Domestic Violence Literature Review: Analysis Report

JSI, with support from Blue Shield of California Foundation, has initiated an effort to develop a ‘business case’ that elevates domestic violence (DV) in health system transformation and triple-aim achievement efforts. As a first step, JSI conducted a literature review and analysis with the goal of exploring the following questions:

1. What is the evidence about the prevalence of DV?
2. What is known about the health consequences of exposure to DV?
3. What is the evidence regarding DV as a driver of health care costs?
4. What are the outcomes from interventions integrating DV response in health care?
5. Are there useful lessons learned from other sectors?

Key Findings include:

• Domestic Violence (DV) is widely prevalent and a well-recognized public health issue.
• DV has immediate, short, and long-term health effects through injuries; chronic health, mental health, and substance abuse conditions; and health risk behaviors.
• A large and growing body of evidence indicates that DV elevates health care utilization and costs, but current estimates are considered to underestimate the true cost of DV due to undisclosed and/or undiagnosed abuse.
• DV not only affects survivors but also their families, in particular children who witness abuse. It impacts their physical and mental health, and increases their risk for adult victimization and perpetration.
• Intervention research largely focuses on process outcomes (e.g., numbers screened, numbers of providers reporting increased screening). There is limited evidence on the effectiveness of interventions in reducing DV, improving health outcomes, and/or reducing health expenditures over time.