by Rainier Dennis D. Bautista, MD
In my years of practice as a physician, I have learned that the body does not forget. It keeps a careful record of everything it has lived through — stress, fear, sleepless nights, and pain.
For many people in our Filipino community here in Hawaiʻi, that record includes something we rarely talk about openly: domestic violence.
This is not an easy subject to raise. I know that. We are raised to value family above almost everything else, to smooth over conflict for the sake of unity, to bear our struggles with quiet dignity.
But as a doctor, I feel an obligation to share what the medical evidence is telling us, because what is happening inside our bodies deserves to be said out loud.
Domestic violence — which includes physical, emotional, sexual, and economic abuse by a partner or family member — is not just a social or legal problem. It is a public health crisis. And for our community in Hawaii, it is one that hits especially close to home.
A Number That Should Stop Us in Our Tracks
Filipinos have been reported to account for a disproportionately high percentage of domestic violence victims in Hawaii.
According to the Domestic Violence Action Center, Filipinos account for approximately 30% of domestic violence victims in Hawaii, even though we make up roughly 25% of the state’s population.
Between 2000 and 2009, 24% of women murdered due to intimate partner violence in Hawaiʻi were Filipino. But even these numbers only reflect the cases we can see.
Domestic violence is one of the most underreported forms of violence, and many survivors never seek help or disclose their experiences.
What Domestic Violence Does to the Body
When most people think about domestic violence, they think about visible injuries like bruises or broken bones.
But as a physician, what concerns me just as deeply are the injuries that don’t show up on the surface. Chronic, long-term exposure to abuse causes real, measurable harm to the body’s systems.
Research from the CDC and the National Academies of Sciences consistently links intimate partner violence to:
Cardiovascular disease: high blood pressure, heart disease, and irregular heartbeat. The body’s prolonged stress response keeps the heart working in a state of constant alarm.
Chronic pain: back pain, migraines, joint pain, and pelvic pain that persists even after the abuse has stopped.
Gastrointestinal disorders: stomach ulcers, irritable bowel syndrome, and digestive problems driven by chronic stress.
Mental health conditions: depression, anxiety, PTSD, and sleep disorders are among the most common and well-documented consequences.
Weakened immune function: leaving survivors more vulnerable to infections and illness.
The mechanism behind many of these conditions is what we call chronic stress activation. When a person lives in fear, always watching for the next outburst, never feeling safe at home, the body stays locked in a fight-or-flight response.
Over months and years, this floods the body with stress hormones like cortisol, which damage the heart, brain, digestive system, and immune system.
The Other Direction: When Illness Makes Leaving Harder
Chronic illness can also make it harder to escape an abusive situation.
Imagine a woman who depends on her partner for transportation to her dialysis appointments, or a man with diabetes who relies on his partner to manage his medications, or an elderly lola whose mobility limitations make her entirely dependent on a family member who is also her abuser. In these situations, illness can be a shackle.
Abusers often use a partner’s health condition as a tool of control: withholding medications, sabotaging access to medical care, or using caregiving as leverage.
Research has shown that individuals with depression or severe anxiety may face increased vulnerability and additional barriers to leaving abusive situations.
This is the two-way relationship between domestic violence and chronic disease. Violence makes us sick. And being sick can make it harder to get free.
Understanding Why Help-Seeking Can Be Hard
There are many reasons why someone may not immediately reach out for help and most of them make complete sense.
Our deep love for family, our faith, practical concerns about finances or immigration status, language barriers, or simply not knowing what resources exist can all make the path forward feel unclear.
For those who immigrated here, there is an added layer: a belief, sometimes, that the protections of the U.S. legal system may not apply to them, or that asking for help will create more problems than it solves. These are understandable fears, even when they are not accurate.
Signs to Watch For in Someone You Love
If you are worried about a family member or friend, here are some things to gently pay attention to:
– Unexplained or recurring injuries
– Withdrawing from friends, family
– A partner who speaks for them, monitors their phone, or doesn’t let them speak privately
– Frequent visits to the doctor for recurring symptoms — headaches, stomach problems, fatigue — with no clear cause
– Signs of anxiety, depression, or fearfulness, especially around their partner
– Being denied access to money, transportation, or their own medical care
You don’t have to confront the situation directly or have all the answers. Sometimes the most powerful thing you can do is sit beside someone, let them know you see them, and say: “Nandito ako para sa iyo.” I am here for you.
What You Can Do
If you or someone you know is in an unsafe situation, please know that help is available right here in Hawaii.
The Domestic Violence Action Center line, (808) 531-3771, is available from 8:30 am to 4:30 pm.
For healthcare providers, this is also a call to strengthen our own skills. Many of us were never formally trained in how to identify and respond to domestic violence in a clinical setting. Yet these encounters are already happening in our exam rooms.
Training in trauma-informed, culturally responsive care can make the difference between a missed opportunity and a moment that helps a patient feel seen, safe, and supported.
Our health is not separate from our safety. We cannot fully care for our bodies if we are living in fear inside our own homes. As a community, we can do better. We can make it safer for people to speak, easier to seek help, and less lonely to carry these wounds.
DR. RAINIER BAUTISTA is a board-certified physician specializing in both Obesity Medicine and Family Medicine. He currently practices at the Primary Care Clinic of Hawaii and serves as the president of the Philippine Medical Association of Hawaii.
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