Intimate partner violence (IPV) is unfortunately a growing public health concern in the United States. The National Institute of Justice and the Centers for Disease Control and Prevention found approximately 1.5 million women are raped and/or physically assaulted by an intimate partner every year in the United States. In 2005, 1,510 deaths were a result of IPV of which 78% were female. The increasing number of women who are being treated for injuries and emotional issues related to IPV has incited controversial debate among clinicians and health professionals in the medical community to consider routinely screening women for IPV. Although the U.S. Preventive Services Task Force released a recommendation outlining insufficient evidence to recommend for or against screening of women for IPV over a decade ago, the medical and public health community are once again left to sort through the costs and benefits of yet another complex health issue to save our women.
While the majority of individuals in the health field are concerned about the greater good of the people and establishing a set of health standards that will ultimately prevent catastrophic, life-altering events for all, it seems likely that routine screening for IPV would create more problems than benefits. A study in the Journal of Women’s Health found there is a lack of evidence suggesting early treatment produces better health outcomes for asymptomatic women, or those who lack any signs or symptoms of the condition. Consequently, it seems likely clinicians and health care providers who already have limited time and resources would be implementing routine IPV screening practices based more on theory than scientific evidence. Additionally, if a woman were found to be a victim of IPV as a result of the screening, the physician would need to have sufficient contacts and resources for additional assistance outside of the physician’s office (i.e. shelters, support groups, social workers) and ensure there is a follow-up (something we don’t always do in the U.S.). It could also be that even after the woman is diagnosed, she may not be ready or willing to use the available services to ultimately end the abuse. I’m sure we’ve all heard the stories about women going back to their partners who have physically and/or emotionally abused them for years. Research has found that women in violent relationships may progress through various stages of emotional and cognitive changes before taking any behavioral steps to improve the situation. Moreover, routine IPV screening could increase feelings of stigmatization and anxiety for women. Therefore, physicians would have to be willing to provide the comfortable, compassionate setting to allow women to discuss such a sensitive topic. Routine screening for IPV would not only place additional responsibilities on health care providers, but it would also require more training and increased levels of cultural competence to ensure all women who are screened are free of judgment, feel safe, and have access to the resources and follow-up they need to end IPV and prevent any future occurrences. The question still remains if health care providers are sufficiently prepared and ready to undertake all the responsibilities to help victims of IPV, particularly with the current shortfalls providers are already facing. So, while it would great to identify women experiencing IPV, we need to know we have the resources to help them and not put them in further danger.
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IPV is a significant women’s health issue that cannot be ignored. While routine screening has yet to be proven effective, more research needs to be done to determine how screening affects women’s health outcomes. To begin making a difference now, we can increase awareness by organizing more educational campaigns, creating a supportive environment in health settings with posters and literature that are inviting and encourage women to discuss IPV, and partnering with domestic violence advocacy groups across the country to establish events and open forums to determine what the women would like to see happen. Women need to be more involved in the decisions and policies that affect their overall health, so it is necessary to establish a platform for them to exercise their voice. This may also empower women to speak about other issues affecting their health. Establishing partnerships between professionals across health and psychosocial disciplines, conducting more scientific research, and empowering women to be strong, resilient individuals can improve health outcomes and ultimately determine if routine screening is indeed beneficial for all stakeholders.