This is the second in a series of weekly articles throughout October to share information on domestic violence and our work in the County to address it. Read the first article from last week.  Visit our blog or follow us on Twitter and Facebook for updates. 

image with illustrations showing the ways health care pros can help (outlined below)Healthcare providers are at the forefront of promoting wellness and resiliency in our community. From primary care to dental care, from maternal health to student health centers, from behavioral health to addiction recovery services, everyone who works within our health centers provides critical services to people of all ages. The same goes for survivors of domestic abuse. Research tells us survivors are four times more likely to use a safety intervention after talking with a trusted healthcare provider about their abuse. 

Over the last decade or so, the healthcare industry has begun to integrate trauma-informed responses into its work. This shift stems, in part, from the wealth of knowledge learned about Adverse Childhood Experiences (ACEs), including childhood exposure to violence and neglect, and their impacts on future adult health outcomes. Sometimes missing from this conversation, though, are the connections between experiences of domestic violence in adulthood and long-term health and well-being. 

Domestic violence can lead to chronic health conditions

It’s easy to imagine how or why someone with a physical injury from a domestic violence assault may seek medical care, but we are increasingly learning that many health effects of domestic violence don’t show up as acute injuries, but rather as chronic health conditions. Research has shown that experiencing adult domestic violence has significant impacts on multiple aspects of health and well-being, including increased risk for:

  • Arthritis

  • Asthma

  • Chronic pain

  • Digestive problems, such as stomach ulcers and Irritable Bowel Syndrome

  • Heart problems, including heart attacks

  • Nightmares and problems sleeping

  • Migraine headaches

  • Sexual problems such as pain during sex, and transmission of sexually transmitted infections, including HIV

  • Problems with the immune system

Additionally, children of mothers experiencing domestic violence are less likely to fully receive immunizations on schedule, and babies born to mothers experiencing domestic violence during pregnancy are more likely to have a low birth weight.

4 steps healthcare providers can take

So, what can healthcare providers do with this information?

Healthcare providers are uniquely positioned to promote safety and well-being for survivors of violence. Research tells us survivors are four times more likely to use a safety intervention after talking with a trusted healthcare provider about their abuse.

1) First, Listen. Believe. Validate. Refer.

If a survivor discloses abuse to you – remember these four critical elements of a response. It is still all too common for survivors’ stories to be dismissed or disregarded. Though you may not have all the answers, you can listen without judgment, express your belief in their pain and experience, validate that abuse is never OK, and refer them to professional, specially trained, confidential advocates within their community. Here is an interactive map of local community programs.

2) Stay informed.  

There are fantastic resources available to further your own education about the connections between health and domestic violence, and we are learning more every day. is the home of the National Health Resource Center on Domestic Violence and offers fact sheets, resources and policy guides for health centers interested in improving their responses to survivors in their clinics.  

3) Consult with a domestic violence specialist.

Here’s one of the most common questions from medical providers: “So, a patient told me they were being abused. Now what do I do?”

The Multnomah County Domestic & Sexual Violence Coordination Office offers specific training and consultation to help you answer this question in a way that works best for your clinic. We can review best practices with you, discuss community resources and connect you with confidential domestic violence advocates, and explore the safety risks of various interventions for survivors. You can request training and/or consultation on these issues by emailing

4) Stock your clinic with signs, posters and safety cards that can be seen and used by patients.

The National Health Resource Center on Domestic Violence provides a variety of materials, both general and culturally-specific, on their website. (The materials are free, except for a $5 shipping cost). Making these materials visible and available shows survivors that what is happening to them matters – and that you are there to listen and help if that’s what they need.