WUNRN
USA - COSTS OF DOMESTIC VIOLENCE -
LIVES, EXPENSES, LOSSES
By Robert Pearl, MD -
12/05/2013
A woman comes to the doctor with depression, fatigue and insomnia. A co-worker stays late in the office even when there is not much to do. A sales associate appears tired and distracted.
For each of these individuals, domestic violence – physical, sexual, verbal, emotional or psychological abuse against an intimate partner – could be the underlying cause of distress. Historically, domestic violence has been viewed as a criminal issue – according to police records, almost 1 in 3 female homicide victims are killed by an intimate partner.
But today we know it as a social, business and health priority, as well. Not
only does it cause personal suffering, but domestic violence also reduces
productivity, leads to absenteeism and drives up health care costs. And unless
people are trained to look for it and ask about it, domestic violence is rarely
identified.
The statistics are staggering
Domestic violence is all around us. It affects our families, our friends, our
coworkers and our neighbors. Most of the time, we are not aware it’s happening.
In the U.S., 24 percent of adult women and 14 percent of adult men have been physically assaulted by a partner at some point in their lives. It is the most common cause of injury for women ages 18 to 44. And it leads to an increased incidence of chronic disease: 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.
Nearly a quarter of employed women report that domestic violence has affected their work performance at some point in their lives. Each year, an estimated 8 million days of paid work is lost in the U.S. because of domestic violence.
Domestic violence costs $8.3 billion in expenses annually: a combination of higher medical costs ($5.8 billion) and lost productivity ($2.5 billion).
Addressing this issue could save thousands of lives and billions of dollars.
But as long as the symptoms and consequences of domestic violence go unnoticed
or overlooked, nothing changes.
Addressing domestic violence starts with raising awareness
A growing number of health care professionals and business leaders understand
the importance of recognizing and addressing domestic violence. But they remain
in the minority. Most doctors don’t take the time to learn about and use
established screening techniques. And unless domestic violence can be
identified, we can’t help victims deal with the abuse or reduce the long-term
consequences.
Some businesses have taken action and seen results. Companies like Verizon, Allstate, Prudential, Avon, Mary Kay, Macy’s and Home Depot have trained their employee assistance teams to screen for domestic violence. They’ve provided necessary information to their staffs and, most importantly, they’ve seen the rate of identification increase significantly.
Several years ago, I had the chance to speak at a conference on domestic violence hosted by Liz Claiborne, now Fifth & Pacific Companies. The meeting was well attended by executives from across the industry. As part of the program’s goal to raise awareness, we heard from the victims about their experiences. Their heart wrenching tales of fear and abuse reinforced this nation’s need for early intervention.
We’ve seen some progress since then, but the silence remains deafening.
Everyone has a role in curbing domestic violence
While there are significant differences in the roles that
colleagues, health care professionals and friends can play, the
secret nature of domestic violence requires vigilance from everyone.
The role of the employer
Employed individuals spend the majority of their waking hours at work. That’s
why employers are ideally suited to spot the symptoms of domestic violence and
intervene. In fact, providing resources and support is part of a company’s
requirement for ensuring a safe work environment.
Senior executives can promote a culture that includes domestic violence awareness and prevention. Information about domestic violence should be shared at every employee orientation. It should be addressed at every occupational health visit. It can be incorporated into workplace wellness activities. When the issues of domestic violence are brought front and center in as many venues as possible, we have a better chance of breaking the silence.
Employee assistance counselors and human resource professionals need to be ready to respond to inquiries, refer victims to advocacy services, engage with law enforcement when appropriate and offer security assistance when necessary.
Managers need to understand that domestic violence may explain absenteeism
and ongoing health problems. They should be trained to recognize potential
signs of domestic violence, including signs of depression and evidence of
physical harm. They should be trained to ask about it with confidence and
without judgment. They should know where to refer individuals who are victims
of domestic violence, including employee assistance programs (EAP) and
community resources.
Without a stable job, most victims are unable to remove
themselves from a dangerous domestic arrangement and escape the long-term
consequences of abuse.
The role of the clinical team
The Affordable Care Act
identifies domestic violence screening as a national health priority, alongside
smoking cessation, exercise, nutrition, substance abuse reduction and the
provision of mental health services.
Health care professionals play an important role in identifying victims of domestic violence. When women talk with their physicians about domestic violence, they are four times more likely to receive the needed services and end the abusive relationship.
Physicians need to pay attention to physical and behavioral signs of
potential abuse. They should ask about domestic violence as a potential cause
of unrecognized medical problems. They need to be trained to communicate in
ways that are supportive and non-judgmental. And when patients ask for help,
they should be aware of the available community and national resources.
The role of family, friends and colleagues
Family members, friends and colleagues are often the first to hear that someone
they know is a victim of domestic violence. When people are educated about the
frequency of domestic violence, they are more comfortable talking with others.
Being able to offer support can mean the difference between life and death. A
simple statement like “I’m sorry this is happening to you” is a start. Offering
to help the victim obtain assistance – whether through the national domestic violence hotline,
a company EAP or a local domestic violence advocacy organization – is a crucial
next step.
Putting an end to domestic violence has broad implications
Regardless of who helps identify the problem or which agency provides the care,
the majority of individuals who end violent relationships do not experience
another one. The victims of domestic violence are just that: victims. They
don’t want to be in abusive situations. They just are. And we all need to
recognize the role we can play in helping them.
When we fail to provide the training and infrastructure needed to address domestic violence, the individual suffers. But so do the individual’s children, business colleagues and all of us. As we search for ways to improve this country’s health while lowering costs, shedding light on domestic violence and protecting the victims of abuse is a great place to start.