline practice continues to use whatever programs are familiar, available, and grant-fundable, regardless of whether they appear in the package.
The romantic lens places one further question. Prevention works, when it works, by changing what young people learn to expect from love. The CDC's strongest programs—Dating Matters, Safe Dates, Shifting Boundaries—are essentially relationship education programs dressed in violence-prevention clothing. They teach what a good relationship looks like, how to handle conflict, how to recognize control. The agency is, quietly and at scale, in the business of teaching adolescents how to love better. The criminal frame cannot do this. The public health frame can, awkwardly, with footnotes, and over the course of a decade of trials. That it does it at all is the achievement.