October is breast cancer awareness month. There are pink ribbons and wristbands to wear, pink products to buy, and pink races to run — all to improve awareness about screening and raise money for a cure. And rightly so, because breast cancer affects 250,000 American women every year.

Fewer people know that October is also intimate partner violence awareness month. Purple is the color representing the more than 1.3 million women and 800,000 men victimized every year in the United States. Purple, like a bruise.

Breast cancer is, of course, worthy of the attention, but for me all this pink highlights the relative absence of purple. Why does intimate partner violence get so little public recognition as a major health problem?

Intimate partner violence is certainly an epidemic of grave proportion. It weakens the fabric of society. Not only does it kill, wound, and demoralize, but it teaches our children that violence is normal and that angry words and hurtful actions bring power.  The financial cost is born in sick days, the need for more police, social workers, and jail cells, as well as the higher cost of health insurance.  We are all paying in one-way or another. And as violence begets violence we collectively give birth to the next generation of batterers, ensuring perpetuation.

We talk so freely about breast cancer while domestic violence generates innuendo and hushed conversations. Is it because domestic violence is ugly and scary?

Well, breast cancer is ugly and scary, but because hundreds of thousands of women have walked and advocated we have collectively become aware. When they were silenced by their cancers the voices of their families and friends continued, screaming to all who would listen, “Get screened.”  The women and men affected by breast cancer have empowered us all.

Few victims of intimate partner violence are able speak up. After years of demoralization many cannot see the danger, while others have sadly resigned themselves to their fate because they can no longer visualize a different life.  Almost all are financially dependent on their batterers and once you factor in children, a complete separation is almost impossible. Many are simply too afraid. Holes in the wall serve as a potent punctuation to the screams explaining exactly what will happen to someone if they were to try to leave. After all, restraining orders don’t stop bullets.

If we heard that someone we loved had breast cancer we would probably say, “I am so sorry, are you okay?”  “Can I help you in anyway?”  We might also silently offer a prayer, both for her and for ourselves, and then quickly book our own long overdue mammogram. We would never ask how her gene malfunctioned, why she didn’t get screened sooner, or if she liked a drink or two, although we are quick to assign blame in intimate partner violence. “Why can’t she just leave?” “Didn’t he know?” “She went back to him again?”

Our attitude towards domestic violence is not just a crime of omission. Universal screening for intimate partner violence is recommended, but in reality doesn’t happen. And if a victim does screen positive and decides to leave, where would she or he go? There are more than twice as many shelters in the United States for abused animals than shelters for women and the paucity of services for abused men is criminal.

How do we empower victims of intimate partner violence to speak up? Never mind the stigma, many are afraid of what the attention might bring. It is hard to run a 5k looking over your shoulder.

Who among us will break the silence and chip away at the chains that bind our sisters, brothers, daughters, sons, mothers, fathers, and friends?  We remind women to get their mammograms so can we not turn the same light on relationships and ask, “Are you safe?” or say, “I’m worried, tell me about things at home?”

I was amazed and empowered by the October wall of pink at my grocery store. It did its job. I booked my overdue mammogram. But it also made me cry, because I wondered if there had been a sea of purple when I was in need if I would have left sooner?

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.