The Globe and Mail investigation into the classification of a shocking number of sexual-assault complaints – one in five – as "unfounded" raises some troubling questions about how seriously police take the issue of sexual violence.

It is a reminder too that, even when the criminal-justice system is working properly, it can only do so much. Prosecution and incarceration of offenders may provide a sense of relief, and maybe even some deterrence, but that's not enough. From a public health perspective, we need to prevent sexual assault and sexual abuse from occurring in the first place, not content ourselves with reacting after someone has been violated and harmed.

When sexual assault or abuse occurs, we must also endeavour to minimize the fallout. The needs of victims don't stop when charges are (or are not) laid; on the contrary, the pain and trauma is often only beginning. Nor can we ignore that perpetrators of violence need treatment as well; too often, incarceration makes violent men more violent, not less so.

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Unfounded: How police and politicians have responded to The Globe's investigation so far

Sexual violence is a silent epidemic. Anyone can, at any age, experience sexual violence, but most victims are female, predominantly young females. One in three women has been a victim of sexual assault in her lifetime. One in five adult women has been raped; so, too, have one in 20 girls. One-third of adolescent girls report their first sexual experience as being forced, or coerced. One in four women has experienced violence by a domestic partner. One in six women has been stalked. (Men and boys suffer all these indignities and crimes, too, but the numbers differ by orders of magnitude.)

Those nauseating numbers are from Western countries. Globally, statistics are harder to come by, but the breadth and complexity of sexual violence is much greater. There are entire societies that treat women as second-class citizens, where women are the property of their husbands. Powerlessness and subjugation result in girls and women being denied an education, being forced to bear children and becoming infected with sexually transmitted infections such as HIV-AIDS by their partners. Female genital mutilation and child marriage are common practices in some parts of the world. Sexual trafficking of women occurs on a large scale. Rape is increasingly being used as a weapon of war.

Misogyny is not academic; it is a disease that poses a significant public health threat to half the world's population.

Regardless of age or where you live in the world, sexual violence can have a profound impact on physical and mental health. Beyond the immediate physical injuries, survivors of assault and abuse have higher rates of misuse of alcohol and drugs, depression, PTSD and suicide.

We know that there are factors that increase a woman's vulnerability to sexual violence: being young, consuming alcohol or drugs, having been previously abused, involvement in sex work, being bisexual or transgender, having a physical, developmental or psychiatric disability, being indigenous and being poor. Being a girl or woman is a risk factor for abuse and assault. But being marginalized greatly increases that risk.

On the other hand, there is little research on the factors that influence men to become sexually violent, but what there is points to the influences of attitudes and beliefs, and the need to address environments that provide opportunities for abuse. Gender-based violence tends to flourish out of a culture that devalues women, where so-called "locker-room talk" that demeans women is casually accepted, where media messages objectify women, where women are held to a different sexual standard (slut-shaming) and where sexual harassment is dismissed as no big deal.

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These attitudes help create an environment where sexual abuse and sexual assault is under-reported, under-prosecuted and under-punished. The reasons women don't come forward have been studied and cataloged extensively: the perception that the way they were treated is normal, or that men can't help themselves; the fear, shame and embarrassment of being a victim of a sexual crime; and a general distrust in the criminal justice system. When data show police routinely dismissing complaints of sexual-assault victims as "unfounded," you can understand the reticence.

As Madam Justice Jean MacFarland wrote in the landmark Jane Doe case, rape "is an act of power and control rather than a sexual act. It has to do with the perpetrators' desire to terrorize, to dominate, to control, to humiliate." The justice system, and the public-health system, should be there to alleviate, not perpetuate, the terror and humiliation.