Last year, advocates from BWRI’s SAFEPLAN program completed 965 surveys with clients in five district courts in our region. The survey asked two medically related questions: “Did you seek medical care as a result of this current domestic violence incident?” and “Have you ever sought medical care as a result of a domestic violence incident?” The results showed that less than 10% of our clients seeking protection orders answered, “yes” to either question. Considering the level of injury (emotionally, physically and sexually) that our clients present, it was shocking to see less than 10% seeking medical care. This is unacceptable.

Coupled with the results of the survey and BWRI’s desire to promote programs that focus on the prevention and early intervention of domestic violence, BWRI has launched a Domestic Violence Health Care Initiative. The initiative is designed for several purposes. The first priority is to raise the awareness of domestic violence as a serious public health issue not only among victims, but members of the medical profession and the community as well. The second priority is to train physicians, nurses and auxiliary health care workers how to recognize, treat and refer patients identified as victims of domestic violence. The initiative will reach all of North Central Massachusetts over the next several years, beginning with a partnership with Health Alliance.

Dr. Bruce Man, a local pediatrician and a member of Health Alliance with Physicians Inc., was awarded an $82,000 grant by Harvard Pilgrim Health to address domestic violence within the Health Alliance system. This grant will be a collaborative project with Health Alliance and BWRI. In addition, BWRI has been awarded a $15,000 grant from Tufts Health Plan and $7000 from the Hoche-Scofield Foundation in Worcester for the health initiative. The funds will be used to design training and public education materials as well as to do trainings for medical professionals throughout the region. The materials for victims will be produced in English, Spanish and Hmong.

Building a coordinated community response to domestic violence is essential to the reduction and the eventual elimination of the violence that impacts our families. The health care system is a crucial piece of that coordinated response; it has as large a role to play in the intervention and prevention of domestic violence, the same as the police and courts.

During the early 1980’s, police departments, prosecutors and court personnel were trained on domestic violence; new laws were written influencing the legal system’s response to domestic violence and systemic change offered increased protection for victims and an awareness in the community that domestic violence was a crime. The same sequence is currently taking place in the health care system with medical research projects indicating that domestic violence is a major public health problem for victims as well as communities.

In a report issued in 2003 by the Center for Disease Control and Prevention, entitled “Costs of Intimate Partner Violence Against Women in the United States”, the CDC estimates the total healthcare costs, including medical and mental health care services, of domestic violence were estimated at $4.1 billion each year! This estimate does not include the costs associated with police, courts, shelters, foster care or days lost from employment.

In Healthy People 2010, the US Department of Health’s report on the ten leading indicators for public health problems in this country, eight are associated directly with domestic violence. “Failure to integrate a coordinated response for domestic violence into public health practices has major consequences. The quality of services and the safety of clients can be seriously compromised when victimization is not identified.”

BWRI is very pleased that the communities of North Central Massachusetts will benefit from this health initiative that targets a serious public health issue such as domestic violence. The key component in this initiative for BWRI, however, is that family and community members hear the message that domestic violence is, in fact, impacting their health and well being, if not their life or the life of a loved one.