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Reducing Violence: Issues, Options, and Opportunities for State Governments

Women & Intimate Partners


Elizabeth Burke, Medical Advocacy Project Administrator, Women's Center and Shelter of Greater Pittsburgh, Pittsburgh, PA.

The State of Pennsylvania has become actively involved in providing services for victims of domestic violence. In 1991, a University of Pittsburgh Medical Center researcher did a comprehensive literature review and found that less than 1 percent of patients coming into emergency departments were being correctly identified as victims of domestic abuse.

Subsequently, Pittsburgh implemented universal screening requirements for women coming into the hospital. Funding was secured for three pilot projects to initiate this program. It required comprehensive provider education, a change in institutional language and understanding of domestic violence issues, and a shift in how care was delivered.

The results were dramatic. Within 2 years the identification of victims went from 1 to 30 percent, with 92 percent of women being screened upon entry into the hospital.

Ms. Burke emphasized that States can play a valuable role in the provision of services for victims of domestic violence. For example, the Pennsylvania legislature took an important role by strengthening domestic violence laws, providing training systems, enhancing services for domestic violence victims, and improving sources of funding for domestic violence initiatives.

Pennsylvania has also improved its domestic violence laws by:

  • Increasing protections for children through restricting mediation.
  • Restricting unsupervised visits.
  • Establishing secure locations for visitation.

There has been a marked improvement in providing enhanced domestic violence services, including:

  • Statewide domestic hotlines.
  • Addressing confidentiality for victims.
  • Bans on insurance discrimination for victims of domestic abuse.

Finally, Pennsylvania has been able to stabilize domestic violence funding sources by initiating innovative programs such as adding a surcharge to marriage licenses that goes directly to domestic violence programs.


Larkin GL, et al. Universal Screening for Intimate Partner Violence in the Emergency Department: Importance of Patient and Provider Factors. Ann Emerg Med 1999;33(6):669-75.

McAfee RE. Family Violence: A Neglected Epidemic. Facial Plastic Surgery 1999;1(2):133-4.

Moore M. Reproductive Health and Intimate Partner Violence. Fam Plann Perspec 1999;31(6):302-6.

Sugg NK, et al. Domestic Violence and Primary Care: Attitudes, Practices, and Beliefs. Fam Med 1999;8(4):301-6.

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