To the Editor.
—I applaud Dr McAfee's editorial comments outlining the American Medical Association's (AMA's) commitment to diagnose and prevent family violence.1 While recognizing the impact of violence on health status and society, he did not discuss the staggering medical costs associated with this behavior.In a study sponsored by the Pennsylvania Blue Shield Institute,2 we found that from 1990 to 1991 medical costs associated with domestic violence totaled $326.6 million in Pennsylvania. Reviewing child abuse data, we projected another $1.7 million in health care expenditures. Medical costs of violence of all forms in the state totaled more than $434 million. Clearly, the medical manifestations of violence directly increase the cost of health care to Pennsylvania and the nation.Recognizing that merely studying the issue of violence is not enough, the Pennsylvania Blue Shield Institute provided funding for a pilot project (the South Philadelphia High School Health Academy
Tyson RR. Family Violence and the Insurance Industry: Education, Not Discrimination. JAMA. 1995;274(18):1428. doi:10.1001/jama.1995.03530180022022