[Svrilist] Intimate partner violence found widespread

svrilist at mrc.ac.za svrilist at mrc.ac.za
Sat May 27 00:51:06 SAST 2006


Intimate partner violence found widespread: 
It harms women's health, say Group Health researchers 
SEATTLE-Intimate partner violence (IPV), a.k.a. 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 Robert S. Thompson, MD, 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."
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 Amy E. Bonomi, PhD, MPH, senior research associate, Group Health
Center for Health Studies, 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 (reporting 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 (slapping,
hitting, kicking, or forced sex) to be stronger than those of
nonphysical abuse (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 those with positive responses 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 Frederick P. Rivara, MD, MPH,
of Harborview Injury Prevention and Research Center and the University
of Washington; and Melissa Anderson, MS; Robert J. Reid, MD, PhD; Jane
A. Dimer, MD; David Carrell, PhD, of Group Health-all in Seattle.
Two commentaries accompany the papers about the study: one by James S.
Marks, MD, MPH, and Elaine F. Cassidy, PhD, of the Robert Wood Johnson
Foundation, in Princeton, NJ; and the other by Ann L. Coker, PhD, of the
University of Texas Health Science Center, in Houston.
About Group Health Center for Health Studies
Founded in 1947, Group Health is a consumer-governed, nonprofit health
care system that coordinates care and coverage. Based in Seattle, Group
Health and its subsidiary health carriers, Group Health Options, Inc.
and KPS Health Plans, serve more than 574,000 members in Washington and
Idaho. Group Health's commercial and Medicare plans have received the
top rating of "Excellent" from the National Committee for Quality
Assurance (NCQA). Group Health encompasses medical and specialty
centers, hospitals (including a full service community hospital), a
nationally recognized research center, and a charitable foundation.
Group Health and Group Health Permanente (its multispecialty medical
group practice) combined employ more than 9,000 staff. 
Group Health Center for Health Studies conducts research related to
prevention, diagnosis, and treatment of major health problems. It is
funded primarily through government and private research grants.

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