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Approximately 20-30% of women and 7.5% of men report having experienced physical or sexual abuse by an intimate partner at some point in their adult lives.[i] Studies indicate that between 25-60% of adolescents have experienced some form of dating violence.,[ii] In 30-60 % of the families affected by IPV, children are also directly abused.[iii] Heterosexual women are 5-8 times more likely than heterosexual men to be victimized by an intimate partner.[iv] The latest U.S. Bureau of Justice Statistics report on intimate partner violence found that 85% of victims are female.[v] The few available studies on IPV in lesbian, gay, transgender and bisexual relationships suggest rates similar to heterosexual relationships, with higher rates in male same-sex relationships than in female.[vi] In a recent survey of men in same-sex relationships, the lifetime prevalence of IPV was 39.2%.[vii] Studies have found the following rates of current (within the past 12 month) IPV victimization: In primary
care settings: 3.4-5.5% of patients.[viii] Though the overall number of crimes decreased by almost 3.5% from 2001, rapes increased from 129 to 153 (19% increase) and aggravated assaults increased from 447 to 490 (10% increase). This is the third year in a row that reported aggravated assaults increased in Vermont. The typical victim of a violent crime in Vermont tends to be a white, female, in her early twenties. The victim and the assailant were known to each other in 87% of violent crime incidents. (Vermont Crime Report 2002) [This means that most of the aggravated assaults were perpetrated against young women, and in the context of domestic violence.] 67 out of the 127 (53%) homicides that were reported in Vermont between 1994 and 2003 were related to domestic violence. 56 of the perpetrators were male, 11 female. 16 perpetrators (15 of them male) committed suicide following the homicide, adding to the death toll. (State of Vermont, Domestic Violence Fatality Review Commission, Statistical Report, January 2004) In 2003, the 16 local programs of the Vermont Network Against Domestic Violence and Sexual Assault served a total of 1158 survivors of sexual violence and 6888 survivors of domestic violence. 469 people stayed in shelters or safe homes for 13,928 person nights. (Vermont Network Against Domestic Violence and Sexual Assault, Annual Report 2003) Common health sequelae of IPV include physical injuries, chronic pain, GI complaints, sexually transmitted infections, and pregnancy complaints.[xii] IPV increases the risk of serious mental health consequences such as depression, post-traumatic stress disorder, anxiety and suicidal ideation.[xiii] IPV victimization can interfere with access to health care and thus with preventive health care behaviors and the management of chronic conditions. IPV victims are more likely to engage in injurious health behaviors like smoking, alcohol and substance abuse.[xiv] IPV can lead to homicide and suicide. Children witnessing intimate partner violence in their homes are more likely to suffer from physical and behavioral health problems. They are also more likely to attempt suicide, and abuse drugs and alcohol.[xv] Victim’s use of Health Care System The CDC found that the costs of intimate partner rape, physical assault and stalking exceed 5.8 billion each year, nearly $4.1 billion of which is for direct medical and mental health care services. Approximately 40% of women raped or physically assaulted by an intimate partner sustained injuries. Of those, around 30% received medical care, such as ambulance/paramedic services, treatment in an emergency department, dental care, or physical therapy. One third of rape victims, 26%of physical assault victims and 42.6% of stalking victims sought mental health care, averaging between 9-13 visits. [xvi] The Role of the Health Care Provider Health Care providers are often the first and only outsiders who have the opportunity to witness the impact of IPV and to offer interventions. Clinical guidelines[xvii] recommend routine screening for IPV victimization, assessment of health impact and safety, documentation in medical records that will hold up in court, offering education and resources, and making effective referrals to community resources. Effective interventions by health care providers open the doors to a range of options and resources, potentially increasing the safety of victims and their children and preventing serious injuries and health problems. More Stats and Facts on the Connection Between Domestic Violence and Health Domestic violence is associated with 8 of the 10 Leading Health Indicators for Healthy People 2010Linda Chamberlain, Making the Connection: Domestic Violence and Public Health, Family Violence Prevention Fund, http://endabuse.org/programs/display.php3?DocID=344 This tool (on CD with an accompanying guidebook) offers the most relevant research on family violence, implications for select public health programs, recommended clinical and policy strategies, promising practices and resources from around the country.
• 68% experienced
physical abuse as adults
• Prevalence ranges from 7.4% to 20.1% in studies that asked about violence more than once during personal interviews or asked later in pregnancy.[xxi]
Women who are forced into sex by an intimate partner are more likely to experience: Chronic headaches, Depression, Pelvic inflammatory disease, Vaginal and anal tearing, Bladder infections, Sexual dysfunction, Pelvic pain, Gynecological problems [xxii] Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems.[xxiii]
Women with a history of domestic violence are more likely to be diagnosed with:
• Posttraumatic
stress disorder[xxiv]
• Abused
women are at increased risk for substance abuse[xxviii]
[i]
National Institute of Justice and
Centers for Disease Control and Prevention. (1998). Prevalence,
Incidence, and Consequences of Violence
Against Women: Findings from the National Violence Against Women Survey.
Washington, DC: National Institute of Justice and Centers for Disease
Control and Prevention, 1998. [ii] Foshee, VA; Linder, GF; Bauman, KE; Langwick, SA; Arriaga, XB; Heath, JL; McMahon, PM; Bangdiwala, S. (1996). “The Safe Dates Project: Theoretical basis, evaluation design, and selected baseline findings.” American Journal of Preventive Medicine, 12(5 Suppl):39-47. Cohall, A; Cohall, R; Bannister, H; Northridge, M. (1999). “Love shouldn't hurt: Strategies for health care providers to address adolescent dating violence,” Journal of the American Medical Women’s Association, 54 (3):144-8. Silverman J, Raj A, Mucci L, Hathaway J. (2001). Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. Journal of the American Medical Association, 286(5). 572-579. [iii] Edleson JL. (1999). The overlap between child maltreatment and woman battering. Violence Against Women. 5(2). 134-154. [iv] U.S. Department of Justice. (1998). Violence by Intimates: Analysis of Data on Crimes by Current or Former Spouses, Boyfriends, and Girlfriends. Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics. [v] Bureau of Justice Statistics Special Report,. Intimate Partner Violence and Age of Victim, 1993-99. October 2003. United States Department of Justice. [vi] Goodenow, Carol. (1998). 1997 Massachusetts Youth Risk Behavior Survey. Malden, MA: Massachusetts Department of Education. Renzetti, C. (1992). Violent Betrayal: Partner Abuse in Lesbian Relationships. Sage Publications. 18. Tjaden P., Thoennes N. (1998). Prevalence, Incidence, and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey. National Institute of Justice, Centers for Disease Control. Bureau of Justice Statistics, 202-633-3047 [vii] Greenwood et al. Battering Victimization Among a Probability-Based Sample of Men Who Have Had Sex With Men. American Journal of Public Health. 2002; 92 (12). [viii] Campbell, JC, Schollenberger, J. O’Campo, PJ, Dienemann, JA, Gielen, AC, Kub, J, Wynne, EC. (1999). Annual and lifetime prevalence of partner abuse in a sample of female HMO enrollees. Women’s Health Issues; 9:6: 295-305. [ix] Abbott J, et al. (1995). Domestic Violence Against Women Incidence and Prevalence in an Emergency Department Population. Journal of the American Medical Association; 273: 1763-67; Dearwater SR. et al. (1998). Prevalence of Intimate Partner Abuse in Women Treated at Community Hospital Emergency Departments. Journal of the American Medical Association; 230: 433-438. Muelleman RA, Lenaghan PA, Pakieser RA. Battered Women: injury locations and types. Annals of Emergency Medicine 1996: 28: 486-492. [x] Gin NE, et al. (1991). Prevalence of Domestic Violence Among Patients in Three Ambulatory Care Internal Medicine Clinics. Journal of General Internal Medicine: 6:317-22. [xi] Gazmararian J, et al. (1996). Prevalence of Violence Against Pregnant Women. Journal of the American Medical Association 1996: 275; 1915-20. [xii] Coker, A., Smith, P., Bethea, L., King, M., McKeown, R. (2000). “Physical Health Consequences of Physical and Psychological Intimate Partner Violence,” Archives of Family Medicine, Vol. 9. Centers for Disease Control and Prevention, (1994). The Atlanta Journal and Constitution, 1994.; Parker, B., McFarlane, J., & Soeken, K. (1994). Abuse During Pregnancy: Effects on Maternal Complications and Infant Birth weight in Adult and Teen Women. Obstetrics & Gynecology, 841, 323-328. [xiii] Danielson, K., Moffit, T., Caspi, A., and Silva, P. (1998). “Co-morbidty Between Abuse of an Adult and DSM-III-R Mental Disorders: Evidence From an Epidemiological Study,” American Journal of Psychiatry, 155(1). Stark, E. and Flitcraft, A.(1995). Killing the beast within: Woman battering and female suicidality, International Journal of Health Sciences, 25(1) Housekamp, B.M. and Foy, D.( 1991). “The assessment of posttraumatic stress disorder in battered women,” Journal of Interpersonal Violence, 6(3). Gelles, R.J. and Harrop, J.W. (1989.). Violence, battering, and psychological distress among women, Journal of Interpersonal Violence, 4(1). [xiv] Silverman JG, Raj A, Mucci LA, Hathaway JE. (2001). “Dating Violence Against Adolescent Girls and Associated Substance Use, Unhealthy Weight Control, Sexual Risk Behavior, Pregnancy, and Suicidality.” JAMA., 286(5),572-579. [xv] Kilpatrick KI, Litt, M, & Williams L. (1997). Post-traumatic stress disorder in child witnesses to domestic violence. American Journal of Orthopsychiatry, 67(4), 639-644. Jaffe, P. and Sudermann, M., (1995). Child Witness of Women Abuse: Research and Community Responses, in Stith, S. and Straus, M. Understanding Partner Violence: Prevalence, Causes, Consequences, and Solutions. Families in Focus Services, Vol. II. Minneapolis, MN: National Council on Family Relations. Wolfe, D.A., Wekerle, C., Reitzel, D. and Gough, R., (1995). Strategies to address violence in the lives of high risk youth.” In Peled, E., Jaffe, P.G. and Edleson, J.L. (eds.), Ending the Cycle of Violence: Community Responses to Children of Battered Women. New York: Sage Publications. [xvi] National Center for Injury Prevention and Control. Costs of Intimate Partner Violence Against Women in the United States. Atlanta, GA: Centers for Disease Control and Prevention; 2003 [xvii] For example: Diagnostic and Treatment Guidelines on Domestic Violence, American Medical Association, 1992. http://www.ama-assn.org/ama1/pub/upload/mm/386/domesticviolence.pdf National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings, Family Violence Prevention Fund, San Francisco, CA 2002. www.endabuse.org [xviii] Silverman JG, Raj A, Mucci LA, Hathaway JE. (2001). “Dating Violence Against Adolescent Girls and Associated Substance Use, Unhealthy Weight Control, Sexual Risk Behavior, Pregnancy, and Suicidality.” JAMA., 286(5),572-579 [xix] Coker, A., Smith, P., Bethea, L., King, M., McKeown, R. (2000). “Physical Health Consequences of Physical and Psychological Intimate Partner Violence,” Archives of Family Medicine, Vol. 9. [xx] Gielen AC, McDonnel KA, Burke JG, O’Campo P. Women’s Lives After and HIV-Positive Diagnosis: Disclosure and Violence. Maternal and Child Health Journal. 2000; 4(2):111-120 [xxi] Gazmararian J, et al. (1996). Prevalence of Violence Against Pregnant Women. Journal of the American Medical Association 1996: 275; 1915-20. [xxii] Campbell JC, Lewandowski LA. Mental and Physical Health Effects of Intimate Partner Violence on Women and Children. Psychiatric Clinics of North America. 1997; 20(2):353-374. Bergman, B., and B. Brismar. (1991) A 5year followup study of 117 battered women. American Journal of Public Health 81(11): 14861489 Plichta, SB. Spouse Abuse, Patient-Physician Communication, and Patient Satisfaction. Am J Prev Med 1996: 12. 297-303. [xxiii] Jacquelyn Campbell, PhD, RN; Alison Snow Jones, PhD; Jacqueline Dienemann, PhD, RN; Joan Kub, PhD, RN; Janet Schollenberger, MHS; Patricia O'Campo, PhD; Andrea Carlson Gielen, PhD; Clifford Wynne, MD Intimate Partner Violence and Physical Health Consequences Arch Intern Med. 2002;162:1157-1163 [xxiv] Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, Smith PG. Physical and Mental Health Effects of Intimate Partner Violence for Men and Women. American Journal of Preventive Medicine. 2002; 22(4):260-268. [xxv] Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, Smith PG. Physical and Mental Health Effects of Intimate Partner Violence for Men and Women. American Journal of Preventive Medicine. 2002; 22(4):260-268. [xxvi] Kernic MA, Wolf ME, Holt V. Rates and Relative risk of Hospital Admission Among Women in Violent Intimate Partner Relationships. Am J Public Health. 2000;90:1416-1420 [xxvii] Stark, E. and Flitcraft, A.(1995). Killing the beast within: Woman battering and female suicidality, International Journal of Health Sciences, 25(1) Bergman BO, Brismar BO. Suicide attempts by battered wives. Acta Psychiatr Scand 1991; 83:380-384 Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, Smith PG. Physical and Mental Health Effects of Intimate Partner Violence for Men and Women. American Journal of Preventive Medicine. 2002; 22(4):260-268. [xxviii] Plichta, SB. The Effects of Woman Abuse on Health Care Utilization and Health Status: A Literature Review. Women’s Health Issues 1992; 2:154-163. [xxix] Miller, B.A.; Downs, W.R.; and Testa, M. Interrelationships between victimization experiences and women's alcohol use. Journal of Studies on Alcohol 11:109-117, 1993 [xxx]
Martin S, Mackie L, Kupper LL, Buescher P, Moracco K. Physical abuse of
women before, during, and after pregnancy. JAMA 2001; 285:1581-1584. |
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