The first time Leslie Morgan Steiner's husband attacked her was five days before their wedding. He choked her so hard he left handprints on her neck, she said.
After that, Morgan said he beat her regularly. She said that during their two-and-a-half year marriage, he threatened her with a loaded gun and pounded her head against walls. Once he threw her down a flight of stairs. Twice he choked her until she blacked out.
After a beating that lasted more than two hours, Steiner said she finally had the courage to file for divorce and take out a restraining order.
Yet 20 years later, Morgan said she still deals with the psychological damage, the fear and physical pain inflicted on her by her ex.
She said her joints constantly ache, and she has some short-term memory loss. Her doctor told her that at 48 years old, she's too young and healthy to experience these kinds of problems.
"I am still terrified of my ex-husband," Steiner said. "It makes perfect sense that my body is suffering."
The research suggests that Steiner is not an isolated example. Once the immediate bruises and broken bones heal, there's evidence that the majority of the 3 million to 4 million women who report a domestic violence incident each year, according to the American Medical Association, have an exceptionally high rate of health problems.
A newly released Verizon Foundation and More magazine survey asked more than 1,000 women about their health and well-being. The 44 percent who identified themselves as survivors of domestic abuse were 20 percent more likely to experience a chronic health condition compared with women who said they'd never been abused. Domestic abuse victims also reported up to twice as many chronic conditions compared with those who said they were not abused, the survey found.
More than 80 percent of domestic abuse survivors, and nearly 90 percent of those who said they had also been sexually abused, reported such problems as low back pain, chronic headaches, arthritis and more. They also reported a higher than average incidence of depression, diabetes, asthma and digestive disease, as well as elevated rates of impaired brain, immune or endocrine system dysfunction.
"We now know from science that exposure to violence leads to significant poor health outcomes across the life spectrum," said Kristin Schubert, the director of the Robert Wood Johnson Foundation's Vulnerable Populations Portfolio.
"When you make this connection and understand the health, economic and social repercussions of intimate partner violence, it becomes clear that this is a problem that should concern everyone," Schubert said.
One of the stumbling blocks to treatment, the survey found, was that women don't make the connection between their health and the abuse. Survey respondents were more likely to blame other things, such as smoking and alcohol for any of their health problems rather than the domestic abuse they had endured.
Health care providers often fail to pick up on the signals, according to the survey.
Seventy-five percent of the women surveyed said they'd never been asked about domestic violence during a physical exam. Only 6 percent said a doctor or nurse had ever made a connection between their abuse and health problems. And less than 20 percent of abuse victims were offered any resources or referrals from a health care professional.
Rose Stuckey Kirk, Verizon vice president of global corporate social responsibility, said that the long-term health consequences of domestic violence couldn't be properly addressed until an association between the two was acknowledged.
"This research is important in that it opens up a new way to understand how health care providers can play a significant role in preventing domestic violence and chronic health problems," she said.
As for Steiner, she's remarried and has three children, and she's written several books, including the bestseller "Crazy Love," about her abusive relationship.
But she's aware of the toll the violence has taken on her well-being.
"The fear, it's like it got into my bones. I feel it on an emotional level but even more so on a physical level," she said.
The effects of domestic violence on its victims don't stop once the abuse is over. It has a bearing on every aspect of victims' lives, including their long-term health.
Please join ABC chief health and medical correspondent Dr. Richard Besser for an ABC health tweet chat today at 1 p.m. ET on the health implications of domestic violence.
We'll be joined by representatives from organizations that support domestic violence survivors, including the authors of the Verizon Foundation and More magazine survey, the Department of Health and Human Services and more than 40 hospitals and research centers. We'll also be joined by survivors who will share their stories with the hope of helping other women, men and children who've been victims of domestic violence.