Domestic violence (DV) affects about 35% of women in the U.S. and the physical, emotional, and psychological trauma these relationships cause are well-documented. We rightly celebrate the women who are able to overcome the tremendous barriers to leaving abusive relationships as survivors, but disturbingly, many of these women have lasting health problems years—or decades—down the road. There is clear association between abusive relationships and chronic health conditions like lower back pain, headaches, memory loss, difficulty sleeping, depression, diabetes, asthma, and digestive disease. Unfortunately, many women never make the link between their health conditions and past abusive relationships, and neither do their doctors.
A recent study conducted by the Verizon Foundation interviewed over one thousand American women and found that women who reported any kind of domestic violence had higher rates of chronic health conditions that women who had experienced no domestic violence. Forty four percent of the women surveyed admitted to experiencing some type of DV including physical abuse, emotional abuse, sexual abuse, and economic abuse. While 77% of women overall suffer from a chronic health condition, prevalence jumped to 88% for women who have experienced sexual abuse and 81% for women who have experienced any form of domestic violence, a statistically significant increase.
How are abusive relationships affecting women’s health even years after they have left their abusers? One explanation could be the prolonged stress of these relationships. When faced with stress (e.g. a physical threat), your body reacts with a “fight or flight” reaction to enable you to fight back or run away from the danger with cortisol hormones. While these hormones help in the short-term, they can hurt your body when produced for longer periods. Since cortisol affects blood sugar and heart rate, chronic stress is linked to gastrointestinal conditions, hypertension, stroke, and heart disease. Another possible explanation is telomeres, the caps on the end of our DNA that become shorter as we age. Several studies have found that people who are under chronic stress tend to lose the length of their telomeres more rapidly, meaning the stress is permanently aging cells. This suggests a possible explanation for why women under the stress of abusive relationship may suffer diseases like arthritis that typically affect women who are much older.
Many domestic violence survivors never make the connection between their health conditions and their past relationships, and even more alarmingly, neither do health professionals. The Verizon Foundation study found that 81% of women who experienced DV have some type of chronic health condition, but that only 6% believe their doctors or nurses ever made the connection. In fact, about 75% of women say they have never been screened for DV by a doctor or nurse at all. Among the women who had experienced abusive behavior, two-thirds expressed that they would have wanted their doctor or nurse to ask them about it.
Why aren’t healthcare providers connecting the dots? Practitioners may feel that relationships are a private matter outside of their medical jurisdiction. In addition, healthcare providers may still operate under the outdated stereotype of domestic violence as a man beating a (usually less educated and lower class) woman in an out-of-control fit of rage, and many only look for bruises. However, abusive relationships take on many forms, including emotional abuse, threats, economic deprivation, stalking, and controlling behavior, that don’t manifest themselves in physical marks—and affect people from all socioeconomic statuses.
It is important to remember that leaving an abuser marks the beginning of a long journey to recovery. Healthcare providers should become more aware of the importance of assessing patients for abusive relationships, not only among women currently experiencing abuse, but also among women who may have abandoned these traumatic relationships years ago.
Maura Duffy is a Research Assistant at the National Research Center for Women & Families, where she focuses on bridging the communication gap between physicians, scientists, and the general public. A graduate of Georgetown University and an Emergency Medical Technician, Maura is passionate about women’s health, the nexus between social issues and health, and Philly sports
Photo Credit: DC Coalition Against Domestic Violence