Battered women: a health care problem in disguise.

Women should have the right to move about within the confines of their homes among those persons with whom they share the most intimate, interpersonal relationships without fearing for their safety and well-being, for life itself. In general women accept and expect that right as a given; however recent studies cited by Davidson (1978) from the National Institute of Mental Health suggest that 50%-60% of all American marriages have experienced at least one incident of minor battering or assault upon the female in the relationship. Understated estimates report greater than three to four million American women are battered on more than one occasion each year (Iver, 1980; Stark, Flitcraft & Fraxier, 1979). The Crime Index of the Federal Bureau of Investigation (1980) reported the incidence of wife beating to be greater than that of rape, another act of violence that frequently goes unreported. The estimates of the Index project the incidence to be ten times more common than official figures indicated. One of the myths surrounding battered women is that it is a lower socioeconomic phenomenon. This assumption interferes with the ability of middle-class and upper-class health care providers to confront the universality of the problem. Citing Fairfax County, Virginia, one of the wealthiest counties in the United States, Martin (1976) reported that during 1974 there were at least 30 assault warrants sought each week by Fairfax County wives, with police receiving approximately 400 family disturbance calls per month. Lichtenstein (1981) echoed the beliefs of victims and many professionals when she stated, “Medical agencies usually only treat physical injuries and do very little to prevent the problem” (p. 241). A study done by Rounsaville and Weismann (1977-1978) revealed that battered women reflect 3.5% of the emergency room population. Tracking twenty women previously treated in an emergency room for injuries secondary to battering, only three medical records included any mention of abuse. Health care providers seem to be more comfortable accepting spurious explanations than probing for the truth. According to Martin (1976), “Even if they suspect that a woman’s injuries are due to a beating they seldom want to risk personal involvement by asking questions” (p. 12). Parker and Schumacher (1977) emphasized the “long suffering inattention to battered women from social agencies and the health care system” (p. 760).