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SAN FRANCISCO -- Blue Shield of California is trying to get the message out to stop domestic violence.

The San Francisco-based insurer has taken the lead among health care companies in the state by holding discussions on domestic violence and distributing information to other businesses, says Donna Norton, manager of the national workplace resource center on domestic violence at the Family Violence Prevention Fund.

Non-health care businesses in the state, including the Gap, Levi Strauss & Co. and McKesson Corp., already have internal programs on domestic violence. Nationwide, Polaroid Corp. and American Express Co. have launched efforts to combat abuse, says Marianne Balin, a public affairs specialist who developed Blue Shield's $150,000 program.

Domestic violence is the leading cause of injury to women in the United States, with almost 4 million women physically abused by their husbands or boyfriends every year. It results in hundreds of millions of dollars in health care costs annually that are borne by employers' benefit programs, according to the Pennsylvania Blue Shield Institute.

Since launching its Domestic Violence Initiative Oct. 1, Blue Shield has received 16 requests for information from benefit managers at California companies, Ms. Balin said.

Blue Shield is distributing a packet with guidelines on talking to victims and setting up informational sessions on domestic abuse.