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Dr. Gregory Taylor, Chief Public Health Officer of Canada, tabled a report to Parliament on Thursday about family violence.Adrian Wyld/The Canadian Press

Family violence is a serious public health issue in Canada, warns the country's Chief Public Health Officer, who is drawing attention to the "long-lasting and widespread" impact on health of crimes that are under-reported and seldom discussed.

"We need to talk about this," said Gregory Taylor, said Gregory Taylor, whose report was tabled to Parliament Thursday about family violence, which includes physical, sexual, emotional and financial abuse, as well as neglect.

The numbers are startling: Every four days in Canada, a woman is killed by a family member. Seven in 10 reported cases of family violence involve girls and women, amounting to 57,835 victims in 2014. About nine million Canadians have reported experiencing abuse before the age of 15.

All told, 233 Canadians a day are victims of violent incidents that are reported to police.

The numbers are absolutely staggering, Dr. Taylor said in an interview. "I was really quite astounded when we did the research, looking at how many Canadians are impacted."

And yet, the statistics are the tip of the iceberg, he said. Just three in 10 victims said police had been made aware when their spouse had become violent – which means the majority of cases are never reported.

Family violence is under-reported for many reasons: Victims may scared to come forward, or dependent on their abusers, or concerned they won't be believed. Dr. Taylor hopes the report will raise awareness and reduce stigma about the issue.

The impact on health is profound, he noted. The negative effects of family violence "extend far beyond physical injuries and include poor mental health, psychological and emotional distress, suicide, and increased risk of chronic diseases and conditions such as cancer, heart disease and diabetes."

The public health officer tables a report on the state of public health each year; this is the first time the theme has been family violence. The report is based on 519 references, including previously reported Statistics Canada and Public Health Agency of Canada data, as well as interviews with experts.

A positive note is that rates of family violence have generally decreased in recent years, though not in the territories. Reasons for the decline aren't clear, but the study said younger generations may be less likely to have experienced this type of violence. Still, in 2014, police reports show there were about 85,000 victims of family violence in Canada.

Family violence is more likely to affect those who are more vulnerable or marginalized, the study said. Parts of the population at greater risk are women, children, indigenous people, people with disabilities, and those in the LGBT community. Women are more likely than men to be killed by an intimate partner, and to experience sexual abuse along with more severe forms of intimate partner violence.

Indigenous women are three times more likely to report spousal abuse than non-indigenous women, while 40 per cent of indigenous people have experienced abuse before the age of 15. Family violence in indigenous communities stems from many factors, it noted, such as gaps in health and social services, a lack of safe places, concerns about the justice system, and intergenerational trauma related to residential schools.

Across Canada, the health effects are extensive, and can range from mental health issues such as depression and post-traumatic stress disorder, to higher rates of injuries and diseases, and a shorter life span.

There is an economic toll as well – costs for health care resulting from spousal violence come to $200-million a year, while costs related to pain, suffering and loss of life are pegged at $5.5-billion annually, the report noted.

Dr. Taylor hopes this will start a national discussion.

"For a whole variety of reasons, people don't talk about family violence, whether it's because they're embarrassed or there's a stigma," he said. "We need to get this out in the open. If we can get it out in the open we'll begin to understand what causes it, what are the risk factors, and get a better concept of what to do."