Statements on Introduced Bills and Joint Resolutions

Floor Speech

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Mrs. HAGAN. Mr. President, today I am proud to introduce the Violence Against Women Health Initiative. October is Domestic Violence Awareness month, and this bill will raise awareness of domestic violence among health care providers and allow them to better assess and treat survivors of domestic violence.

The rates of violence and abuse in this country are astounding. Nearly one in four women in the U.S. has reported experiencing domestic violence at some point in her life. In 2007, there were 248,300 reported incidents of sexual assault in the U.S. Young women experience the highest rates of sexual assault and stalking. Sadly, 15.5 million children in the U.S. live in families in which partner violence has occurred in the past year, and 7 million children live in families in which severe partner violence has occurred.

Domestic violence has a significant impact on our country's health. According to the Centers for Disease Control and Prevention, CDC, intimate partner violence costs the health care system over $8.3 billion annually.

In addition to injuries sustained during violent episodes, survivors suffer lifelong health complications. Research published in the journal of Women's Health in 2007 found that women who are victimized by violence have 17 percent more primary care doctor visits, 14 percent more specialist visits, and 27 percent more prescription refills than non-abused women.

Physical and psychological abuse are linked to a number of adverse physical health effects. A study released in 2010 that compared victims with never-abused women found abuse victims had an approximately six-fold increase in clinically-identified substance abuse, a more than three-fold increase in depression diagnoses, a three-fold increase in sexually transmitted diseases, and a two-fold increase in lacerations.

But it is not just the spouse who suffers these lifelong consequences. It is their children, too. Children who witness domestic violence are more likely to exhibit behavioral and physical health problems, including depression, anxiety, and violence towards peers. They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, and commit sexual assault crimes. Fifty percent of men who frequently assault their wives also frequently assault their children, and the U.S. Advisory Board on Child Abuse and Neglect suggests that domestic violence may be the single major precursor to child abuse and neglect fatalities in this country.

Without question, we must tackle the underlying causes of domestic violence and abuse in this country. At the same time, we must strengthen our health care response to this abuse.

Despite the commitment of health care providers to help domestic violence victims, a critical gap remains in the delivery of health care to victims. Health care providers often only address immediate injuries, without tackling the underlying cause of those injuries. For example, each year, about 324,000 pregnant women in this country are battered by their intimate partners. However, few physicians screen pregnant patients for abuse. This highlights the need to ensure that health care providers have the necessary training and support in order to assess, refer, and support victims of domestic and sexual violence.

Victims know and trust their health care providers. Almost 3/4 of survivors say that they would like their health care providers to ask them about violence and abuse.

Multiple clinical studies have shown that short interventions in the medical environment protect the health and safety of women. These interventions are short between 2 and 10 minutes, and effective. In repeated clinical trials, violence decreased and health status improved following simple assessment and referral protocols. Integrating these effective protocols into our health care system will save lives.

This is why routine assessments for intimate partner violence have been recommended for health care settings by the American Medical Association, American Psychological Association, American Nurses Association, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and the Joint Commission on the Accreditation of Health Care Organizations.

Since its passage in 1994, the Violence Against Women Act, VAWA, has transformed our criminal justice system and social service system, helping to prevent and respond to domestic violence. The last reauthorization of VAWA, set to expire this year, included a new title authorizing three programs that support the health system's efforts to help victims, preventing further abuse and improving the health status of women. The bill I am introducing today will continue those important efforts.

This bill would consolidate the three existing health programs into one program, while increasing evaluation and accountability. Specifically, this bill would foster public health responses to intimate partner violence and sexual violence; provide training and education of health professionals to respond to violence and abuse; and support research on effective public health approaches to end violence against women.

I urge my colleagues to join us in supporting this important bill.

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