THE HEALTH CARE RESPONSE TO DOMESTIC VIOLENCE FACT SHEET

Domestic Violence:  The actual or threatened physical, sexual, 
psychological or economic abuse of an individual by someone 
with whom they have or have had an intimate relationship.

Prevalence
The following prevalence statistics have been culled from 
numerous individual studies; they provide an indication of the 
range of estimates of domestic violence or battering instances. 
However, it is generally believed that domestic violence is 
seriously underreported and undiagnosed.  The paucity of 
accurate incident information underscores the problem. Within 
the last year, 7% of American women (3.9 million) who are 
married or living with someone as a couple were physically 
abused, and 37 % (20.7 million) were verbally or emotionally 
abused by their spouse or partner.In the U.S., every 7.4 
seconds a woman is beaten by her husband.

**The U.S. Department of Justice estimates that 95% of assaults 
on spouses or ex-spouses are committed by men against women. 
Domestic violence is repetitive in nature: about 1 in 5  women 
victimized by their spouse or ex-spouse reported that they had  
been a victim of a series of at least 3 assaults in the last 6 
months.A 1993 national poll found that more people (34% of men 
and women) have directly witnessed an incidence of domestic 
violence, than muggings and robberies combined (19%). And 14% 
of American women acknowledge having been violently abused by a 
husband or boyfriend.

Injuries & Fatalities

One study showed that 30% of women presenting with injuries in 
an Emergency Department were identified as having injuries 
caused by battering. Pregnancy is a risk factor for battering.  
Several studies indicate a range of incidence from 8% to 15% of 
pregnant women in public and private clinics to 17% to as much 
as 24% to 26%.The level of injury resulting from domestic 
violence is severe: of 218 women presenting at a metropolitan 
emergency department with injuries due to domestic violence, 
28% required admission to hospital for injuries, and 13% 
required major medical treatment.  40% had previously required 
medical care for abuse. 30% of women murdered in the U.S. in 
1992 were murdered by a husband or boyfriend.

Cost:

A study conducted at Rush Medical Center in Chicago found that 
the average charge for medical services provided to abused 
women, children and old people was $1,633 per person per year. 
This would amount to a national annual cost of $857.3 million.

Identification:

Close to half of all incidents of domestic violence against 
women discovered in the National Crime Survey (48%) were not 
reported to police. 92% of women who were physically abused by 
their partners did not discuss these incidents with their 
physicians; 57% did not discuss the incidents with anyone. In 
40% of cases in one study in which physicians treated battered 
women in an emergency department setting, staff did not discuss 
the abuse with the patients. In one study of 476 consecutive 
women seen by a family practice clinic in the midwest, 394 
(82.7%) agreed to be surveyed.  Of these patients, 22.7% had 
been physically assaulted by their partners within the last 
year, and the lifetime rate of physical abuse was 38.8%.  
However, only six women said they had ever been asked about 
domestic violence by their physician.. In a study of a major 
metropolitan emergency department that had a protocol for 
domestic violence, the emergency department physician failed to 
obtain a psychosocial history, ask about abuse or address the 
woman's safety in 92% of the domestic violence cases.  A recent 
national study of the 143 accredited U.S. and Canadian medical 
schools revealed that 53% of the schools do not require medical 
students to receive instruction about domestic violence.

Policy Recommendations:

A national public health objective for the year 2000 is for at 
least 90% of hospital emergency departments to have protocols 
for routinely identifying, treating, and referring victims of 
sexual assault and spouse abuse.The Joint Commission for the 
Accreditation of Hospitals and Healthcare Organizations (JCAHO) 
requires that accredited emergency departments have policies 
and procedures, and a plan for educating staff on the treatment 
of battered adults.

**PRODUCED BY THE FAMILY VIOLENCE PREVENTION FUND & THE TRAUMA 
FOUNDATION, 1994, San Francisco, CA(415)821-8209