Health Survey of Domestic Violence Survivors Finds Major Unmet Health Needs


The National Family Justice Center Alliance has released the results of a national survey of domestic violence survivors, identifying major unmet needs and significant long-term health impacts from violence and abuse.

The survey—conducted in Family Justice Centers across the United States during a one-week period last fall—found that victims and their children are uninsured or underinsured, rarely receive needed medical, dental, and vision services, and fail to understand the profound short and long-term impacts of the violence and abuse they are suffering at the hands of abusive partners.

The major findings of the study included:

Respondents were largely un/underinsured: 44% have no insurance and of those with insurance 65% have public insurance such as Medicaid or Medicare. 

Half went to an emergency room in an effort to meet their medical needs, while only 30% saw their primary care provider in 2013.

Respondents reported more mental health needs (an average of four concerns) than physical or sexual health needs.

Less than one in four victims attribute their health problems to abuse.

Dental and vision services were the most requested health services: 40% and 43%, respectively, would like to have these services available in Family Justice Centers or domestic violence agencies rather than going to hospitals or doctor’s offices.

The primary barriers to care were lack of insurance and the cost of insurance.

Survivors of domestic violence do not realize the possible health impacts from near-fatal strangulation assaults they are suffering in their abusive relationships.

70% of survivors reported at least one physical health need, but only 49% had a primary care provider and 30% saw a doctor in 2013.

The Alliance is calling for all domestic violence agencies, Family Justice Centers, and other community-based service providers to:

* Begin screening survivors for pressing health needs in their intake and case management services

* Build partnerships with community-based health clinics, hospitals, and health service providers to ensure victims receive the medical services they need

* Help get survivors signed up for health insurance immediately, pursuant to the Affordable Care Act

“This is a life-and-death issue for victims of domestic violence,” said Casey Gwinn, president of the Alliance. “The consequences of violence are long-term medical issues, chronic health problems, and shortened life span.”

The health effects of domestic violence are vast and long lasting, affecting nearly every aspect of health. Beyond direct injuries from physical abuse, victims suffer disproportionately from indirect effects of long-term abuse.

* Women who experience abuse are three times more likely to have reproductive health complications than non-victims.

* 48% of women who are abused will also experience depression.

* In the US, 24 percent of adult women will experience intimate partner violence. It is the most common cause of injury for women ages 18 to 44.

* Victims are more likely to use emergency rooms for regular healthcare.

* Victims are significantly more likely to have chronic health conditions than non-victims.

* Abused women are 70 percent more likely to have heart disease, 80 percent more likely to experience a stroke and 60 percent more likely to develop asthma than women who have not experienced abuse.

* For children growing up in an abusive home, the impact of this trauma affects mortality dramatically according to recent findings of the nationally known ACE Study (Adverse Childhood Experiences). According to Dr. Vincent Fellitti, a child with a score of six (multiple adverse childhood experiences) in the ACE Study has a reduced life expectancy of 19 years compared to a child with no adverse childhood experiences.

* The economic impact of violence is estimated at $5.8 - $8.3 billion each year; the vast majority attributed to healthcare costs and lost productivity (CDC, 2013).

“Today, thousands of survivors of domestic violence have unaddressed medical, dental, and vision needs across the United States,” said Alliance CEO, Gael Strack. “Most community-based domestic violence agencies do not have the capacity to meet these needs. Criminal justice interventions, social services, civil legal services, mental health counseling, and other assistance is available in many communities, and multi-agency and multi-disciplinary approaches such as Family Justice Centers are bringing together more accessible services under one roof. But health-related services are not generally included even in the most dynamic multi-agency, multi-disciplinary service approaches,” said Strack.

Dr. Dean Hawley, one of leading forensic pathologists in the United States points out: “The Affordable Care Act may well be a system changer to help address the needs of domestic violence victims. Doctors want to provide services to these victims but a funding stream is critical.”

The National Family Justice Center Alliance is working with the Verizon Foundation, Blue Shield of California Foundation, and other allied national organizations to address health needs of survivors of domestic violence and their children, particularly in Family Justice Centers or other types of multi-agency, multi-disciplinary service approaches that serve victims of domestic violence.