GUEST COMMENTARY: Focusing on the health impacts of domestic violence

October is National Domestic Violence Awareness Month and Oct. 10 was Health Cares about Domestic Violence Day. These annual events raise awareness about the essential role of health care and domestic violence agencies in promoting survivor health and safety.

Domestic violence, also described as intimate partner violence, is a pattern of abusive behavior and coercive control that can happen in a dating, marital, or live-in intimate partner relationship. In an abusive relationship, one partner tries to maintain control over the other by using physical, psychological, verbal, sexual violence and/or coercion. Although factors such as drug and alcohol use, stress, or a family history of abuse may contribute to the problem, domestic violence is primarily an issue of power and control. Domestic violence looks different in every relationship. It can occur among heterosexual or same-sex relationships and does not require sexual intimacy.

Intimate partner violence is associated with a range of trauma-related chronic and long-term health and mental health conditions, including depression, heart disease, substance abuse, unintended and teen pregnancies, poor pregnancy outcomes, diabetes, and asthma. The physical and mental health and social impacts of IPV also extend to children in the family who may witness violence or be in a controlling household. The more Adverse Childhood Experiences children face, the greater their risk for chronic diseases, alcoholism and drug use, and or dropping out of school according to the Centers for Disease Control and Prevention. Interventions for women of child-bearing age are especially critical, as homicide is the leading cause of death for pregnant and post-partum women.

As reported in the National Intimate Partner and Sexual Violence Survey, in Delaware, nearly 240,000 women and men have experienced intimate partner violence (IPV) during their lifetime and more than 1 in 4 (28.6%) women and 1 in 12 (8.5%) men report having experienced negative impacts (such as injury, fear, PTSD, and needing services) at some point during their lives.

Importantly, for many victims of domestic violence the first source of help will not be law enforcement, but rather their medical provider. Victims who may be too frightened to involve the police or the courts because of retribution by their abuser may seek assistance through their doctor. The healthcare provider’s role as a first responder highlights the pressing need for well-trained medical staff able to identify domestic violence and respond with safety resources.

Even more, patient surveys indicate that 90% don’t mind being asked and 71% wished that a previous healthcare provider had asked about it. Recent research by DCADV showed that 76% of Delaware patients surveyed thought it was helpful for providers to talk to patients about relationships. In one clinic, 100% of patients interviewed reported that, “it is helpful for providers to talk with patients about healthy and unhealthy relationships.”

The impact of intimate partner violence on health highlights the need for an integration of community-based domestic violence services with healthcare, to address both the safety and health needs of patients experiencing domestic violence. In recognition of Domestic Violence Awareness Month last October, DCADV and the Division of Public Health (DPH) held a workshop for DPH staff and community partners to explore domestic violence as a health issue and how it impacts physical and mental health. Currently, DCADV in collaboration with healthcare and domestic violence service providers is developing a coordinated response for victims of domestic violence to address the need for easily accessible community-based health and safety services.

Domestic violence is a terrifying experience for many women and men, as well as any children who may be exposed. It is important that we bring awareness to this and give victims all the support and resources we can to help them overcome, recover and feel safe enough to move forward and live healthy, fulfilling lives.

If you know of someone who is experiencing domestic violence please share these 24-hour resources:

24 Hour Domestic Violence Hotlines:

•CHILD Inc.’s DV Program

New Castle County

302-762-6110

•The SAFE Program at People’s Place II

Kent & Sussex Counties

302-422-8058

•Abriendo Puertas Bilingual Hotline

Sussex County

302-745-9874

More information on domestic violence and resources for help are available from the DPH Office of Women’s Health at: https://dhss.delaware.gov/dph/mh/owh.html.

Dr. Karyl Rattay

Director, Delaware Division
of Public Health

Sue Ryan

Executive Director,
Delaware Coalition Against
Domestic Violence

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