Public Violence Dominates The Media, Domestic Violence Often Goes Unnoticed

Increased attention has been focused on violence in public places. It is now nearly commonplace to hear and read of devastating school violence. We are becoming accustomed to reports of people heavily armed storming into public places ranging from daycare centers to places of worship, firing off a storm of bullets. Reports of hate-related violence are appearing all too frequently.

These public displays of violence do not go unnoticed. They reach the consciousness of the media, the community and on an individual level they cause alarm as we question our perception of safety in an increasingly more violent world.

Many of us may think of public places as dangerous, but rarely do we think of home as a place of danger. Violence that goes on behind closed doors in homes against a spouse or a child known as domestic violence often goes unnoticed by the media, neighbors and co-workers. This tears apart our conception of safety and rips apart the lives of its victim through dangerous physical and emotional scarring and even death.

Domestic Abuse

Writing in The New England Journal of Medicine on Sept. 16, 1999, Eisenstat and Bancroft give this definition: "Domestic abuse, or battering, is a pattern of psychological, economic and sexual coercion of one partner in a relationship by the other that is punctuated by physical assaults or threats of bodily harm."

The authors examine the magnitude of domestic violence in America. They note that more than 90 percent of cases of partner violence involve women being abused by men. Domestic violence is also perpetrated against women in same sex relationships. Women are not the only victims of domestic violence. Men are physically abused by women and in same sex relationships. Older adults are victims of domestic violence with more cases of abuse against older women being reported.

The signs of domestic violence can be recognized in health settings when the victims seek care. Through routine medical, gynecological and pediatric visits, physicians and other healthworkers have the opportunity to prescreen for domestic violence. By identifying the signs of domestic violence, there is a chance to offer the victim early help. All too frequently these signs are only identified later by police in calls for domestic violence and in homicide cases by coroners.

The New England Journal of Medicine article indicates the prevalence of domestic violence in the health care setting as follows:

Emergency Medicine

One in four women seeking care in the emergency department is a victim of domestic violence. The incidence of domestic violence against women often increases when they are pregnant.

Obstetrics and Gynecology

One in six pregnant women is abused during her pregnancy. A women's refusal to seek prenatal care may be a sign of possible domestic violence.