Thursday, August 12, 2010

Intimate Partner Violence - More and Deadlier For Women

Violence against women is an enormous health issue in the United States. According to an FBI report in 2001, nearly a third of female homicide victims were killed by an intimate partner. Intimate partner violence, or IPV, is violence committed by a spouse, ex-spouse, or current or former boyfriend or girlfriend. IPV includes physical violence, sexual violence, threats of such acts, and emotional abuse. Although both genders are affected, the vast majority of this physical and psychological burden is borne by women.

In 2003, the CDC published a report on the costs of Intimate Partner Violence and estimated that 5.3 million IPV victimizations occured in adult women each year, 2 million of which were injuries and 550, 000 which required medical attention. The costs associated with IPV totalled over $4 billion for medical services and nearly $1 billion in lost work productivity and earnings. The health sequelae are well-established; IPV is linked to low self-esteem, eating disorders, depression, suicidal thoughts, and harmful health behaviors such as smoking, alcohol abuse, drug use, and risky sexual behavior.

So how well do physicians screen their patients for IPV? An ongoing 2010 multi-center Canadian study (Bhandari, et. al) looked at IPV screening attitudes and behavior amongst orthopaedic surgeons. 87% of orthopods believed that less than 1% of female patients in their care were victims of IPV. This was in stark contrast to prior data from fracture clinics that found one-third of women had been victims of IPV within the past year and 2.5% had presenting injuries directly resulting from IPV.

It also turns out that primary care physicians are slightly better at screening for IPV than orthopods, yet still fall far short of expectations. The American Academy of Family Physicians cites on their website a recent study that estimated that 10% of physicians routinely screen for domestic violence during new-patient visits. Where patients presented with physical injuries from abuse, only 79% of physicians asked patients direct questions about domestic violence. 17% of obstetrician-gynecologists routinely screen, compared with 10% of family physicians and 6% of internists.

Resources on Intimate Partner Violence:
National Domestic Violence Hotline  1-800-799-SAFE (7233), 1-800-787-3224 TTY, or
National Coalition Against Domestic Violence
National Sexual Violence Resource Center
Family Violence Prevention Fund
When Closeness Goes Wrong - Podcast

 PRevalence of Abuse and Intimate Partner Violence Surgical Evaluation (P.R.A.I.S.E.): rationale and design of a multi-center cross-sectional study.BMC Musculoskelet Disord. 2010; 11: 77.Published online 2010 April 23.

Blog Submission by Olivia Wang, MS4; WH Pathway, Class of 2011


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