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Building Bridges, Eliminating Walls: Why Philanthropy Should Care about Domestic Violence

September 2017

Lucia Corral Pena, Senior Program Officer, Blue Shield of California Foundation

Imagine a pregnant woman going to a health clinic for routine pregnancy care and having her partner show up, threatening clinic staff in a fit of anger while she tells her provider that she fears for her life.

Imagine a husband shooting his wife in front of her classroom full of students, killing her and one child in the process. 

Imagine a young mother being shot in her car by an ex-boyfriend while her two children and residents witness the entire scene from the backseat.

Unfortunately, we do not have to imagine any of these scenarios, because all of them actually took place. What each of them have in common is that they were preventable, and they all impacted not only the victims, but also the health and well-being of the people, families, children, and communities around them. Despite its far-reaching consequences, domestic violence is an issue that is still held at the societal margins of silence and unwillingness or inability to act. The examples above are the tragic manifestation of power, control, and inequity that will continue if we do not recognize the ways in which health care, philanthropy, and many other sectors can join in the effort to end domestic violence, and address the root causes that perpetuate it, generation after generation.

What We Are Funding

Though domestic violence touches so many lives, there are still too few who are working to prevent its detrimental effects on those who struggle the most. The leaders who stand at the helm of domestic violence agencies, shelters, and advocacy organizations are courageous leaders and vital assets for community-level prevention. 

Since 2002, Blue Shield of California Foundation has awarded more than $110 million to these vital organizations, but it is not enough. What we need is for others who may not initially see their connection to domestic violence to join us in the effort toward its end.

Here in California, our health care system has shown up in a significant way to engage in the effort to prevent domestic violence and support patients who are experiencing abuse. We already know that providers can be key allies in this work, but they still need the resources and guidance to respond effectively when the well-being of their patients is at risk.

Whether you are a health funder with the ability to encourage and help your grantees cultivate strategic partnerships with local domestic violence agencies or a foundation driving toward health equity and whole-person care: there is a space for you; there is a need for you. 

Do You Fund Issues Related to the Social Determinants of Health? The health care system has recently begun tackling health inequity by embracing and addressing the social determinants that impact overall wellness–one of which is domestic violence. It affects the physical and mental health of those who are experiencing it, and it is also a causal determinant of poor health, chronic conditions, and longer-term issues.

Do You Fund Issues Related to Trauma and Youth Violence? Those developing trauma-focused strategies and community-centered approaches (for example, efforts to prevent youth violence) must also recognize that young people who are exposed to violence and trauma early in their life are more likely to have adverse health issues as adults and/or to perpetuate or experience abuse as adults. Most gang interventionists will tell you that the majority of young men and women they work with were first exposed to violence when they saw their mother being harmed.

Do You Fund Prevention? Addressing domestic violence involves responding in moments of crisis, as well as preventing violence before it starts. This work will require new allies and new solutions to help us build a future in which health and healing can overcome violence and harm.

Do You Fund Issues Related to Equity? It is also important to note that domestic violence affects people at every income level and every age and ethnicity. However, poverty and social and structural barriers make it harder for some to get the help that they need. Statistics show that certain communities require additional concern and support, including Native Americans, young African-American women, immigrant populations, and LGBTQ communities.

Where we began and where we are now

The anti-domestic violence movement initially began as a way to challenge gender norms and societal power dynamics, while demanding dignity and equal treatment of all women and all people. Despite more than thirty years of work, and fierce and successful leadership from advocates— many of whom are survivors themselves—domestic violence rates remain at epidemic levels, with a troubling increase in domestic violence homicides in recent years. Today, we understand much more about the broader implications and consequences of domestic violence and the influences that enable it to continue. For example, we now know that:

Domestic violence is detrimental to health. Domestic violence was first declared a public health issue in the 1990s, but is still not fully viewed or treated as a co-occurring issue alongside the multiple other influences and conditions that collectively affect an individual’s well-being and ability to thrive. Addressing these issues independently—without also identifying the underlying traumas and connections among them—are half-measure at best.

We already know that even when children are not targets themselves, the impact of witnessing violence can have a lasting, negative impact on their health and development.

Data also clearly show us that domestic violence is an ongoing driver of health care utilization and emergency services, resulting in significant cost implications for the health care system.

Over-criminalization impacts prevention. The current response to domestic violence is an “emergency room” approach that relies heavily on law enforcement and requires victims to commit to leaving their abuser in order to access services. To overcome this, we need more community-centered solutions that promote trust and cooperation between multiple systems (health care, mental health, social services, the justice system, etc.), and we must ensure that survivors and affected communities cocreate solutions alongside them.

An overreliance on criminal justice solutions is also a barrier. Many survivors (and bystanders) view the engagement of law enforcement as an avenue that could potentially make them less safe, which makes them hesitant to disclose abuse. This was reaffirmed by foundation-funded focus groups among diverse communities of color throughout California. Current anti-immigrant policies only further reinforce this practice and are discouraging even more people from seeking help or speaking up. This is all the more reason for health care practitioners—as trusted resources for victims—to step in and play a role.

How Health Funders Can Get Involved

  • Invest in prevention: Breaking the cycle of violence and stopping abuse before it starts is still an area that is largely underfunded across the country.

  • Focus on protective and risk factors for health: Recognize that domestic violence is both a determinant of health and an outcome, and build upon facilitating factors as well as barriers to positive health outcomes.
     
  • Broaden our base of change-agents: Cultivate new leaders (men and women, boys and girls) and community partners from a variety of sectors to help open the door to new possibilities and solutions.
     
  • Facilitate supportive policies: Advocate for legislative and institutional changes that enable equal access to services and lift up the voices of those who are most impacted to help drive policy and systems change.
     
  • Cultivate cross-sector collaboration: Connect systems, organizations, and services to build strong networks that allow all people to thrive. This includes exploring the intersections between health, domestic violence, housing, substance abuse, environmental influences, and more.
     
  • Support accountability in our communities: We believe that entire communities, not just systems, have a role to play in preventing domestic violence. Accountable communities are empowered, educated, and collectively prepared to address domestic violence and health in an equitable way.
     
  • Consider the role of culture and intersectional issues: Acknowledge that place, ethnicity, background, immigration status, social stigma, and personal identity all influence survivor experience and their ability to seek care.

Multiple support systems and services are needed to prevent domestic violence and ameliorate its impact on those who experience it both directly and indirectly. As philanthropists—the individuals and organizations committed to having a positive impact on this world—we can and must do more to prevent and address domestic violence. Through new partnerships, advocacy, collective will, and innovation, we can create a better, healthier future for all.

Learn more about how you can get involved today.