From the Family Violence Prevention Fund
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 who are physically abused per year.
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.
Nearly one-third of American women (31 percent) report being physically or sexually abused by a husband or boyfriend at some point in their lives, according to a 1998 Commonwealth Fund survey.
Thirty percent of Americans say they know a woman who has been physically abused by her husband or boyfriend in the past year.
While women are less likely than men to be victims of violence crimes overall, women are five to eight times more likely than men to be victimized by an intimate partner.
Injuries and Other 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.
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.
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.
In 1996, approximately, 1,800 murders were attributed to intimates; nearly three out of four of these had a female victim.
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).
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.
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.
Identification of Domestic Violence:
92% 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.
In a major metropolitan emergency department that had a protocol for domestic violence, the emergency department physician failed to obtain a psychosocial history, ask about abuse or address the woman's safety in 92% of the domestic violence cases.
A recent study published in The Journal of the American Medical Association found that an estimated 10% of primary care physicians routinely screen for intimate partner abuse during new patient visits and 9% routinely screen during periodic checkups.
Recent clinical studies have proven the effectiveness of a 2-minute screening for early detection of abuse to pregnant women. Additional longitudinal studies have tested a 10-minute intervention that was proven highly effective in increasing the safety of pregnant abused women.
Pregnancy:
Each year, at least 6% of all pregnant women, about 240,000 pregnant women, in this country are battered by the men in their lives.
Complications of pregnancy, including low weight gain, anemia, infections, and first and second trimester bleeding are significantly higher for abused women, as are maternal rates of depression, suicide attempts, tobacco, alcohol, and illicit drug use.
Policy Recommendations:
A national public health objective for the year 2000 is for at least 90% of hospital emergency departments to have protocols for routinely identifying, treating, and referring victims of sexual assault and spousal abuse.
The Joint Commission for the Accreditation of Hospitals and Healthcare Organizations (JCAHO) requires that accredited emergency departments have policies and procedures, and a plan for educating staff on the treatment of battered adults.
U.S. Department of Justice, Violence by Intimates: Analysis of Data on Crimes by Current or Former Spouses, Boyfriends, and Girlfriends, March 1998.
The Commonwealth Fund, First Comprehensive National Health Survey of American Women, July, 1993.
UNICEF, The Progress of Nations, 1997.
The Commonwealth Fund, Health Concerns Across a Woman's Lifespan: The Commonwealth Fund 1998 Survey of Women's Health, May 1999.
Lieberman Research Inc., Tracking Survey conducted for the Advertising Council and the Family Violence Prevention Fund, July-October, 1996.
U.S. Department of Justice, Violence by Intimates: Analysis of Data on Crimes by Current or Former Spouses, Boyfriends, and Girlfriends, March 1998.
U.S. Department of Justice, August 1997. Violence-related Injuries Treated in Hospital Emergency Departments. Michael R. Rand. Bureau of Justice Statistics.
Zawitz, M. et.al. Highlights from 20 years of Surveying Crime Victims: The National Crime Victimization Survey, 1973-1992. Washington, D.C.: U.S. Department of Justice, Bureau of Justice Statistics, October 1993.
Berios, D.C. and Grady, D. Domestic Violence: Risk Factors and Outcome. The Western Journal of Medicine, Vol. 155(2), August 1991.
Supplementary Homicide Reports, 1976-96.
National Institute of Justice, 1996. Victims Costs and Consequences, A New Look. Washington, D.C.
Meyer, H. The Billion Dollar Epidemic. American Medical News, January 6, 1992.
Wisner, C., Gilmer, T., Saltzman, L., & Zink, T.(1999). Intimate Partner Violence Against Women: Do Victims Cost Health Plans More? The Journal of Family Practice, 48, No. 6 (June) 1999.
The Commonwealth Fund, First Comprehensive National Health Survey of American Women Finds Them at Significant Risk, (News Release). New York: The Commonwealth Fund July 14, 1993.
Warshaw, C. ´Limitation of the Medical Model in the Care of Battered Women.´ Gender & Society, Vol. 3(4) December 1989.
Rodriguez, M., Bauer, H., McLoughlin, E., Grumbach, K., (1999). Screening and Intervention for Intimate Partner Abuse: Practices and Attitudes of Primary Care Physicians. The Journal of the American Medical Association, 282, No. 5, August 4, 1999.
Soeken, K., McFarlane, J., Parker, B. (1998). The Abuse Assessment Screen. A Clinical Instrument to Measure Frequency, Severity and Perpetrator of Abuse Against Women. Beyond Diagnosis: Intervention Strategies for Battered Women and Their Children. Thousand Oaks, CA: Sage.
McFarlane, J., Parker, B., Soeken, K., Silva, C., & Reel, S. (1998). Safety Behaviors of Abused Women Following an Intervention Program offered During Pregnancy. Journal of Obstetrical, Gynecological and Neonatal Nursing, January 1998.
Centers for Disease Control and Prevention, The Atlanta Journal and Constitution, 1994.
Parker, B., McFarlane, J., & Soeken, K. (1994). Abuse During Pregnancy: Effects on Maternal Complications and Infant Birthweight in Adult and Teen Women. Obstetrics & Gynecology, 841, 323-328.
McFarlane, J. Parker B., & Soeken, K. (1996). Abuse during Pregnancy: Association with Maternal Health and Infant Birthweight. Nursing Research 45, 32-37.
McFarlane, J., Parker, B., & Soeken, K. (1996). Physical Abuse, Smoking and Substance Abuse During Pregnancy: Prevalence, Interrelationships and Effects on Birthweight. Journal of Obstetrical Gynecological and Neonatal Nursing, 25, 313-320.
Public Health Service. Healthy People 2000: National Health Promotion and Disease Prevention Objectives--full report with commentary. Washington, DC: U.S. Department of Health and Human Services, Public Health Services, 1991.
Joint Commission on Accreditation of Healthcare Organizations. 1997 Hospital Standards--Possible Victims of Domestic Abuse and Neglect.
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