Domestic Violence Is Devastating, and Causes Serious, Chronic Health Problems

Leslie Morgan Steiner got married just after graduating from Harvard College in her early 20s. Soon after, things went terribly south. But even after her husband pushed her down the stairs, threw boiling water at her, and held a loaded gun to her head, she says she never thought of herself as a battered wife.

“Instead, I thought I was a smart, strong, independent woman in love with a deeply troubled man who was trying to overcome abuse he had suffered as a child at the hands of his stepfather,” she told AlterNet. “I thought I could help him.”

Steiner’s divorce was finalized in 1993 when she was 28. It wasn’t until five years after the divorce that she began speaking about what happened. She ultimately decided to talk about the violence she endured because so few people understand the “complicated, psychologically devastating dynamics” of domestic violence.

“I speak out about relationship violence as a way of expressing my gratitude to everyone who stood by me and helped in those dark times, and I also speak out because so few victims can — they have children to protect, cultural or financial ties to their abuser, or are afraid of retaliation,” she said. “And of course, tragically, many cannot speak out because their abusers killed them.”

After she found the strength, and as she put it, she was lucky enough to end the abusive relationship with her husband, Steiner began to wonder how and why she’d stayed with a man clearly intent on destroying her. The exploration led her to write her memoir, Crazy Love, which took 10 years to write and was published in 2009. Then, in November 2012 she presented a TED Talk about why victims stay with abusive partners.  

While Steiner has come a long way in confronting the violence she endured, she still experiences chronic health problems including tendonitis, joint pain, and significant short-term memory loss. All of these conditions, as it turns out, directly relate to the abuses she suffered all those years ago.

Steiner participated in research for a recent survey by the Verizon Foundation and More magazine, titled “Exploring the Relationship between Domestic Violence and Chronic Health Conditions,” which found significant links between domestic violence and chronic health conditions.

“My doctors have said for years that I am too young to have these symptoms,” she says. “Even though I speak openly and publicly about being a domestic violence victim, neither I nor my doctors ever thought my problems were related to being abused in my 20s. When I was interviewed by More magazine as part of the Verizon research, a light bulb sparked in my mind. Could it be that I am still suffering because of the pain my ex-husband inflicted, the times he strangled me, kicked me, hit me, and terrorized me? The way I describe being a DV victim is that the fear gets into your bones. Turns out, that wasn't a metaphor — it was the truth.”

For the survey, researchers conducted interviews with 1,005 women and found that 70 percent of all women suffer from a chronic health condition. That number increases to 81 percent when women have experienced domestic violence, and 88 percent when women have experienced sexual abuse.

But while women who had experienced domestic violence were significantly more likely to suffer from a chronic health condition, just one in four women had ever been asked by her healthcare professional about domestic violence.

Each year the U.S. spends $4.1 billion on the medical and mental health costs of domestic violence, and despite national recommendations, as the new research shows, doctors are not effectively screening patients for abuse. The main reason for this is that doctors lack the training.

Steiner was one of four presenters in a briefing on Capitol Hill hosted by the Congressional Caucus for Women’s Issues last Thursday, which explored the survey findings as well as a white paper released by Robert Wood Johnson University Hospital. Both point to significant links between domestic violence and many chronic health conditions, including stress-related physical consequences like asthma, memory damage, arthritis and other diseases that can last long after the abuse has ended.

Based on the findings, the briefing aimed in part to educate policymakers and healthcare industry professionals about those connections, as well as present strategies to tackle domestic violence within the healthcare system.

As Steiner pointed out, violence in a relationship is the number one reason women call 911 and visit hospital emergency rooms, and every day in the U.S.  three women are killed by their abusive partners or ex-partners. Additionally, the Centers for Disease Control estimates that 15 million children are victims of family violence each year in the U.S.

“How can anyone not call this a critical, national health issue?” Steiner said. “Everyone in our society needs to understand the high price we all pay for allowing domestic violence in our communities.… Quantifying the costs of relationship violence through its burden on our healthcare system is an important step towards raising awareness of [domestic violence’s] seriousness, alleviating the suffering of victims, and one day ending domestic violence for good.”

The white paper presented at the briefing, titled “Domestic Violence and the Role of the Healthcare Provider,” explores the reasons doctors and nurses have trouble talking to patients about domestic violence, and the need to train healthcare professionals to help patients feel comfortable and safe enough to use their doctors as resources.

Elaine Hewins is a social worker in New Jersey and co-author of the white paper. She works as domestic violence education and awareness program coordinator for Robert Wood Johnson University Hospital. She has helped to expand the program’s educational seminars over the last year and a half to educate a total of 480 healthcare professionals about confronting domestic violence.

Hewins told AlterNet that healthcare providers play a key role in ending domestic violence because their offices are often the only places where abused women can go and have privacy with a professional.

“We know that more women are seriously injured or killed when they leave [abusive partners], which doesn’t mean staying is the solution—but leaving has to be done carefully and include safety planning,” she says. “That’s why healthcare providers have a vast opportunity to create a bridge to those domestic violence professionals who understand safety planning. The onus is not on the healthcare professional to solve the problem. They obviously can’t. But they can be a bridge and they can empower the patient.”

Often, Hewins said, healthcare providers or someone in their family have experienced domestic violence.

“One time we did a presentation and one of the nurses said ‘Wow, you know, my daughter is a survivor and I just learned today that I said all the wrong things to her,’ which was kind of heartbreaking,” she said. “But part of the seminar is to not focus on why they stay [in abusive relationships] because that’s a way of blaming the victim.”

During their talks, Hewins and colleagues provide specific tips to healthcare professionals. For example, if a partner is hovering in the doctor’s office, ask him to go grab something, like water or ice, and send him on the scenic route in order to allow more time for a private conversation. They also provide nurse pocket cards that have a list of questions to ask in a screening and emergency numbers to call.

“It’s important to think of [domestic violence] as a health issue for a variety of reasons, and one of the main ones is that it has a huge detrimental effect to the people that are victimized, and to the children who witness it,” Hewins said. “To have the opportunity to be in Washington D.C. to do the briefing and have a spotlight on this issue was tremendous because it is an epidemic, and we’re all either a survivor or we know one.”

At the briefing, Verizon and the Society for Women’s Healthcare Research announced the formation of an international, interdisciplinary network of healthcare providers, domestic violence awareness advocates, and academic, government and healthcare technology leaders. The network will conduct an in-depth examination of the chronic health consequences of violence against women and explore ways in which technology can help address this issue.  


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