Nursing in Washington
Violence and Safety

What We Know About Violence and Safety in Washington

Individuals who are exposed to violence directly may experience pain, suffering, injury, and premature death. Repeated exposure to violence is linked to adverse behavioral and mental health outcomes, especially among children, adolescents, and women exposed to intimate partner violence [7]. Women exposed to intimate partner violence have an increased risk of injuries and adverse mental health outcomes such as eating disorders, depression, and suicidal ideation [7]. Intimate partner violence might be expressed as a partner who says mean, hurtful, and unsupportive things or hits them. The scope of intimate partner violence and domestic violence and the varied manifestations (stalking, reproductive coercion, etc.) are complex. Unless discussed, these factors might appear hidden in a patient-provider interaction. 

Nurses need to understand the barriers survivors face in seeking help. For example, geographic location and isolation can put individuals at a disadvantage when obtaining support services for intimate partner violence [8]. There may be a limited number of shelters and social services available in rural areas, and transportation may be a barrier. Furthermore, rural individuals may seek care in nonrural settings to remain anonymous. Nurses in all settings should consider understanding the prevalence of intimate partner violence in the area they work and live.

Explore Washington Data

As you explore these data, here are some discussion points to consider:

• Consider the geographical area and the resources available where you work. Do your patient population experience barriers to accessing support services in the area where they live? What guidelines are in place to support individuals who reveal inter-partner violence?

• Listen to what is most important to that individual at any given moment (food, legal help, shelter, clothing, transportation, etc.) and be prepared to provide a referral to social services or a behavioral health expert who can help find support for the individual that they can access privately.

• Nurses who work in small communities may often encounter their patients in multiple settings. These interactions can provide an opportunity to observe for risk factors and indicators of intimate partner violence, thereby improving their ability to identify factors when presenting for care.

• Cultural norms may increase reluctance to talk. Normalizing the conversation and using sensitive language suggests the topic is an issue you can engage in to help meet their needs. 

Explore the Data

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Violence and Safety Indicators

Other Resources

•  Washington Tracking Network IBL Mapping Tool for health disparities information | An interactive tool to identify health disparities in a community. This tool should not be used to diagnose a health issue or label a community

•  Robert Wood Johnson Foundation’s County Health Rankings | County health snapshots of economic and social factors

About the Data

The following existing public data sources were used:

•  Struck by data is from Washington Tracking Network (WTN)

•  Assault mortality data in this story was queried from the CDC Wonder API, based on the following parameters: Underlying Cause of Death, ICD-10 codes: X85-Y09, Y87.1.

•   Firearms mortality data in this story was queried from the CDC Wonder API, based on the following parameters: Underlying Cause of Death, ICD-10 codes: W32-W34, X72-X74, X93-X95, Y22-Y24, Y35.0; Firearm homicides: X72-X74; Firearm suicides: X93-X95.


7. U.S. Department of Health and Human Services [HHS], (2020). Healthy People 2030 Framework, from,

8. Dudgeon, A., & Evanson, T. (2014, May). Intimate Partner Violence in Rural U.S. Areas: What Every Nurse Should Know, from,