Domestic violence is a devastating health concern in Hawaii, affecting not just the well-being of the individuals experiencing abuse, but also their entire family and the community in which they live. People need to feel safe and comfortable in their living situations to be able to achieve optimal health. While health care workers have a unique opportunity to intervene and help those experiencing violence in their home, every community member has a duty to address abuse.

Abusive relationships take many forms, but they always involve one partner exerting control over the other partner in an unhealthy way, creating an environment of fear and intimidation. Tactics used to gain this psychological upper hand may include physical or sexual violence, emotional harm, verbal mistreatment, or exertion of control over other aspects of a person’s life such as their finances, religious practices, or their reproductive health.

An abusive partner may also threaten children, pets or extended family members. Frequently, abuse takes on several of these forms at the same time.

More than 1 in 4 women and 1 in 10 men have experienced physical or sexual violence or stalking by an intimate partner in their lifetime, leading to at least one measurable negative impact on their life (feeling unsafe, physical or psychological health issues, or unmet social needs such as houselessness or income loss). Intimate partner or domestic violence often begins early. The 2011 Youth Risk Behavior Survey showed that 9% of high school students experienced violence committed by the person they were dating.

Medical research confirms the detrimental impacts violent relationships can have on health. Physical injury from violence is the most obvious danger, but underlying long-term impacts from physical, sexual and emotional violence in a relationship can have lasting and significant consequences for the person experiencing violence. People who have been in an abusive relationship have increased risk of depression, anxiety, post-traumatic stress disorder, traumatic brain injury, unplanned pregnancy, sexually transmitted diseases, and chronic pain.

Children who witness violence between adults in their home are also at higher risk of poor mental and physical health in the future, and they are more likely to enter an abusive relationship themselves when they become adults.

I am saddened to see the negative impacts abuse has on my patients all too often. While I can encourage healthy nutrition, regular exercise, good sleep habits, and treatments or medications as needed, my patients must have freedom from fear in their personal lives before they can comfortably make healthy choices in other areas of their lives. It is important that we in health care ask patients about their relationships if we are to truly help them reach their full healthy potential, but we can’t do it alone.

It is past time all of us speak up about violent, abusive and unhealthy relationships we see in our patients, work colleagues, neighbors, friends and family. Let people you are concerned about know you are worried about their safety and health. Ask if they need support and give them information about organizations that can provide sensitive and knowledgeable assistance, such as the Domestic Violence Action Center. Support these committed organizations to further the important work they do in our community.

Finally, prevent violence in our future generations by teaching your children the importance of healthy, respectful relationships, and modeling them in your own home.

We all must treat violence in relationships as a serious harm, offer support for those experiencing abuse, and form a community that does not tolerate domestic violence.

Dr. Alexandra Sueda, an obstetrics/gynecology physician at Kaiser Permanente Hawaii, serves on the Kaiser Permanente National Family Violence Prevention Program committee.

To mark this year’s 30th anniversary of the Domestic Violence Action Center, the Star-Advertiser will run a column each month this year to highlight aspects of the problem of domestic abuse. Authors will be from DVAC’s Council of Allies, formed to raise awareness about this communitywide issue.