Violence and Your Health

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The National Health Collaborative on Violence and Abuse (NHCVA), comprised of more than 30 national health professional organizations dedicated to addressing the health consequences of violence and abuse, held its annual meeting this month at the Center for Total Health. Brigid McCaw, MD, of Kaiser Permanente’s Family Violence Prevention Program participated in the meeting. “What I love about hosting meetings here at the center is the connections that you make. The center allows conversations to happen that are bigger than the building itself, bigger than what’s just included in its four walls. Diverse groups gather here and tackle issues bigger than themselves and implement real solutions to problems that impact everyone’s health.”

Two focus areas emerged during the meeting: 1) education of health care professionals from all disciplines and 2) understanding current/potential legislative policy on issues related to adult, child and elder abuse. All forms of violence were discussed. Speakers from medical societies, advocacy orgs and the federal government shared best practices so everyone could learn from one another.

“The relationship between violence and health is becoming more well-known. We know that exposure to violence as a child can impact your long-term health, said Paula Amato, MD, immediate past chair of NHCVA. “We need to promote the science of violence to the next generation of health care leaders.  Partners such as Kaiser Permanente, as well as other member organizations, are helping shape that progress.”

Moving forward, NHCVA members would like to see greater access to resources for victims of violence.  Health care providers and health systems are starting to share best practices in caring for victims of violence. Longer-term and, perhaps more pro-actively, health care systems can play a bigger role in the prevention, the intervention and the promotion of healthier relationships.

Futures without Violence is a member of NHCVA. Futures offers numerous resources for trauma-informed care. Through the collaborative work facilitated through NHCVA, we can expect to see promotion of tools for clinics and health professionals as well as discussions on what models of care are available to be better integrate care for victims of violence wherever they enter the health care system.

Ultimately, violence is just as much a part of someone’s health as are other social and behavioral determinants of health (e.g., race, ethnicity, food insecurity, depression, substance misuse, etc.)  Thankfully, the work of NHVCA are starting to raise the visibility of this issue and bringing forth the opportunity for real change.

IOM Meeting Addresses the Science of Family Violence

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The Institute of Medicine (IOM) held its 43rd annual meeting on The Science of Violence: Causation, Mitigation, and Prevention on Monday, Oct. 21, 2013, in Washington, DC. The meeting served as a catalyst to bring attention to this issue.

Mark Rosenberg, MD delivered the keynote address.  Dr. Rosenberg has devoted his career to approaching violence as a public health issue and in 1994 started the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention.

The concept that violence is preventable is a paradigm shift that has occurred during the last 40 years. Throughout the day, participants heard about the extent of the problem and the extraordinary impact of violence on families, communities, and its contribution to health disparities.

Dr. Rosenberg raised the questions: “What is the problem?” “What are the causes?” “What works?” and “How do you it?”

Brigid McCaw, MD

Brigid McCaw, MD

There are answers: Brigid McCaw, MD, medical director for Kaiser Permanente’s Family Violence Prevention Program and member of the IOM Forum on Global Violence Prevention, participated in a panel discussion and offered an example of a successful approach to family violence prevention in a large health care delivery organization. Read on to hear what she has to say.

Dr. McCaw, your contribution focused on answering the question, “what works and how do you do it?” What were you hoping to communicate to the audience about the health care system’s role in responding to family violence?

Health care has a unique and important role in violence prevention. For instance, over the past decade Kaiser Permanente has transformed the clinical practice in the area of family violence prevention, specifically intimate partner violence (IPV). Using an evidence-based “systems model” approach that has been widely implemented in our medical centers, we have shown a 7-fold increase in IPV identification. And this approach is being used in other health care settings in the U.S and abroad. The “systems model” approach serves as an example of practice-based evidence that provides valuable “learnings” for the field of violence prevention and offers a very powerful message to the clinicians and scientists who are members of the IOM, and who have a unique opportunity to promote research and funding to move the field forward.

Who else besides health care systems should be paying attention to this topic of family violence?

The response to family violence is going to require a collaborative approach from a variety of stakeholders – schools, criminal justice, public health, elected officials, patient and family advocacy groups – to name a few. Effective investments in preventing violence must recognize and address violence within the family, strengthen social norms that promote healthy relationships, and reduce community-level risk factors.

For more information on this topic, check out Kaiser Permanente Institute for Health Policy’s “Transforming the Health Care Response to Domestic Violence,” – one of the Kaiser Permanente Policy Stories (Vol 1, no.10 , 2012).

Domestic Violence Awareness: Be Informed

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October is National Domestic Violence Awareness Month, and the statistics are sobering:  In the United States alone, one in 4 women and one in 14 men – from all social, racial and economic backgrounds – will experience violence in an intimate relationship during their lifetime.  Below is a video on what Kaiser Permanente is doing to help break the cycle of family violence.

For more information on KP’s award-winning Family Violence Prevention Program, check out this podcast, featuring an interview with Brigid McCaw, MD, MS, MPH — Kaiser Permanente’s clinical lead on family violence prevention in northern California.

Brigid McCaw, MD on Family Violence Prevention

Looking for more information?  Visit the Domestic Violence Awareness Project website.  And if you or someone you know needs help, the National Domestic Violence Hotline is 1-800-799-7233 (TTY:  1-800-787-3224).