• Karyn Hall
  • Healthcare Issues and Violence in the Home
Healthcare Issues and Violence in the Home
Contributor
Written by
Karyn Hall
September 2009
Contributor
Written by
Karyn Hall
September 2009
September 19, 2009 With the increasing dilemma of how to responsibly provide quality healthcare to those who need it, I hope those in power will consider long-term corrective solutions as well as urgently needed acute remedies. For many years we have known prevention is the best intervention. Consider this excerpt from a World Health Organization (WHO) fact sheet revised in 1972: Not only are chronic conditions projected to be the leading cause of disability throughout the world by the year 2020; if not successfully prevented and managed, they will become the most expensive problems faced by our health care systems. This same fact sheet identified the following as essential elements for action: Support a paradigm shift towards integrated, preventive health care Promote financing systems and policies that support prevention in health care Equip patients with needed information, motivation, and skills in prevention and self-management Make prevention an element of every health care interaction In the thirty-seven years since this was written, how are we doing? In some areas, such as smoking, there are significant efforts being made. An emphasis on healthy diet and exercise is also more evident in the media now. Yet we still are not applying critical knowledge about prevention to difficult areas such as abuse. Estimates are that women in their rate 40s who were physically or sexually abused as children may spend up to 36% more on hearth care, according to a February 19, 2008, news release from The Ohio State University, Columbus. After accounting for other factors (eg, age, education), researchers concluded that childhood abuse correlated with increased spending on health care later in life. Plichta (Womens Health Issues - 01-OCT-1992; 2(3): 154-63) completed a literature review on the effects of abuse on health care utilization and health status of women in the US. The abuse of women was defined as any physical abuse of a woman by an intimate male partner. She reported that Victims are more likely to have poor health, chronic pain problems, depression, suicide attempts, addiction, and pregnancy problems. Abused women were found to use a disproportionate amount of health care services including emergency rooms visits, primary care, and community mental health center visits. Despite its high prevalence and the disproportionate use of health care services it causes, woman abuse is rarely recognized by health care providers. Even when health care professionals detect woman abuse, they often provide inappropriate or harmful treatment. Thus, health providers need to educate themselves about women abuse, know community and legal sources to which to refer abused women, and develop protocols for identifying and caring for such women. More than one third of all partner-committed rapes and physical assaults result in injury requiring medical care (NVAW Survey, July 2000). According to the CDC, there are 2 million injuries and 1,300 deaths caused by intimate partner violence. Medical expenses from domestic abuse totaled $3-5 billion (Domestic Violence for Health Care Providers, 3rd Edition, Colorado Domestic Violence Coalition, 1991). In an article published in the American Journal of Obstetrics and Gynecology(Battistutta, et al,1996) a survey of pregnant women who were domestic violence survivors were found to be less healthy than women who had never been abused. The survivors used more prescription medications,required more hospitalizations, experienced asthma at almost twice the rate of the nonabused and were more likely to suffer from epilepsy. Research supports logical thinking about these issues. Survivors of domestic violence child abuse are more likely to suffer from depression and anxiety as well. (eg, Carlson et al, Journal of Interpersonal Violence,18, 8, 924-941 (2003). According to recent statistics from the Child Welfare Protection Services, 80% of child abuse and neglect victims developed at least one psychiatric disorder by the age of 21, including depression, anxiety, eating disorders and post-traumatic stress disorder. Moreover, children who experience abuse and neglect are 59% more likely to be arrested as a juvenile, 28% more likely to be arrested as an adult and 30% more likely to commit violent crimes. Abused children are also 25% more likely to experience teen pregnancy, 2.5 times more likely to develop alcoholism and 3.8 times more likely to develop drug addictions. One third of these abused children will go on to abuse their own children one day (Mike Selvon, Ezine). There are caring people working hard everyday to address this issue, not because of the monetary cost of the issue but because of the value of life and safety. If part of the reason people don't address this issue is because it isn't their business, then perhaps the health care delimnea and the costs of treating the effects of abuse will help them see differently. Today is the time to make a difference. Mental health practitioners know how to treat the problems, so there is intervention that can be taken. Social media makes the world a small place now and education and awareness can be done easier than ever before. There is even a more accepted understanding of the connection between mental health and physical health. Now is the time. We can't afford to not address the issues, either morally or financially, any longer. It's about time. Whatever the motivation for a concerted effort to prevent violence in the home, I'll be glad to see it done.

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Comments
  • AnnaBeth Hawkins Davidson

    Wow, I just read through that and saw myself very clearly. The medical costs I have accrued over the past 3+ years are incredible, just to treat headaches and some anxiety. Just recently the doc decided to send me for counseling for PTSD, and really, this is the root of so much. The correlation you have made between abuse and medical issues does need to be recognized. Thank you for your post. I hope that many more read this.