JUNE 2005
In this issue...
News
Announcements
NEWS
Title V of VAWA 2005 Strengthens Healthcare Response to Family Violence
Senators Joseph Biden (D-DE), Orrin Hatch (R-UT) and Arlen Specter (R-PA) introduced the Violence Against Women Act of 2005 in the United States Senate on June 8. Representatives Mark Green (R-WI), John Conyers (D-MI), Ginny Brown-Waite (R-FL) and Hilda Solis (D-CA) introduced it in the House of Representatives a week later. The bill, which was first enacted in 1994 and re-authorized in 2000, will expire in September unless Congress acts.
The bipartisan Violence Against Women Act of 2005 takes the ground-breaking Act of 1994 to the next level. It not only renews existing, fundamental programs, but also focuses on other crucial aspects of domestic violence and sexual assault, such as treating children impacted by the violence, enhancing health care for rape victims, holding repeat offenders and high tech stalkers accountable, easing housing problems for battered women, and helping domestic violence victims hold on to their jobs. The bill is a comprehensive measure that strikes the right balance between rejuvenating core programs, making targeted improvements, and responsibly expanding the Violence Against Women Act to reach the needs of America’s families.
VAWA Health:
Doctors and nurses, like police officers on the beat, are often the first witnesses of the devastating aftermath of abuse. As first responders, they must be fully engaged in the effort to end the violence and possess the tools they need to faithfully screen, treat and study family violence. Title V of the VAWA 2005 bill strengthens the health care system’s response to family violence with programs to train and educate health care professionals on domestic and sexual violence, foster partnerships between advocacy groups and public health officials, and new research on ramifications of health care interventions with victims.
Section 503 of the bill provides $3 million in grants each year from 2006 through 2010 for training medical and other health professional students on recognizing and appropriately responding to domestic and sexual violence. Funds will be administered by the Department of Health and Human Services and will go to medical schools working in collaboration with other health professional schools, including schools of nursing, public health and dentistry, and may be used to offer specialized training for rural areas, and to provide stipends to students underrepresented in the health professions. Funds may also be used to address child and elder abuse as part of a comprehensive program.
Section 504 of the bill authorizes $5 million each year from 2006 through 2010 in grants to foster public health responses to domestic violence, dating violence, sexual assault and stalking. These grants are intended to promote collaborations between domestic and sexual violence service providers and health care providers including state hospitals and public health departments. These programs would provide training and education to health care providers and would develop policies and procedures that enhance screening of women for exposure to domestic and sexual violence, and encourage proper identification, documentation and referral for services when appropriate.
Section 505 authorizes $5 million each year from 2006 through 2010 for research on effective interventions in the health care setting to address domestic violence. This includes funding for the Centers for Disease Control and Prevention (CDC) and Administration for Healthcare Research and Quality (AHRQ) to evaluate effective interventions within the health care setting to improve abused women’s health and safety and prevent further victimization.
“These lawmakers did a great service to the nation by introducing a strong Violence Against Women Act,” said Family Violence Prevention Fund President Esta Soler. “If it is fully funded, strengthened and passed, this bill can do a tremendous amount to prevent violence of all kinds, and to help victims of domestic and dating violence, sexual assault and stalking.”
To learn more about the Violence Against Women Act reauthorization, Click Here or contact Kiersten Stewart at (202) 682-1212 or Kiersten@endabuse.org.
Harvard Study Shows Link Between IPV and Adverse Health Behaviors
Harvard researchers report that a woman who smokes and displays evidence of problem drinking has nearly a one-third likelihood of having been abused by an intimate partner within the preceding 12 months. That percentage jumps to a 54% likelihood of abuse in the course of her lifetime. The findings appear in the May 9, 2005 edition of Archives of Internal Medicine.
The study's lead author, Dr. Megan Gerber, a practicing physician at Cambridge Health Alliance and Instructor of Medicine at Harvard Medical School, notes “Our study hopes to raise physician awareness of how common domestic violence is in practice, especially among women who exhibit adverse health behaviors. Physicians regularly screen for tobacco and alcohol use in their practices, however routine assessment for domestic violence has been much more controversial, and many clinicians do not regularly ask their patients about it.”
Intimate Partner Violence (IPV) is a major public health problem in the United States and victims are commonly encountered in medical settings. Many barriers exist to clinician-initiated screening for IPV. However, smoking and problem drinking are conditions that clinicians commonly screen for and both have been strongly associated with IPV in prior studies. By estimating the predicted probability of 12-month and lifetime IPV for a given patient based on whether she presents with these conditions, this study gives clinicians information that can help them identify patients at risk for IPV.
These findings were drawn from the Women and Family Life Project, a government-funded study that examines the health of battered women. The research was funded by a grant from the Agency for Healthcare Research and Quality.
A written survey was administered to 2,386 female medical patients throughout the greater Boston area. The probabilities of 12-month and lifetime abuse by an intimate partner were estimated based on women's reports of their smoking and drinking behaviors. Women who neither smoked nor drank in the study still had a 10% likelihood of abuse in the preceding year and a nearly 40% chance of lifetime abuse, illustrating how common this problem is in medical populations.
Gerber and her colleagues concluded that the presence of smoking or problem drinking should raise clinicians' suspicion for IPV. This paradigm should not replace direct questioning about IPV, but may aid in detection of abuse in patient populations.
Authors of the study include Megan R. Gerber, MD, MPH, Cambridge Health Alliance, Harvard Medical School, Michael L. Ganz, MS, PhD, Harvard School of Public Health, Erika Lichter, ScD, Harvard School of Public Health. Corrine M. Williams, MS, Harvard School of Public Health and Laura A. McCloskey, PhD, Harvard School of Public Health and University of Pennsylvania School of Social Policy and Practice, Philadelphia, PA.
Source: Medical News Today; Released Tuesday May 25, 2005
Exposure to Domestic Violence Harms Children's Health: Study
Being abused, exposed to domestic violence and having a mother who abuses substances are associated with a high number of health problems for low-income pre-school children. In fact, the mother’s poor health and the child’s level of trauma are the strongest predictors of poor child health. These are among the findings of a study entitled Violence Exposure and Traumatic Stress Symptoms as Additional Predictors of Health Problems in High-Risk Children published in the March 2005 issue of the Journal of Pediatrics.
Researchers looked at 160 pre-school age children from low-income Michigan families, and found that three in four (78 percent) had been exposed to some form of violence, either in the home or the community. Nearly half (46.7 percent) of the children in the study had been exposed to at least one incident of mild or severe violence in their family.
The children who were exposed to violence suffered symptoms of post-traumatic stress disorder, such as bed-wetting or nightmares, and were at greater risk than their peers of having allergies, asthma, gastrointestinal problems, headaches and flu. Children experiencing post-traumatic stress disorder had four times the risk of asthma and gastrointestinal problems than their peers.
The study is authored by Dr. Sandra A. Graham-Bermann, PhD and Julie Seng, PhD, CNM. They write: “Although stopping intrafamilial and community violence may be daunting projects beyond the scope of health care providers’ direct practice, clinical interventions to increase the mother’s safety and improve her ability to protect her child are of the highest priority. Child traumatic stress symptoms are also treatable, and referring violence-exposed child patients to group or individual therapy specifically aimed at bolstering their power to cope and at reducing post-traumatic stress reactions may be effective in preventing some of the adult [consequences] of these adverse childhood events.”
“Advocates are trying to get more money for prevention and intervention services for children exposed to violence in the Violence Against Women Act that Congress will consider this year,” said Family Violence Prevention Fund President Esta Soler. “If lawmakers really care about improving children’s health and prospects, they will allocate these funds.”
ANNOUNCEMENTS
Summary Report on Health Costs of Intimate Partner Violence in Australia Released
VicHealth in partnership with the Department of Human Services in Australia has released a summary of findings of a joint study conducted to assess the health impact of intimate partner violence on women in Victoria, Australia. The summary report entitled Health Costs of Violence: Measuring the Burden of Disease Caused by Intimate Partner Violence draws from research evidence to demonstrate the social and economic consequences of the health impacts for women, their families and the community resulting from domestic violence.
A publication providing further detail on the study, and in particular the methodology used to estimate the burden of disease contributed by intimate partner violence, is currently under preparation and information about its availability will shortly be available here.
The Health Costs of Violence Report assessed the health impact of intimate partner violence for Victorian women in relation to its prevalence, the health problems it causes and its contribution to the total disease burden in women. Key findings include:
Intimate partner violence has wide ranging and persistent effects on women’s physical and mental health and contributes 8.8 per cent to the total disease burden in Victorian women aged 15 to 44 and three per cent in all Victorian women;
It is the leading contributor to death, disability and illness in Victorian women aged 15-44, being responsible for more of the disease burden than many well-known risk factors such as high blood pressure, smoking and obesity;
Direct health consequences for women exposed to violence include depression, anxiety and phobias, suicide attempts, chronic pain syndromes, psychosomatic disorders, physical injury, gastrointestinal disorders, irritable bowel syndrome and a variety of reproductive consequences;
The economic consequences of violence against women are also increasingly recognized with Australian businesses losing at least $500 million per year because of the effects of family violence on their employees.
One in five Australian women report being subjected to violence at some stage in their adult lives, increasing their risk of mental health problems, behavioral and learning difficulties. As estimated, one in four Victorian children has witnessed intimate partner violence, increasing their risk of mental health problems, behavioral and learning difficulties.
The summary report has a comprehensive list of references for those wishing to read more widely on this subject. To download a PDF version of the summary, Click Here.
New Resource Webpage on Intimate Partner Violence for Health Care Practitioners
The Vermont Medical Society together with the Vermont Network Against Domestic and Sexual Violence has developed a new resource webpage on Intimate Partner Violence (IPV) for health care practitioners.
The webpage provides state-of-the-art information, tools, resources and links specifically designed for clinicians, administrators and educators working in health care and public health settings to enhance the health care response to intimate partner violence.
To view this new resource, please visit the Vermont Medical Society’s website.
New Curriculum on Intimate Partner Violence for Health Care Providers
The Vermont Network Office in collaboration with the Vermont Department of Health and the Vermont Medical Society has created a curriculum specifically designed for health care providers. The comprehensive curriculum packet contains power point lectures with extensive lecture notes, handouts and exercises for the participants, videos, and materials to organize a community resource panel. It comes with a detailed facilitator’s guide.
The curriculum is based on the result of focus groups with Vermont health care professionals and follows the recommendations on family violence education for health care professionals provided by the Centers for Disease Control and the Institute of Medicine. It is designed to be facilitated by a teaching team including both health care professionals and domestic violence advocates. The four units can be implemented in 4-6 hours, either in four separate sessions or in one full-day training.
The statewide Health Care and Intimate Partner Violence Leadership Team is currently discussing strategies to make this curriculum available to Vermont health care providers and to recruit and train future facilitators. If you have questions, comments or ideas regarding this project, please contact the Health Care Project Coordinator at (802) 223-1302 or vtnetwork@vtnetwork.org.
Call for 2006 NCHS/Academy Health Fellowship Applications
The National Center for Health Statistics (NCHS) in the Center for Disease Control and Prevention's (CDC), U.S. Department of Health and Human Services (DHHS), and AcademyHealth seek applicants for their 2006 Health Policy Fellowship. This program brings visiting scholars in health-services-research-related disciplines to NCHS to use NCHS data systems and collaborate on studies of interest to policymakers and the health services research community.
Each year, up to two individuals will be selected for the fellowship. Fellows will conduct their research and work collaboratively with NCHS staff on joint projects of mutual interest while in residence at NCHS in Hyattsville, Maryland. The duration of the full time fellowship is 13-24 months, beginning in September 2006 to January 2007.
Applicants must demonstrate training or experience in health services research and methodology, reflecting disciplines such as:
Public Health
Public Administration
Healthcare Administration
Statistics
Sociology
Economics
Behavioral Sciences
Applications are welcomed from doctoral students through senior researchers/faculty. Doctoral students must have completed course work and be at the dissertation phase of their programs. Applicants must be U.S. citizens or permanent residents. The deadline for receipt of applications is Monday, January 9, 2006. For more information, Click Here or email nchs@academyhealth.org.
Health e-News is a monthly electronic news digest focusing on health care and domestic violence policy, research, prevention and advocacy. Health e-News is available in both text and html formats. To subscribe Click Here.
We encourage you to use Health e-News to share news, views, and experiences concerning your projects and activities on addressing domestic violence as a health care issue. To post an announcement or ask a question, send an e-mail to HealthE-News@endabuse.org. The digest is monitored by Vibhuti Mehra, Senior Program Assistant with the Family Violence Prevention Fund.
Thank you for your ongoing commitment to end domestic violence!
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This publication is funded in part by U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Family and Youth Services Bureau.
Copyright © 2003 Family Violence Prevention Fund
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