(Click here
for a page that defines the dynamics of domestic violence in
general)
For more information on the intersection of domestic violence and health, contact the National
Health Resource Center on Domestic Violence, which provides technical
assistance and information to strengthen the health-care system's response to
domestic violence.
The NHRC can be reached at 1-888-RX ABUSE
Domestic Violence Threatens the Health of Individuals as well as Society
- Domestic Violence is the leading cause of
serious injury to American women. (Stark and
Flitcraft 1985).
- One out of every two female victims of domestic
violence reports an injury of some type. (US
Department of Justice, 1998. Violence by intimates: Analysis of data on crimes by
current or former spouses, boyfriends, and girlfriends. Publication number
NCJ-167237. Washington, D.C., U.S. Government Printing Office.)
- Each year, medical expenses related to domestic
violence total at least 3 billion to 5 billion. (Colorado Domestic Violence Coalition. 1991. Domestic
Violence for Health Care Providers--3rd edition)
- Every 14 days in West Virginia, domestic
violence claims a life. (West Virginia State Police
Uniform Crime Reporting 1997. Crime in West Virginia 1997)
- Pregnant women are more at risk for domestic
violence than for preeclampsia, gestational diabetes, or placenta
previa. ( Peterson, Saltzman, Goodwin, & Spitz
1997. Key Scientific issues for research on violence occurring around the time
of pregnancy Atlanta: Centers for Disease Control and Prevention)
How can a Health Care Provider tell if a
Person is a Victim of Domestic Violence?
One important way that health care providers can
identify domestic violence is by routine screening of all patients. Domestic
violence has many indicators.
Physical Indicators
- History of recurrent injuries, particularly to
the head, neck, torso, breasts, abdomen, or genitals
- Unexplained injuries or injuries inconsistent
with the explanation given.
- Delay in seeking treatment for injuries
- Physical injury during pregnancy, especially on
the breast and abdomen.
- Chronic pain symptoms with no evident
cause
- Presence of a partner who seems overly
protective or controlling
Behavioral Indicators
- Depression
- Thoughts of suicide
- Anxiety and/or panic attacks
- Sleeplessness
- Alcohol/substance abuse problems
How can Health Care Providers Help Victims of Domestic
Violence?
Because domestic violence is the cause of so many
injuries and illnesses, health care providers have great potential to help
victims of domestic violence. However, a recent study found that physicians are
more likely to counsel women about exercise and diet or weight than about
violence in the home. In addition, among abused women who discussed the issue
with their doctors, only one in five reported that the doctor raised the
subject, and less than half of those were referred to a support service. In a
rural state such as West Virginia, victims of domestic violence may find it even
more difficult to seek help due to geographic isolation.
For these reasons, it is critical that health
care providers take a proactive response to domestic violence. Here are some
steps that health care providers can take:
- Begin with routine screening of every adult
patient. A patient may be reluctant to tell you about the abuse and may hope
that you will ask about it. When you screen, speak with the patient alone, and
ask directly if she is in a violent relationship. Some helpful questions:"
Because domestic violence is so prevalent in women's lives, I've started asking
all of my patients about it. Has your partner or ex-partner ever hit you or
physically hurt you? Has he/she ever threatened to hurt you or someone close to
you? Has he/she ever tried to keep you from seeing people you care about or from
doing things that are important to you?
- Express your concern for the patient's safety,
and the safety of her children, provider her with information about the local
domestic violence program, and tell her that you are there for her no matter
what her decision. (click here for a listing
of the local domestic violence programs in West Virginia.)
- Be prepared for the possibility that a victim of
domestic violence may not want to leave the relationship, and may blame herself
for the injuries or make excuses for the abuser. If she chooses not to leave,
you should respect her decision and tell her that you are there for her.
- Document what you see and what the patient tells
you. Take pictures if possible.
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