Citation

Cohen S, De Vos E, Newberger EH. Acad. Med. 1997; 72(1 Suppl): S19-25.

Affiliation

Health and Human Development Programs, Education Development Center, Inc., Newton, Massachussetts 02158, USA. eddevos@edc.org

Copyright

(Copyright © 1997, Association of American Medical Colleges, Publisher Lippincott Williams and Wilkins)

DOI

unavailable

PMID

9008584

Abstract

An exploratory study, initiated in 1990 by the Robert Wood Johnson Foundation in 5 US cities (Atlanta, Georgia; Duluth, Minnesota; Providence, Rhode Island; Riverside, California; and Roswell, New Mexico), identified numerous barriers to an effective response by the health care system to family violence. Over the course of 2 visits to each site, 484 health professionals and community activists were interviewed. Although respondents in all 5 communities agreed that family violence was having a serious impact on the lives and health of women, children, and the elderly, none of the health systems addressed family violence comprehensively in terms of programs, policies, or clinical practice norms. Physicians, nurses, and other health care professionals who worked with victims of family violence reported they were marginalized by their colleagues and identified economic, social, and psychological disincentives to work in this area. The health care system's ability to respond to family violence was significantly impeded by providers' prejudices (e.g., class elitism, racism, sexism, ageism, homophobia) toward both the victims and perpetrators of violence. Overburdened public facilities, the unwillingness of private facilities to serve this clientele, low Medicaid participation rates, underinsured or uninsured status, and poor public transportation further restricted victims' access to services. Service provision was most lacking for victims of elder abuse. Finally, there was a lack of effective coordination among agencies responsible for addressing family violence.

Language: en