How does trauma-informed care address violence in social determinants of health?
Violence is a social determinant of health that can cause lasting trauma. Trauma-informed care (TIC) is an approach that recognizes the widespread impact of trauma and seeks to avoid retraumatizing patients. Trauma- and Violence-Informed Care (TVIC) expands this by explicitly addressing structural violence and systemic inequities that shape health outcomes 2. By integrating awareness of violence into care, TIC helps mitigate the health effects of violence and promotes healing.
What the research says
TVIC reframes trauma as both an individual and collective experience rooted in social and structural determinants of health 2. It acknowledges that systemic oppression, institutional violence, and inequitable hierarchies shape access to care and can perpetuate cycles of revictimization 2. In practice, TVIC calls for compassionate, non-judgmental, strengths-based care at the individual level; culturally, emotionally, and physically safe organizational practices; and intersectoral collaboration to reduce systemic barriers 2. A systematic review and meta-analysis found that trauma-informed care significantly reduces symptoms of post-traumatic stress disorder, depression, and anxiety among women experiencing intimate partner violence 7. The review highlighted that TIC interventions improved psychological health outcomes at short-term (3 months) and medium-term (6 months) follow-ups 7. Additionally, trauma-informed care is increasingly recognized as a universal approach to address adverse childhood experiences (ACEs) and toxic stress, which are linked to chronic illness, mental illness, and substance abuse 8. The Substance Abuse and Mental Health Services Administration's six principles of TIC provide a framework for implementation across healthcare and public sectors 8.
What to ask your doctor
- How does your practice incorporate trauma-informed care principles, such as ensuring physical and emotional safety?
- What training do staff receive on recognizing and responding to signs of trauma or violence?
- Can you provide resources or referrals for patients who have experienced violence or trauma?
- How does your organization address systemic barriers that may affect care for marginalized groups?
- Are there specific programs or protocols for patients with a history of intimate partner violence?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.