May 18, 2006
Violence at home affects nearly half of all women
Intimate partner violence (IPV), also called domestic violence, is common and damages women’s physical and mental health significantly, according to a Group Health study reported in two papers in the June issue of the American Journal of Preventive Medicine.
In a random sample of more than 3,400 women members of Group Health Cooperative, nearly half—44 percent—reported having experienced IPV during their adult lifetime.
“This is an epidemic,” said Dr. Robert S. Thompson, senior investigator, Group Health Center for Health Studies, lead author of one paper. “But it flies under the radar, because of the stigma and shame associated with it — as well as the fear that many health care providers have of opening what some call a ‘Pandora’s Box’ of difficult problems that they are unsure how to address.” Thompson is also a UW clinical professor of pediatrics and of health services.
This study is the first to find that the more recent a woman’s IPV, and the longer it has gone on, the worse her physical and mental health and social network are likely to be.
“IPV harms women’s physical and mental health even more than do other common conditions, such as back pain and even several forms of cancer,” said Dr. Amy E. Bonomi, research associate at Group Health Center for Health Studies and lead author of the other paper. Compared to women with no IPV, women with recent physical IPV were four times as likely to report symptoms of severe depression, nearly three times as likely to report poor or fair health and more than one additional symptom. They also reported lower social functioning by several measures.
Previous estimates ranged from a quarter to a half of women experiencing IPV during their adult lifetimes, depending on how researchers defined IPV and whom they sampled, with young, low-income women reporting more IPV. Interestingly, this study, which reports a prevalence of nearly one half, involves health-plan enrollees who tend to be older and have higher incomes and more education than average, making it clear that IPV is an equal-opportunity problem.
Bonomi and Thompson found the effects of physical abuse, such as slapping, hitting, kicking, or forced sex, to be stronger than those of nonphysical abuse, such as threats, chronic disparaging remarks, or controlling behavior, alone. But they also found that both physical and nonphysical IPV significantly damage women’s health, and that physical abuse often accompanies nonphysical abuse.
IPV persisted for more than 20 years in 5 percent to 13 percent of the women, with more than one partner perpetrating IPV on 11 percent to 21 percent of them, with these ranges depending on the type of abuse. Prevalence was 15 percent in the last five years, and 8 percent in the last year, for any IPV.
“We are at a point with IPV that seems similar to where we were with cigarette smoking and alcoholism 20 years ago,” said Bonomi. “To prevent IPV from starting and continuing, we need interventions that span individual, community and social levels.” She and Thompson suggest that these interventions should include inquiring routinely about IPV and linking people to appropriate services.
The Agency for Health Research and Quality funded the study. The other authors of the papers about the study are Group Health Center for Health Studies affiliate scientific investigator Dr. Frederick P. Rivara of Harborview Injury Prevention and Research Center and the UW; and Melissa Anderson, Dr. Robert J. Reid, Dr. Jane A. Dimer and Dr. David Carrell of Group Health.
