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Intimate Violence Hurts Health

CDC: 1 in 4 Women, 1 in 9 Men Suffer Intimate-Partner Violence

Intimate Violence Linked to Long-Term Health Problems continued...

Black is quick to note that survey data do not show whether partner violence caused these health problems. But she says previous studies have found high stress levels in people with abusive spouses -- and that high stress levels are linked to chronic health problems.

Stress isn't the only health issue for victims of domestic violence.

"The perpetrator of domestic violence often controls household financial resources," Sherman says. "Part of the control may be limiting that person's access to health care. Or the abused individuals may feel depressed or disempowered, making it hard for them to get to the help they need or to adhere to medications."

Because of the link to health problems, the CDC recommends that doctors ask patients about intimate-partner violence. That may be harder to do than it would seem.

"If you are a provider in a busy clinic, do you want to ask? Do you have the time? And if you ask, you open a complicated issue that takes even more time you don't have," Sherman says. "I like the philosophy of asking, but the health care system has to develop the resources. One reason docs don't ask is they don't feel all the resources they need are in place. You'll find that where there are domestic-violence resources, the levels of asking are higher."

Black says that contrary to common assumptions, patients being abused by an intimate partner want their doctors to ask them about it.

"Those asked about intimate-partner violence do respond very well by making changes in individual behaviors and reducing their safety risk," Black says. "They respond very well to being asked about intimate-partner violence by their doctor. It builds rapport with the doctor. People do think they should be asked and appreciate it when they are asked."

The CDC's ultimate goal is to prevent intimate-partner violence in the first place. Last year the CDC launched the multimedia "Choose Respect" initiative to encourage 12- to 14-year-old adolescents to learn about positive relationship behaviors.

"We try to teach these things early, before people are dating, before norms for partner violence are established," Black says.

Domestic violence has other victims beyond the abused partner.

"One thing not paid enough attention to is the effect on children," says Sherman, a pediatrician. "There are children in most households with intimate-partner violence. There is an enormous impact on these kids' emotional and physical health -- and on how they will respond to relationships as adults, either by being perpetrators or victims of domestic violence."

The CDC report appears in the Feb. 8 issue of Morbidity and Mortality Weekly Report.

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