The Importance of Healthcare Services for Survivors of Domestic Violence during COVID-19
Updated: Mar 23, 2021
Illustrations by Alex McPhail, BA
My name is Brittany Pompilii, and my pronouns are she/her. I reside on the traditional territory of the Haudenosaunee, Anishinabewaki, Attiwonderonk, Mississauga, and the Mississaugas of the Credit First Nations peoples. This land is currently known as Niagara, Ontario. As the author of this post, I acknowledge that my privilege, and therefore my experiences, inform my perspectives on the issues of domestic violence, access to healthcare, and COVID-19. I am a white, able-bodied, heterosexual, cisgender woman. I do not intend to speak on behalf of all women who have experienced domestic violence or limits in access to healthcare during the COVID-19 pandemic, especially the experiences of BIPOC and LGBTQ2S+ folks. I also want to acknowledge that my privilege has provided me safety, opportunities, and financial stability across my life. As a research team member, I am committed to using my research and writing skills to contribute to helping all women access public health information - a right that all women are entitled to yet do not always receive. I hope that one day, the public health system represents all peoples’ experiences and treats all people equitably. Until that day, I hope to continue advocating for women and their health and safety in any way I can.
In this post, I work to shine light on the experiences of all folks who experienced a lack of access to healthcare, especially domestic violence survivors, during the COVID-19 pandemic. However, the data published on this topic did not include disaggregated demographic information, meaning there is no confirmation that these research findings represent all folks’ experiences with the healthcare system during COVID-19. I hope to continue updating this post as more research gets published on this topic. As you read this post, please keep in mind previous research indicates BIPOC (10), disabled (5), and LGBTQ2S+ folks (2) are disproportionately impacted by domestic violence and by COVID-19 and have experienced a lack of access to healthcare before the pandemic.
The COVID-19 outbreak has caused a massive strain on healthcare systems around the world. Frontline healthcare workers are experiencing major increases in patient intakes with little to no preparation, resources or capacities to appropriately respond to the rapid spread of the virus. In turn, healthcare facilities have been forced to reduce in-person contact and move a large proportion of services online or by phone (also known as telemedicine). These new measures drastically reduced the quality of care many women received, as healthcare workers prioritized COVID-19 patients (9). As a result, some women have been left without access to any healthcare services (4*; 3*). Women living with an abusive partner are disproportionately experiencing a lack of access to healthcare, as abusive partners maintain strict control over their partner during the pandemic (6).
Domestic abusers have used the pandemic to enforce greater power imbalances in the home. Specifically, abusers prevent their partners (the majority of whom are women) from accessing any kind of healthcare, out of fear that their partners may be exposed to COVID-19 in healthcare facilities. This has led many women to live without proper treatment for injuries, illnesses, or other ailments, resulting in negative health consequences such as (7; 1):
Increased risk of cardiovascular disease
Increased risk of mental illness
Gastrointestinal and respiratory issues
In addition, less practitioner-patient contact means women living with abusers have less opportunities to disclose abuse and seek help from healthcare professionals in a safe space. Healthcare workers are the people that women disclose domestic violence to the most. Since access to healthcare (and healthcare workers) decreased for many women, there was a decrease in domestic violence disclosures (8). This is not reflective of a decrease in domestic violence cases. In fact, domestic violence cases increased by 30% globally since March 2020 (8).
Since the majority of healthcare services are now offered online or by phone, medical professionals are unable to recognize physical indicators of domestic violence, such as bruises and fractures on the face, hands, and arms, which are commonly affected areas in self-defence actions. Even when women are able to attend appointments in-person, healthcare workers are strained for time and resources, which has resulted in many professionals missing these key indicators of violence (6). The focus on COVID-19 patients has left domestic violence survivors behind.
By now, we’ve all heard the phrase, “the new normal”, but this cannot be the new normal. Women, especially BIPOC and LGBTQ2S+ folks, are suffering the brunt of the pandemic. Moving forward, women, gender diverse folks, and domestic violence survivors need to be prioritized in our pandemic response, as these groups are vulnerable to lapses in care. Healthcare providers need training on domestic violence during COVID-19 so they are able to create safe spaces for disclosures via video conferencing or phone (6). Interventions such as asking patients, “Is it safe to talk?” can increase disclosures under this adapted healthcare system. Medical professionals should also educate themselves on community resources and domestic violence safety planning to provide appropriate information to patients who may need support during this time (9).
Learn the importance of protecting individuals who are at a risk of abuse during COVID-19 here.
*These sources do not specify the gender identity of the women included. Historical representation leads us to believe only cisgender women were included.
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Barbara G, Facchin F, Micci L, Rendiniello M, Giulini P, Cattaneo C, Vercellini P, & Kestermann A. COVID-19, lockdown, and intimate partner violence: Some data from an Italian service and suggestions for future approaches. Journal of Women’s Health, 2020, 29(10), 1239-1242. Available from: https://doi.org/10.1089/jwh.2020.8590.
Brown TNT & Herman JL. Intimate partner violence and sexual abuse among LGBT people. The Williams Institute, 2015, 1-32. Available from: https://williamsinstitute.law.ucla.edu/wp-content/uploads/IPV-Sexual-Abuse-Among-LGBT-Nov-2015.pdf.
Chirwa E, Jewkes R, Van Der Heijden I, & Dunkle K. Intimate partner violence among women with and without disabilities: a pooled analysis of baseline data from seven violence-prevention programmes. BMJ Global Health, 2020, 5(11), 1-13. Available from: http://dx.doi.org/10.1136/bmjgh-2019-002156.
Connor J, Madhavan S, Mokashi M, Amanuel H, Johnson NR, Pace LE, & Bartz D. Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review. Social Science & Medicine, 2020, 26113364. Available from: https://doi.org/10.1016/j.socscimed.2020.113364.
Cousins S. COVID-19 has “devastating” effect on women and girls. The Lancet, 2020, 396(10247), 301-302. Available from https://doi.org/10.1016/S0140-6736(20)31679-2.
Matoori S, Khurana B, Balcom MC, Froehlich JM, Janssen S, Forstner R, King AD, Koh DM, & Gutzeit A. Addressing intimate partner violence during the COVID-19 pandemic and beyond: how radiologists make a difference. European Radiology, 2020, 1-6. Available from: https://doi.org/10.1007/s00330-020-07332-4.
Kofman YB & Garfin DR. Home is not always a have: The domestic violence crisis amid the COVID-19 pandemic. American Psychological Association, 2020, 12(1), 199-201. Available from: http://dx.doi.org/10.1037/tra0000866.
Kumar A. COVID-19 and domestic violence: A possible public health crisis. Journal of Health Management, 2020, 22(2), 192-196. Available from: https://doi.org/10.1177/0972063420932765.
Moreira DN & da Costa MP. The impact of the Covid-19 pandemic in the precipitation of intimate partner violence. International Journal of Law and Psychiatry, 2020, 71, 101606. Available from: https://doi.org/10.1016/j.ijlp.2020.101606.
Wood L, Baumler E, Schrag RV, Guillot-Wright S, Hairston D, Temple J, & Torres E. “Don’t know where to go for help”: Safety and economic needs among violence survivors during the COVID-19 pandemic. Journal of Family Violence, 2020, 1-9. Available from https://doi.org/10.1007/s10896-020-00240-7.