Though more difficult to discuss than sports injuries or the pains associated with aging, domestic violence is a very serious health care issue that needs to be discussed openly.  Victims deserve to have safe spaces to disclose the abuse and seek treatment not only for their physical wounds, but also support for their emotional and psychological harm.  As a community, we need to take domestic violence on as the public health issue that it is.   

Unlike argumentative fighting, domestic violence is a pattern of behavior that abusers use to control their intimate partners through fear and intimidation.  Based on the abuser’s desire for power and control, abuse can be verbal, emotional, physical, sexual and/or economic.  According to the Centers for Disease Control, domestic violence results in around 2 million injuries and 1,300 deaths nationwide every year with costs exceeding $5.8 billion each year, $4.1 billion of which is for direct medical and mental health care services. 

Some of the numerous physical consequences include: bruises, knife wounds, broken bones, chronic pain in any organ, sexually transmitted infections, pregnancy difficulties, gynecological disorders, symptoms of post-traumatic stress disorder, migraines, heart or circulatory conditions, and gastrointestinal disorders.  Psychological consequences include depression, antisocial behavior, suicidal behavior, anxiety, low self-esteem, inability to trust the opposite sex, and fear of intimacy.  Victims often cope with their trauma by engaging in behaviors that present further health risks, such as smoking cigarettes, abusing drugs and alcohol, fasting, vomiting, overeating, engaging in high-risk sexual behavior, and attempting suicide.  Children who witness domestic violence are also more likely to exhibit behavioral and physical health problems including anxiety, depression, suicide attempts, substance abuse, and violence towards peers. 

Because domestic violence has many health consequences and because nearly every person in the U.S. utilizes the health care system at some point in their lives, clearly health care providers should be, and many are, involved with awareness and prevention.  Although health care professionals have a limited amount of time to cover many health aspects of the patients’ lives, taking a few minutes to assess whether each patient has ever or is currently experiencing domestic violence provides victims with a safe place to disclose abuse and allows for more holistic treatment including intervention options to help reduce further violence and potential death.  This assessment also greatly reduces the $4.1 billion dollars spent on the direct health costs of domestic violence.  Many hospitals, including St. Clare Hospital in Baraboo, have specific staff training on what signs to look for to see if the patient is being abused.  When patients fill out history forms at St. Clare Hospital and Clinic, they are also asked a safety question, such as “Are you currently or have you ever been physically, emotionally, financially, or sexually abused?”    

In addition to the training and the written form, many health care providers also ensure that they ask about safety in the home every time they see a patient.  The Family Violence Prevention Fund recommends that health care providers begin assessment with a framing statement, “I don’t know if this is, or ever has been, a problem for you, but many of the patients I see are dealing with abusive relationships.  Some are too afraid or uncomfortable to bring it up themselves, so I’ve started asking about it routinely.”  If victims choose not to disclose, they will realize they have an ally in the healthcare field that cares about the issue of domestic violence and would offer support if they ever did disclose.  If patients have never been victims of domestic violence, the screening question demonstrates that their healthcare provider believes domestic violence is a serious health issue that can affect anyone. 

With October being Domestic Violence Awareness Month, Hope House would like to take this opportunity to thank all health care providers who take a stand against domestic violence and work to prevent it in their everyday lives.  In particular, we would also like to thank Dean Health System for its continued support of Hope House and this year’s Women’s Expo on November 17^th in the Baraboo Arts Banquet Hall.

Jess Ritschke

Community Educator

Hope House