Domestic Violence:

A pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks as well as economic coercion, that adults or adolescents use against their intimate partners.

Prevalence:

Domestic violence is virtually impossible to measure with absolute precision due to numerous complications, including the societal stigma that inhibits victims from disclosing their abuse and the varying definitions of abuse used from study to study.Estimates range from 960,000 incidents of violence against a current or former spouse, boyfriend, or girlfriend per year¹ to 3.9 million women raped and/or physically assaulted by an intimate partner annually.²

On July 22, 1997, UNICEF released The Progress of Nations, 1997, which found that a quarter to half of women around the world have suffered violence from an intimate partner.³

Nearly one-third of American women (31%) report being physically or sexually abused by a husband or boyfriend at some point in their lives, according to a 1998 Commonwealth Fund survey.⁴

Thirty percent of Americans say they know a woman who has been physically abused by her husband or boyfriend in the past year.⁵

While women are less likely than men to be victims of violent crimes overall, women are five to eight times more likely than men to be victimized by an intimate partner.⁶

Health Consequences of Domestic Violence:

The U.S. Department of Justice reported that 37% of all women who sought care in hospital emergency rooms for violence-related injuries were injured by a current or former spouse, boyfriend or girlfriend.⁷

Domestic violence is repetitive in nature: about 1 in 5 women victimized by their spouse or ex-spouse reported that they had been a victim of a series of at least 3 assaults in the last 6 months.⁸

The level of injury resulting from domestic violence is severe: of 218 women presenting at a metropolitan emergency department with injuries due to domestic violence, 28% required hospital admission,and 13% required major medical treatment. 40% had previously required medical care for abuse.⁹

In 1996, approximately, 1,800 murders were attributed to intimates; nearly three out of four of these had a female victim.¹⁰

In addition to injuries sustained during violent episodes, physical and psychological abuse are linked to a number of adverse physical health effects including arthritis, chronic neck or back pain, migraine and other frequent headaches, stammering, problems seeing, sexually transmitted infections, chronic pelvic pain, stomach ulcers, spastic colon, and frequent indigestion, diarrhea, or constipation.¹¹

Fifty-six percent of women who experience any partner violence are diagnosed with a psychiatric disorder.¹² Twenty-nine percent of all women who attempt suicide were battered,¹³ 37% of battered women have symptoms of depression,¹⁴ 46% have symptoms of anxiety disorder,¹⁵ and 45% experience post-traumatic stress disorder.¹⁶

Children's Health and Domestic Violence

Children who witness domestic violence are more likely to exhibit behavioral and physical health problems including depression, anxiety, and violence towards peers.¹⁷ They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, and commit sexual assault crimes.¹⁸

Fifty percent of men who frequently assault their wives frequently assault their children,¹⁹ and the U.S. Advisory Board on Child Abuse and Neglect suggests that domestic violence may be the single major precursor to child abuse and neglect fatalities in this country.²⁰

Costs of Domestic Violence:

From 1987 to 1990, crime costs Americans $450 billion a year. Adult victims of domestic violence incurred 15% of the total cost of crime on victims ($67 billion).²¹

A study conducted at Rush Medical Center in Chicago found that the average charge for medical services provided to abused women, children and older people was $1,633 per person per year. This would amount to a national annual cost of $857.3 million.²²

A study conducted at a large health plan in Minneapolis and St. Paul, Minnesota, in 1994, found that an annual difference of $1775.00 more was spent on abused women who utilized hospital services than on a random sample of general enrollees. The study concluded that early identification and treatment of victims and potential victims will most likely benefit health care systems in the long run.²³

Identification of Domestic Violence:

Ninety-two percent of women who were physically abused by their partners did not discuss these incidents with their physicians; 57% did not discuss the incidents with anyone.²⁴ Additionally, in four different studies of survivors of abuse, 70% to 81% of the patients studied reported that they would like their healthcare providers to ask them privately about intimate partner violence.^{25 26 27 28}

A 1999 study published in The Journal of the American Medical Association found that an estimated ten percent of primary care physicians routinely screen for intimate partner abuse during new patient visits and nine percent routinely screen during periodic checkups.²⁹

A 1999 survey of managed care organizations found that less than one-third (29%) of health maintenance organizations in the United States have policies, protocols, guidelines, or materials on screening for domestic violence.³⁰

A 2001 study in North Carolina found that only 23% of women injured shortly after pregnancy received treatment for their injuries. However, almost all of these women used care for their infants indicating that pediatric practices are important settings for identifying domestic violence.³¹

Recent clinical studies have proven the effectiveness of a 2-minute screening for early detection of abuse of pregnant women.³² Additional longitudinal studies have tested a 10-minute intervention that was proven highly effective in increasing the safety of pregnant abused women.³³

Pregnancy:

Each year, at least six percent of all pregnant women, about 240,000 pregnant women, in this country are battered by the men in their lives.³⁴

Complications of pregnancy, including low weight gain, anemia, infections, and first and second trimester bleeding are significantly higher for abused women,^35 36
as are maternal rates of depression, suicide attempts, tobacco, alcohol, and illicit drug
use.³⁷

Pregnant and recently pregnant women are more likely to be victims of homicide than to die of any other cause,³⁸ and evidence exists that a significant proportion of all female homicide victims are killed by their intimate partners.³⁹