Domestic violence has long been viewed as a criminal justice problem. The health care system has started aiding in identifying, treating and ultimately reducing domestic violence. While domestic violence is not a new topic, there has been a lack of a systemic, health-focused response. Experts and advocates are now pushing for routine patient screenings and conversations about relationships — not just in emergency rooms but in a range of medical settings including primary care and particularly in pre-and post-natal care, because the time around childbirth is a high-risk time for escalating abuse, according to Politico. Physicians and other health providers are forming closer collaborations with domestic violence organizations that have the know-how to help survivors, rather than sending them to a shelter or calling the cops. Policymakers are helping, making some approaches more consistent and providing incentives for looking harder at abuse as a factor in health. “Exposure to violence, including intimate partner violence, has a direct impact on mental and physical health outcomes, and is directly tied to injury, psychological distress, and death in all age groups,” said Center for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure. The goal is a health-based approach with a smooth handoff to the right social service partners, along with the recognition that larger social and economic factors affect women’s health.
Experts estimate that 35 percent of women experience sexual or domestic violence over the course of their lifetimes. To address domestic abuse, health providers have started building better processes for treatment by beginning with screening. “By screening for and identifying unmet social needs, providers are better positioned to serve their patients in a more holistic way — such as connecting patients experiencing interpersonal violence with community resources or services,” said Brooks-LaSure. In recent years, health systems have come to better recognize and understand what’s been labeled “the social determinants” of health, meaning socioeconomic forces that contribute to poorer health and lower life expectancy. That includes factors like homelessness, food insecurity and domestic violence. This allows doctors, nurses, clinics and hospitals to approach these problems differently — understanding that they are indeed health problems — aggravated by economic hardship and inequality. Health systems are working more collaboratively with social services to address them together. Virginia Duplessis of the National Health Research Center on Domestic Violence said , police sometimes must be involved. The emphasis is less on cops and courts, and more on partnerships between health care and domestic violence programs with the expertise to do safety planning, or more immediate interventions for those women whose lives are in imminent danger.