Christine Desiato
Wife abuse is now considered a leading public health concern as it
compromises the personal health and safety of millions of women annually. Wife abuse
represents an attempt to control the behaviour of a wife, common law partner, or
girlfriend. It is a misuse of power that uses the bonds of intimacy, trust, and dependency
to make a woman unequal, powerless, and unsafe (MacLeod, 1995).
A national survey revealed that 29% of women who had ever married or
lived in a common-law relationship had experienced physical or sexual violence at the
hands of a male partner (Rodgers, 1993). Battered women often suffer from immediate
physical injuries, chronic health problems, and subsequent psychological distress in
response to their victimization (Rodgers, 1993; Sutherland, Bybee, & Sullivan, 1998;
Warshaw, 1989).
Despite the incongruity between violence and women's health, the health
care sector has largely failed to recognize wife abuse as a serious health issue. Some of
the barriers facing health care providers include lack of knowledge about wife abuse,
belief that wife abuse is not a medical concern, and uncertainty about what to do in the
event of disclosure (Sugg & Inui, 1992; Warshaw, 1994). Ultimately, the failure of the
health care system in identifying and treating battered women lies in very the structure
and philosophy of modern medicine itself. Health professionals are trained in detecting
and treating health problems with physical and psychosomatic etiologies, not those with a
social etiology (Ferris, McMain-Klein, & Silver, 1997).
In recent years there has been a proliferation of discussion
surrounding universal screening for wife abuse. Universal screening seeks to increase the
number of identified cases of wife abuse in health care settings. It requires that all
women be questioned about violence in their intimate relationships each and every time
they access health care services. This can be done by nurses, physicians, psychologists,
or social workers.
Regrettably, few health care institutions routinely screen for abuse as
a possible etiological or complicating condition, and policies to promote this practice
have often been ineffective (Thurston, 1998). For many women, the health care system is
their first contact with an agency or program that provides intervention. Therefore, the
health care community could play a pivotal role in responding to wife abuse. How can the
health care sector better address violence in women's lives? It has been suggested that a
health promotion framework would drastically improve the health system's response to wife
abuse (Thurston, 1998).
Health promotion has been defined as "the process of enabling
people to increase control over, and improve, their health (Harvey & Kinnon, 1993,
p.9). From a psychological perspective, health promotion initiatives attempt to promote
the healthy functioning of individuals, families, and communities before problems occur.
Health promotion also advocates for structural change and personal empowerment. To date,
health promotion models have not yet been applied to wife abuse. Clearly, future research
is needed to explore the potential role of health promotion in addressing wife abuse.
In summary, wife abuse is a critical health care issue that demands
attention from the health care system. Interventions that incorporate a health promotion
framework would provide a more holistic approach to the treatment of battered women.
References available upon request. Please contact Christine Desiato directly.
This article first appeared in the Summer 1999 Edition of the APAGS
Newsletter, Vol. 11(3)
