Health centers and domestic violence and sexual assault (DV/SA) advocacy programs are natural partners given their shared mission to improve the health, wellness, and safety of their clients. Use this toolkit to build a comprehensive and sustainable response to intimate partner violence (IPV) and human trafficking (HT) in your health center, in partnership with social service organizations.
"When health center leadership commits to the system-wide integration of care, including developing formal partnerships with community based social service organizations to address intimate partner violence, we find they are better positioned to improve health outcomes for the patients they serve.”*
- Judith Steinberg, MD, MPH, Chief Medical Officer, Bureau of Primary Health Care, Health Resources and Services Administration
“Domestic violence programs and health centers, working in partnership, create communities where victims of domestic violence who ask for help receive a compassionate and helpful response.”
-Marylouise Kelley, Ph.D., Director,
Division of Family Violence Prevention and Services, Administration for Children and Families
*All quotes throughout this toolkit have been used with permission.
Follow these essential steps to address IPV in your health center:
Intimate partner violence and human trafficking are public health epidemics in the U.S.
The U.S. Centers for Disease Control and Prevention defines IPV as physical violence, sexual violence, stalking and psychological aggression (including coercive acts) by a current or former intimate partner.
The Trafficking Victims Protection Act of 2000 defines human trafficking as exploitation of a person through the use of force, fraud, or coercion to obtain a labor or sex act. For minors, sex trafficking is defined as any commercial sex act with a minor under age 18.
DV/SA is a key social determinant of health and impacts your patients: At least 1 in four women have experienced IPV1 and 1 in 7 men have experienced severe physical violence by an intimate partner2. LGBTQ communities experience violence at similar or higher rates to that of heterosexual women. 3,4,5,6,7,8
Human trafficking is also widespread: 88% of sex trafficking survivors had some contact with health care while being exploited.9
Health consequences can be severe. The long term impact of DV/SA includes physical injuries, chronic health and mental health issues, and high risk health behaviors.10
The long-term health impact of human trafficking can include back pain, stomach pain, dizziness, chest/heart pain, and respiratory problems.11, 12
Why health centers?
Given their enormous reach and overarching goals to promote health and safety, health centers are uniquely positioned to be leaders in violence prevention across the U.S. One in 13 people nationwide rely on a HRSA-funded health center for their health care needs.13 Locate a health center near you. Many health centers have already partnered with DV/SA organizations to implement health interventions with promising results to achieve better health outcomes for patients.
Between 2014-2016, 10 health centers and 10 DV/SA programs across the country participated in the Improving Health Outcomes Through Violence Prevention Pilot Project to identify promising ways to promote the health and safety of patients. The U.S. Department of Health and Human Services, Health Resources and Services Administration, and the Administration for Children and Families funded this project, in collaboration with Futures Without Violence, who provided training and workflow redesign support, and an evaluation by the University of Pittsburgh. Under this pilot, health centers and partnering DV/SA programs tested all steps to address and respond to DV/SA. This pilot has since evolved to become Project Catalyst, a national project to foster leadership and collaboration between DV/SA advocates and health professionals at the state and territory level. Key findings are distilled here into actionable steps for other health care providers, administrators, DV/SA advocates, and community partners to easily adapt for their own settings.