Recording-2025-01-30T18:42:30.630Z

Family Violence and Human Trafficking Overview

• Intimate partner violence, child abuse, elder abuse, and human trafficking are significant health issues that require recognition and assessment in every patient.

• The Joint Commission mandates that all healthcare settings have policies for assessing, documenting, and referring issues related to family violence.

Intimate Partner Violence (IPV)

• Statistics: 10 million people experiences physical abuse by intimate partners annually (20 people every minute).

• Prevalence: Over 20% of women and nearly 14% of men report severe physical abuse by an intimate partner.

• Definition: IPV occurs between partners with a close relationship characterized by emotional connection and physical/sexual contact.

Categories of IPV

1. Physical Violence: Use of force causing death, disability, or injury.

2. Sexual Violence: Non-consensual sexual acts, including rape and unwanted sexual contact.

3. Stalking: Repeated unwanted attention causing fear.

4. Psychological Aggression: Emotional abuse via verbal or nonverbal communication to exert control or harm.

5. Teen Dating Violence: Includes physical, sexual violence, or psychological aggression among adolescents.

   • Outcomes: Increased risk for depression, anxiety, unhealthy behaviors, and suicidal thoughts among youth.

Child Abuse and Neglect

• Statistics: Approx. 5 children die from abuse and neglect daily; 656,000 children are victims annually.

Types of Child Abuse

• Neglect: Failure to meet basic needs (e.g., physical, medical).

• Physical Abuse: Non-accidental injuries from hitting, shaking, etc.

• Sexual Abuse: Engaging in sexual acts with a child or exposing them to sexual situations.

• Emotional Abuse: Behaviors that harm emotional development, such as belittling or rejection.

Elder Abuse and Neglect

• Statistics: 10% of Americans aged 60+ have experienced elder abuse.

• Common Perpetrators: Family members, often adult children or spouses.

Forms of Elder Abuse

1. Physical Abuse: Intentional injury or threats.

2. Sexual Abuse: Non-consensual sexual contact.

3. Psychological Abuse: Inflicting fear, humiliation, or social isolation.

4. Neglect: Failing to meet basic needs.

5. Financial Abuse: Misuse of an elder's resources for personal gain.

Human Trafficking

• Statistics: 40 million victims worldwide; 25 million exploited for labor, 15 million in forced marriages.

• Demographics: 71% are women and girls; 25% are children.

• Vulnerable Groups: Unhoused individuals, runaway youth, sexual/gender minorities, undocumented migrants, and victims of prior violence.

• Definition: Human trafficking involves coercing individuals into labor, services, or commercial sex acts.

Health Effects of Violence

• Immediate issues: injuries; long-term implications include chronic health problems.

• Victims experience higher rates of:

  • Cardiovascular diseases, endocrine, immune, gastrointestinal issues.

  • Mental health issues: depression, PTSD, substance abuse.

  • Women face reproductive health problems such as STIs, unintended pregnancies.

  • Children: Risks of improper brain development, health issues, higher likelihood of juvenile arrest, and adult criminal behavior.

Genetics and Environment

• Increased IPV prevalence among ethnic/racial minorities and non-Hispanic white populations.

• Societal stressors: poverty is a significant risk factor.

• Barriers to seeking help include fears of discrimination, legal status concerns, and cultural challenges.

Legal Protections

• The Violence Against Women Act offers resources for IPV survivors and migrant protections.

Culturally Sensitive Care

• Importance of culturally appropriate care to reduce barriers for immigrants and ethnic minorities.

• Recommendations include access to:

  • Bilingual, bicultural providers, translators.

  • Education about legal rights, and community outreach to raise IPV awareness.

Sexual and Gender Minority (SGM) Considerations

• Higher risk for family violence among SGM individuals compared to cisgender heterosexual peers.

• Higher likelihood of adverse childhood events and IPV experiences.

• Unhoused SGM individuals are significantly more likely to face sexual violence.

Documentation of Abuse

• Important to maintain non-biased, detailed medical records including:

  • Progress notes, injury maps, and photographic documentation.

  • Verbatim phrases from victims regarding perpetrators and threats; avoid sanitizing language used in reports.

• Ensure detailed documentation during physical examinations while avoiding speculation.

Child Abuse Documentation

• Use the child's words to describe injuries and conduct interviews away from the suspected abuser.

• If nonverbal, rely on caregivers for statements.