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Violence: a household word for many


Last week, as I moved through the cafeteria line at lunch, one of the doctoral students from Johns Hopkins Hospital's Injury Prevention Center stopped me to ask why I haven't written anything about women and domestic violence.

When she told me that injuries related to domestic violence appear to be the single most common cause of injuries to women, I resolved to do a column and asked Linda Chamberlain of the Injury Prevention Center to help me.

What is domestic violence?

Domestic violence against women is defined as a pattern of abusive behavior in which one person, usually a husband or boyfriend, victimizes a woman through physical abuse, emotional abuse, intimidation, sexual assault, social isolation or deprivation. Although a few women leave an abusive situation after the first time they are assaulted, many return to the same abusive home environment.

Family violence is recurrent in 90 percent of the cases, and increases in frequency and severity over time.

Because abusers have a need to control and dominate, they usually keep the woman dependent by restricting her access to money, friends, food, clothes, transportation and health care. This increasing isolation from outside support and resources helps keep many women from getting the help they need to escape the abusive situation.

How many women are abused by their partners?

Of all domestic violence victims, 95 percent are women. It is estimated that an astounding 50 percent of women in the United States will beabused by a partner at some time during their lives. One in 12 women report being battered during pregnancy. According to the FBI, 30 percent of the women who were murdered in 1990 were killed by their partners, while only 6 percent of male homicide victims are killed by wives or girlfriends.

Studies indicate that 22 percent to 35 percent of women treated at emergency rooms are there for symptoms related to domestic violence.

In fact, domestic violence against women has become such a problem that the American Medical Association (AMA) has published a physicians' guide to the diagnosis and treatment of domestic violence, urging doctors to look for signs of abuse and describing ways that physicians can intervene.

What the signs of abuse?

If you have a friend or colleague who has frequent injuries or has been treated for injuries more than once and whose explanations about how she was injured do not make sense, you may be seeing a victim of abuse. The most commonly injured areas of the body due to battering are the head, neck, chest, abdomen, breasts and upper extremities. Pregnant women usually sustain injuries to the abdomen.

Symptoms may also include not getting treatment for injuries that deserve medical attention, depression, anxiety, alcohol or drug abuse and even suicide attempts.

What can I do to help someone who may be abused?

The best support depends on helping a woman find someplace in the community to turn for safety, legal protection and emotional support. Although women are reluctant to talk about their abuse, many may open up if asked caring and direct questions. Even if they do not respond to you, the fact that you asked may give validity to their concerns and make it easier for them to seek help.

The first concern must be to prevent death or injury from any future abuse to the woman and her children. There is a strong association between domestic violence and the risk of child abuse in the same household. Most community groups that work with abused women are prepared to work with the entire family, including the abusing partner.

How can I learn more about domestic violence?

In Baltimore, you can call the House of Ruth, a safe, confidential shelter for battered women and their children.

The House of Ruth operates a domestic violence hot line for counseling and referrals 24 hours a day, seven days a week for battered women, children, abusers and concerned family members and friends. The staff can be reached at 889-RUTH (889-7884).

For additional information, callers can reach the National Coalition Against Domestic Violence at (303) 839-1852.

An informative pamphlet, "The Battered Woman," can be obtained by calling the American College of Obstetricians and Gynecologists at (202) 836-5577.

Health care providers can call the AMA at (312) 464-5066 to get the brochure, "Diagnostic and Treatment Guidelines on Domestic Violence."

The AMA has also established a National Coalition of Physicians Against Domestic Violence.

Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health.

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