Extensive research indicates that intimate partner violence (IPV) poses a significant risk to the physical health of women. IPV is associated with increased mortality, injury and disability, worse general health, chronic pain, substance abuse, reproductive disorders, and poorer pregnancy outcomes. IPV is also associated with an overuse of health services and unmet need for services, as well as strained relationships with providers. The body of IPV research has several critical gaps. There are almost no longitudinal studies of IPV and health. Most studies are clustered into a few specialties, with almost no research in the areas of allied health, dentistry, or management. A common definition of IPV is still not used. Finally, with some notable exceptions, there has been little success in moving the health care system to routinely screen women for IPV.

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Intimate partner violence (IPV) affects the use of health care by increasing the risk of poor health outcomes. IPV victims seek health services as often as others but are less likely to receive needed services, more likely to overuse services, and more likely to have a poor relationship with their health care provider. This stems from patient and provider barriers to care that are exacerbated by the lack of a clear and consistent health care system response to IPV. Most health care systems are not equipped to assist either victims or providers seeking to help victims. There are a few models of system-wide interventions, but these are not the current standard. A strong health policy framework is needed, but the decision of the U.S. Preventative Task Force not to recommend universal screening is a setback. Overall, there is limited progress in moving the health care system toward assisting IPV victims.

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The current worldwide decline in the initiation and duration of breastfeeding has increased the need for effective breastfeeding promotion. Promotion policies and programs need to be sensitive to those factors that may help or hinder a mother in her efforts to breastfeed. Such factors include sociodemographic characteristics, maternal employment, and social support. Social support that increases breastfeeding includes emotional, tangible, and educational components from both informal social network members (male partner, mother, family/friends) and professional network members (health care professionals, lactation consultants). Conversely, negative social support may decrease breastfeeding.

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Our purpose was to measure the beliefs of physicians about victims of spouse abuse and to examine factors related to holding positive (e.g., supportive) and negative beliefs about providing services to victims of domestic violence. This was a total site sample of 150 physicians (76 responded; RR 51%), surveyed at one time, practicing in a large general hospital and the surrounding urban/periurban area. Four specialities are represented: emergency medicine, family practice, obstetrics-gynecology, and psychiatry. Three aspects of beliefs are measured: beliefs toward physician role in assisting victims of spouse abuse, beliefs about victims of spouse abuse, and beliefs about resources available to physicians to assist victims of spouse abuse. Almost all (97%) physicians believe it is part of their role to assist victims of domestic violence. Almost one third (30%) hold victim-blaming attitudes toward victims of spouse abuse, and the majority (70%) do not believe that they have the resources available to them to assist victims of domestic violence. Being female, younger, practicing obstetrics-gynecology, and having fewer years in practice are all significantly related to holding supportive (positive) beliefs. The majority of negative beliefs held are about resource availability. Hence, training programs may need to be developed locally for physicians and tailored to individual community characteristics. Training programs should also emphasize the importance of understanding the victims of spouse abuse and of not blaming the victims for the violence.