How Our Current Health System Is Failing Victims Of Domestic Violence

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Two decades ago, Leslie Morgan Steiner was beaten, threatened at gunpoint, and thrown down a flight of stairs by the man who was then her husband. After leaving that abusive relationship, she became an advocate for domestic violence awareness. Nonetheless, when her doctors recently told her that her chronic health issues seemed unusual for someone as young as she is, she didn’t immediately make the connection.

Morgan Steiner is deeply involved in the domestic violence prevention community. She wrote a book about her experiences, and she typically makes between 20 and 30 public appearances each year. She still thinks about the fear that would consume her if she were to ever be in the same room as her ex-husband. But it just didn’t occur to her that she could be experiencing the health effects of that abuse 20 years later — and it didn’t occur to her doctors, either, who never once asked about her history with intimate partner violence.

Something finally clicked for her when the Verizon Foundation and More Magazine released new research exploring the connection between domestic abuse and long-term health issues. That study found that victims of domestic abuse are 20 percent more likely to suffer from a chronic health condition — like depression, diabetes, asthma, and digestive disease — compared to people who have never been abused.

“It just makes sense,” Morgan Steiner explained in an interview with ThinkProgress. “Almost all of these problems are stress related. The thing every victim has in common is that we internalize an enormous amount of stress — it’s fundamentally what domestic is about, being terrified and stressed every minute of every day. It makes sense that you can’t forget it and get away from it.”

Morgan Steiner noted that there’s a common expression among domestic violence survivors: You can feel the fear in your bones. And it turns out that’s not just theoretical language. Domestic abuse does impact victim’s bodies — including their musculoskeletal systems — in fundamental ways.

Obviously, we know that domestic violence has serious health consequences. Federal officials estimate that the country spends $4.1 billion each year on the medical and mental health costs stemming from domestic abuse. But across the country, there are still countless women like Morgan Steiner who have never considered that their current health issues may have resulted from their history of abuse, and who have never once had this conversation with their doctors. Among the domestic violence victims with long-term health issues who participated in Verizon’s and More’s study, just six percent said their doctor made the connection.

That makes some sense. Despite the fact that intimate partner violence is incredibly widespread in this country, it still remains somewhat shrouded in secrecy and stigma.

The Verizon Foundation is pushing to change this dynamic. As a follow-up to the new research, the foundation is partnering with the Society for Women’s Healthcare Research to come up with some solutions for shifting the current medical approach to these issues. The groups are unveiling their materials, along with new information from the Robert Wood Johnson University Hospital regarding the role of health care providers in this area, at a Capitol Hill briefing on Thursday. They’re pushing for more awareness about the complex issues related to intimate partner violence and offering up some simple guidelines for moving forward.

Elaine Hewins authored the new Robert Wood Johnson University Hospital white paper that’s being released on Thursday. In an interview with ThinkProgress, she noted that training doctors to get better at screening for domestic abuse isn’t necessarily a big lift.

At the very minimum, medical professionals simply need to be educated about the link between common health issues and domestic violence, so they’ll understand what should trigger questions about intimate partner violence. All doctors should memorize the domestic violence hotline for their state, so they’re ready to relay it to patients without needing to give them any additional paperwork that may not be safe for them to bring home. They need to know that they should repeatedly ask about intimate partner violence, because it may take a victim several visits to be comfortable enough to speak openly about it.

Giving medical professionals some simple tips about how to effectively initiate these conversations can go a long way. “Doctors are afraid of offending their patients by asking these questions,” Hewins explained to ThinkProgress. In her research, she found that medical professionals are worried that asking about a patient’s history with domestic violence might appear as though they’re singling out, judging, or accusing that individual. Teaching them how to frame their questions — for instance, “We’re finding that intimate partner violence is really widespread among our patients, so we’re asking everyone if it’s something they’ve ever experienced, and I just want to check in about that with you” — can help address those concerns.

Morgan Steiner doesn’t blame her doctors for failing to check in with her about whether she’d ever been the victim of domestic violence. After all, she didn’t know about the potential link between her abuse and her health issues, either. But she does hope that the entire medical field will eventually become more familiar with these issues.

“The reason that I speak out about being a domestic violence survivor is because we need to deepen the public’s understanding about it. That includes health care professionals,” she explained.

And although the Verizon Foundation’s new materials about the issue refer to domestic violence as the “hidden cause” of chronic health conditions, the most important thing to Morgan Steiner is that it doesn’t remain hidden.

“I think it took something like this Verizon research to make us step back and think about potential long-term physical consequences,” she told ThinkProgress, pointing out that survivors are often simply focused on the immediate, short-term solutions to get themselves out of dangerous situations. “But the greater public needs to understand that this is part of why domestic violence is so damaging to society in the long term. Victims need to know about it, and perpetrators need to know too, because they need to know how serious it is what they’re doing to people.”