Every five years, the number of American women who die due to family violence equals the 48,000 U.S. men who were killed in battle during the nine-year long Vietnam War, says Dr. Antonia C. Novello, the U.S. surgeon general.
The degree of violence against women is so broad now that "it's unbelievable," the nation's top doctor said yesterday in an interview. "Women have to learn to talk about it and to bring it up to their doctors," she said.
And, Novello is confident that doctors across the land will be willing to listen because she and the American Medical Association have just launched a nationwide campaign to heighten awareness of the problem.
"We're getting in the middle to make sure that both woman and doctors do something about it," said Novello, who will be the keynote speaker tomorrow at the College of Notre Dame at a conference on "Empowering Women Over 40." It also is being sponsored by Greater Baltimore Medical Center and the Sheppard Pratt National Center for Human Development.
"Women must feel comfortable enough to talk about family violence, they must not feel embarrassed to address the issue, while the doctor -- he or she -- must also be able to ask about it."
She said the AMA is moving to change medical school curricula and hospital residency programs so that all doctors understand the extent and seriousness of the problem of the battered woman.
"Once a woman knows she is at risk, she has to put the pressure on all members of the community to help her," Novello said
The Physicians Campaign Against Family Violence was launched Wednesday at Cook County Hospital emergency room in Chicago. Dr. Robert E. McAfee, an AMA vice chairman, said letters are going out to all 570,000 U.S. physicians encouraging them to join.
"We also have a cadre of physicians who deal with the problem a lot -- in emergency medicine, in psychiatry, substance abuse counseling -- who have been screaming for some nationally coordinated effort," McAfee said.
Novello, a pediatrician, said doctors have played a vital role in the movement to prevent and treat abused children but have barely addressed other forms of family violence, including sexual abuse and elder abuse.
The surgeon general said she also will tell more than 400 women who have signed up for the conference that by the year 2000, the life expectancy of women will be about 80.
"Women who are 40 today will have the opportunity to do the sec
ond phase of their life and do it well," she said.
But, irrespective of their age, she said, women will have to take care of their health. "Women will have to be very vigilant," she said. "They cannot expect the government or the community alone to take charge of their lives."
An annual physical exam, debunked by some, is an absolute must once a woman hits mid-life, she said.
"Remember, breast cancer will occur in one out of nine of us, just because we are older," she said. "And, the new cases of AIDS in women between 30 and 49 years of age show they got it because their partners were bisexuals. As we women grow older, we believe that AIDS will not happen to us, but the new cases show it's there."
Women need to fit exercise into their busy routines and consider estrogen replacement therapy so that when menopause happens at 50 or 55 "we do not feel we are not as important or capable of sensuality," Novello said. In the absence of estrogen a woman "can have very painful sex," she said.
Unless women have risk factors, like heart disease or breast cancer in the family, they should seriously consider taking estrogen, she said.