By Caroline Newman
UAB News
Among the hidden costs of the COVID-19 pandemic is an alarming rise in domestic violence and intimate partner violence.
According the American Journal of Emergency Medicine, domestic violence cases increased by 25-33 percent globally in 2020. At the local level, domestic violence calls in Jefferson County increased by 27 percent in March 2020 compared to March 2019. This trend continued in other cities around the United States, including Portland, San Antonio and New York.
In the midst of Domestic Violence Awareness Month, Sumayah Abed, M.D., assistant professor in the University of Alabama at Birmingham’s Department of Family and Community Medicine and UAB Hoover Primary Care Clinic physician, is working to raise awareness among health care providers. She is especially concerned about the risk of intimate partner violence, which is already underreported and underdiagnosed by physicians.
“Even after recognizing the problem of intimate partner violence, victims may not get the necessary support,” Abed said. “Unfortunately, many health care workers are unfamiliar with the policies and the resources to help them.”
Intimate partner violence, defined as violence among current or former partners that may include stalking and physical, psychological and sexual violence, is common worldwide and affects both males and females. It is more commonly reported by heterosexual women, but it is likely to be underreported in men, transgender and gender non-conforming people, and same-sex relationships.
According to the National Coalition Against Domestic Violence, nearly 20 people per minute are physically abused by an intimate partner in the United States. Intimate partner violence accounts for 15 percent of violent crime in the United States. Approximately one in four women and one in nine men experience intimate partner violence.
The pandemic intensified many of the conditions that can fuel intimate partner violence, with many families facing economic tension along with the stress and uncertainty created by COVID-19.
“Besides the quarantine situation, the pandemic also aggravated alcohol abuse, depression and post-traumatic stress disorder,” Abed said. “All of these factors created an environment that exacerbates domestic violence.”
Assessing Risks
As the pandemic continues, health care providers should be conscious of those risk factors, including psychiatric illness, alcohol consumption, drug abuse and economic stress. Pregnant women are also at higher risk of domestic violence, which can increase the risk of pregnancy-related complications, such as miscarriage, pre-term labor and low birth weight in infants.
Additionally, children who come from families with a history of domestic violence are at a higher risk of replicating or falling victim to those behaviors in adulthood. All forms of domestic violence, including intimate partner violence, can have a devastating ripple effect in families and communities, something that health care providers like Abed are particularly concerned about. Fortunately, early awareness and intervention can help prevent generations of trauma.
Health Care Providers Can Help
At the clinical level, prevention of intimate partner violence starts with consistent and accurate screening, Abed says. She and her colleagues at Hoover Primary Care use several screening tools to detect domestic violence and intimate partner violence, including both self-reported information from the patient and physician-administered questions. They also follow the U.S. Preventive Services Taskforce recommendation to screen all women of childbearing age for intimate partner violence.
Health care providers should pay particular attention to families at risk of domestic violence, Abed says, in order to protect the family and prevent future domestic violence by children in that family, who are exposed to that behavior early on.
More broadly, media campaigns, such as one launched by the World Health Organization to provide education about intimate partner violence, can also help to raise awareness and educate patients and providers. The WHO campaign aims to make that information accessible in clinics and patient settings, as well as among policymakers and researchers.
Finally, macro-level changes such as empowering women economically and creating a broad, interprofessional support network for victims can help bring about long-term change.
“Interprofessional collaboration is key to helping victims of domestic violence,” Abed said. “Health care workers, social services, and legal and law enforcement officers are all essential to help victims and survivors of domestic violence.”
Anyone experiencing domestic violence or concerned about a loved one facing domestic violence can connect with a crisis counselor by calling the Birmingham Crisis Center at 205-323-7777.
