When Home Is Where It Hurts
- Domestic violence (DV) accounted for 21% of all violent victimization between 2003 to 2012.
- Intimate partner violence (IPV) accounted for 15% of violent victimization as compared to violence committed by immediate family members (4%) or other relatives (2%).
- Of IPV, 32% were committed by well-known or casual acquaintances and 38% were committed by strangers.
- The majority of reported DV incidents were committed against female at 76% compared to incidents committed against male victims at 24%.
- 77% of DV incidents occurred at or near the victim's home.
Domestic violence (DV) includes the classification of acts wherupon victimization is perpetrated by intimate partners (current or former spouses, boyfriends, or girlfriends), immediate family members (parents, children, or siblings), and other relatives. Victims of DV may experience any or all of the following: physical, sexual and psychological attacks, and economic control. DV impacts and changes the lives of women, men and children of all ages, from all backgrounds, social strata and beliefs. Whether from one act, a series of incidents and/or a pervasive intent to control and inflict harm, DV reshapes the view of the world, others and the image of self for the victim. Intervention, treatment and ongoing support to break the silence of DV all make up a public health need.
One in four women seeking care in emergency rooms has injuries related to a DV incident. It is documented that DV female victims have higher health care use, even after the abuse has ended, than the general female population. The physical marks left after an injury are only one of the visible signs of DV. DV female victims tend to experience more headaches, chronic pain, gastrointestinal, and gynecologic problems, as well as depression and anxiety, and other physical injuries. While health care cost may decrease after the immediate IPV has stopped, there is still a 20% higher rate of utilization even after 5 years. Overall, female victims of IPV have a 50% higher health care cost compared to women with no reported IPV history for emergency department use. Female IPV victims also have twice the utilization rate for mental health visits and six times higher for alcohol and drug services compared to women with no reported IPV history.
Children of female IPV victims have significantly higher utilization use of mental health, primary care, specialty care and pharmacy services with 24% higher overall cost than children of mothers who had no abuse history. In 2005, of the 6,700 children hospitalized for physical abuse or neglect, more than 200 died and all fatalities were under the age of 5. Abused children under the age of 5 made up 80% of all children under the age of 18 who were seen for abuse or neglect in 2005. Hospital cost of care for children seen for physical, sexual, emotional abuse or neglect totaled almost $100 million.
Critical services are needed at the community level of care and within hospital centers to provide information about safe haven resources, safe exit planning, and to offer accurate screening, with emotional support to women and their children seeking treatment and support services. Trauma- informed care for both the mother and child is essential and staff at all levels must be trained to identify and provide support to the mother and child at all points of contact in the treatment process. And treatment must not omit addressing the issue of secondary trauma experienced by the child. The development and evaluation of the DV program design and treatment process must address the social, cultural, and environmental context of the individual's service and treatment needs. DV treatment is not a "one-fit-all" model of care, and thus evaluation measures must be inclusive of the individual's specific cultural values, norms and beliefs, and therefore flexible in the interpretation of impact and need. This must be accompanied by a robust public education campaign.
Stand up and speak out to break the silence of DV.