Oregon Public Health Week panel: Domestic violence is preventable
In a typical year, 24 Oregonians die of injuries from domestic violence. But in late 2009, the toll spiked to 18 deaths in just over a month, including five murder-suicides.
"Imagine if we had 18 deaths from measles in a month," said Dr. Bruce Goldberg, director of the Oregon Health Authority.
Dr. Goldberg was one of five speakers in a panel discussion titled "Not on Our Watch: Preventing domestic violence murder-suicides" and sponsored by the Oregon Health Authority's Public Health division as a part of Oregon Public Health Week.
The discussion, moderated by Public Health division director Dr. Mel Kohn, was informed by a growing body of evidence that suggests there are benefits in treating the study and prevention of violence as though it were a preventable disease. The approach is backed by a coalition of law enforcement officers, advocates and counselors.
Dr. Goldberg said health officials and others can do plenty to raise awareness of domestic violence, look for patterns and design preventive strategies. Too often, the public tends to view domestic violence as a personal matter that happens to someone else.
"This is really our problem and not somebody else's," he said.
Other panelists included Erin Greenawald, a domestic violence prosecutor with the Oregon Department of Justice; Sybil Hebb, from the Oregon Law Center; Gabby Santos, from the Oregon Coalition Against Domestic and Sexual Violence; and Cynthia Stinson, director of the Crime Victims Service Division in the Oregon Department of Justice.
The panel focused on one piece of the injury prevention puzzle: couple or family disputes that escalate into sometimes-deadly violence. Speakers called on officials to target domestic violence as seriously as other public health messages that address smoking, seatbelt use and drunken driving.
"We need to vaccinate our communities against domestic violence," Stinson said.
"Health reform needs to be about the health of our communities," Goldberg said. "And I don't know of anything more destructive to the health of our communities than violence."
Health reformers trying to restrain health costs talk about moving care "upstream." That means preventing health problems rather than simply responding after the fact and treating their costly "downstream" consequences. Violence results not only in traumatic injuries and deaths, but also is a contributing factor in illnesses as varied as post-traumatic stress disorder, depression and arthritis.
As a prosecutor, Greenawald has investigated "dozens and dozens of deaths" in domestic violence cases. Even when the outcome is brutally clear, she finds "upstream" complications and warning signs that went ignored. "There's always more to the story that we should be putting together sooner," she says. Oregon is joining at least 17 other states in setting up a statewide Fatality Review Panel to study specific cases — tracing how they happened by "going as far upstream as we can go." The goal is not blame but prevention:
"What could we have done?"