The health care response to domestic violence fact sheet

Domestic Violence: The actual or threatened physical, sexual, psychological or economic abuse of an individual by someone with whom they have or have had an intimate relationship.

Prevalence

The following prevalence statistics have been culled from numerous individual studies; they provide an indication of the range of estimates of domestic violence or battering instances. However, it is generally believed that domestic violence is seriously underreported and undiagnosed. The paucity of accurate incident information underscores the problem. Within the last year, 7% of American women (3.9 million) who are married or living with someone as a couple were physically abused, and 37 % (20.7 million) were verbally or emotionally abused by their spouse or partner.In the U.S., every 7.4 seconds a woman is beaten by her husband.

**The U.S. Department of Justice estimates that 95% of assaults on spouses or ex-spouses are committed by men against women. Domestic violence is repetitive in nature: about 1 in 5 women victimized by their spouse or ex-spouse reported that they had been a victim of a series of at least 3 assaults in the last 6 months.A 1993 national poll found that more people (34% of men and women) have directly witnessed an incidence of domestic violence, than muggings and robberies combined (19%). And 14% of American women acknowledge having been violently abused by a husband or boyfriend.

Injuries & Fatalities

One study showed that 30% of women presenting with injuries in an Emergency Department were identified as having injuries caused by battering. Pregnancy is a risk factor for battering. Several studies indicate a range of incidence from 8% to 15% of pregnant women in public and private clinics to 17% to as much as 24% to 26%.The level of injury resulting from domestic violence is severe: of 218 women presenting at a metropolitan emergency department with injuries due to domestic violence, 28% required admission to hospital for injuries, and 13% required major medical treatment. 40% had previously required medical care for abuse. 30% of women murdered in the U.S. in 1992 were murdered by a husband or boyfriend.

Cost:

A study conducted at Rush Medical Center in Chicago found that the average charge for medical services provided to abused women, children and old people was $1,633 per person per year. This would amount to a national annual cost of $857.3 million.

Identification:

Close to half of all incidents of domestic violence against women discovered in the National Crime Survey (48%) were not reported to police. 92% of women who were physically abused by their partners did not discuss these incidents with their physicians; 57% did not discuss the incidents with anyone. In 40% of cases in one study in which physicians treated battered women in an emergency department setting, staff did not discuss the abuse with the patients. In one study of 476 consecutive women seen by a family practice clinic in the midwest, 394 (82.7%) agreed to be surveyed. Of these patients, 22.7% had been physically assaulted by their partners within the last year, and the lifetime rate of physical abuse was 38.8%. However, only six women said they had ever been asked about domestic violence by their physician.. In a study of a major metropolitan emergency department that had a protocol for domestic violence, the emergency department physician failed to obtain a psychosocial history, ask about abuse or address the woman's safety in 92% of the domestic violence cases. A recent national study of the 143 accredited U.S. and Canadian medical schools revealed that 53% of the schools do not require medical students to receive instruction about domestic violence.

Policy Recommendations:

A national public health objective for the year 2000 is for at least 90% of hospital emergency departments to have protocols for routinely identifying, treating, and referring victims of sexual assault and spouse abuse.The Joint Commission for the Accreditation of Hospitals and Healthcare Organizations (JCAHO) requires that accredited emergency departments have policies and procedures, and a plan for educating staff on the treatment of battered adults.

**PRODUCED BY THE FAMILY VIOLENCE PREVENTION FUND & THE TRAUMA FOUNDATION, 1994, San Francisco, CA(415)821-8209


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