Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States

Davidov, Danielle M.; Davis, Stephanie M.; Zhu, Motao; Afifi, Tracie O.; Kimber, Melissa; Goldstein, Abby L.; Pitre, Nichole; Gurka, Kelly K.; Stocks, Carol

doi:10.1371/journal.pone.0184222

Cited by 16 publications

(16 citation statements)

References 46 publications

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“…Our study extends previous research 4,12 including one recent cross-sectional study that also used the NEDS for the years spanning 2006 to 2009 13 and one using the State Inpatient Database from 2007 to 2011. 14 In our study, the demographics including age, income level, and payer group are consistent with at least one other report from this database. 13 In addition, our study reveals that most patients came from metropolitan areas (93.7%), which is higher than the previous study (79.8%), 13 although this may be due to the change in the database definition of "rural" after 2010.…”

Section: Discussionsupporting

confidence: 88%

A Nationwide Study of Intimate Partner Violence

Quezada

Mustafa

Zhang

et al. 2020

The American Surgeon™

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Background Intimate partner violence (IPV) refers to physical or sexual violence, stalking, and psychological aggression by an intimate partner. The present study aims to examine the incidence, injury patterns, and outcomes using a representative nationwide data set. Study Design The Nationwide Emergency Department Sample database was queried from 2010 to 2014 to identify IPV in adult patients by injury code E967.3. Demographics, diagnoses, and injury mechanisms were captured. Primary outcome was mortality, and logistic regression analyses were used to compare the baselines and outcomes. Results 132 806 IPV emergency visits were identified, with 5.1% of patients requiring hospitalization. Most patients were female (92.6%). The most common injury mechanisms were unintentional injury (36%) and striking (22.0%). Contusions of face/scalp/neck (13.2%) and unspecified head injury (6.9%) were the most common diagnoses. Males were significantly older [median and interquartile range of 39 (30, 50)] than females [33 (26, 43)], and were more frequently hospitalized (6.7% vs. 5.0%, P = .002) with more injuries with injury severity score ≥ 15 (.7% vs. .4%, P = .004) than females. Overall, IPV-related mortality was .06%, .26% in males and .05% in females ( P = .003). Older age (odds ratio (OR) = 1.053) and male gender (OR = 3.102) were significantly associated with mortality. The annual incidence rate decreased from 9.7 in 2010 to 8.2/100 000 US population in 2014 ( R2 = .659). Conclusions Young women are more likely to be victims of IPV, whereas men are more likely to be older and hospitalized with more severe injuries and worse outcomes.

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Section: Discussionsupporting

confidence: 88%

A Nationwide Study of Intimate Partner Violence

Quezada

Mustafa

Zhang

et al. 2020

The American Surgeon™

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“…Increased state funding is needed for the myriad social support services that intersect in the lives of women experiencing IPV (e.g., domestic violence shelters, job support services, family support services, and crisis hotlines) (Hall-Sanchez, 2016), especially to increase service access in rural areas. Until funding is obtained, those with limited access to resources may benefit from community collaboration and coordinated responses among providers (Davidov et al, 2017). Although rural residents may be less supportive of government involvement in issues related to IPV (Edwards, 2015), public support for additional funding could be enhanced by providing additional context and framing of IPV as a societal-level rather than an individual-level issue (Seely & Riffe, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Regional disparities may exist that put vulnerable groups at increased risk of pressure regarding contraceptive decision-making. Appalachian counties have been shown to have significantly higher rates of IPV-related hospitalizations associated with IPV compared to non-Appalachian counties; however, it is unclear whether this is due to a higher prevalence of IPV, more severe IPV, or an overutilization of emergency services due to fewer resources in rural areas (Davidov et al, 2017). In one study specific to Appalachia, cost was shown to be a significant barrier to utilization of LARCs in an Appalachian sample with private insurance (Broecker et al, 2016).…”

Section: Reproductive Autonomy In Appalachiamentioning

confidence: 99%

Reproductive Autonomy in Appalachia: An Investigation into Perceived Contraceptive Pressure

Huslage

Ely

Nugent

et al. 2022

J Interpers Violence

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The reproductive autonomy of persons who can give birth can be impeded through forms of interpersonal violence and coercion. Moreover, macro-level factors (e.g., poverty, discrimination, community violence, legislative policies) may impede the reproductive autonomy of entire communities. This study investigates a form of violence we term perceived contraceptive pressure in Appalachia, an understudied region of the Eastern U.S., regarding reproductive health and decision-making. Through targeted Meta advertising, participants ( N = 632) residing in Appalachian zip codes completed an online survey on reproductive health. The focus of this study was to investigate the prevalence of perceived contraceptive pressure, who was at increased risk of experiencing pressure, and the source(s) of perceived pressure. Binomial regressions were conducted on three different dependent variables: perceived pressure to be sterilized, perceived pressure to use birth control, and perceived pressure not to use birth control. Approximately half of all respondents (49.5%) reported experiencing at least one type of pressure targeting contraceptive decision-making. The most prevalent source of perceived pressure to use birth control was from the healthcare provider (67.4%), and the most prevalent source of perceived pressure not to use birth control was the respondent’s partner (51.1%). Recommendations for providers serving clients in the Appalachian region include pursuing education regarding contraceptive pressure at the individual level and macro-level. In addition, Appalachian residents may benefit from educational programming on reproductive autonomy, healthy relationships, and how to navigate pressure in relationships.

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“…These communities have higher levels of economic distress and have long suffered an extreme shortage of health care providers and services [80]. Furthermore, Davidov et al recently demonstrated that hospitalizations for IPV were disproportionately higher in Appalachian counties, compared to non-Appalachian areas, suggesting IPV is a significant healthcare disparity issue in this region [81].…”

Section: Discussionmentioning

confidence: 99%

Intimate Partner Violence Experiences Among Men Living with HIV in Rural Appalachia

et al. 2019

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There has been limited study of the syndemic link between HIV and intimate partner violence (IPV) among rural populations in the United States. We utilized the Revised Conflict Tactics Scale-2 to examine the past year prevalence, type (psychological aggression, physical assault, and sexual assault), and the impact of IPV on HIV clinical outcomes among men living with HIV in rural Appalachia. Approximately 39% of participants experienced some type of IPV in the preceding year, with 67% of those individuals experiencing more than 1 type of IPV. Approximately 77% of participants endorsing IPV exposure experienced psychological aggression. Most participants exposed to psychological aggression (70%) and/or physical assault (57%) were both victims and perpetrators, and those experiencing sexual assault reported being exclusively victims (65%). There were no significant differences in clinical outcomes including viral load and CD4 count, which may be secondary to small sample size derived from a clinic population with a high rate of virologic suppression (94%). This study demonstrates the need to assess IPV exposure in men living with HIV and further highlights the intricacies of relationship violence in these individuals.

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Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States

Cited by 16 publications

References 46 publications

A Nationwide Study of Intimate Partner Violence

A Nationwide Study of Intimate Partner Violence

Reproductive Autonomy in Appalachia: An Investigation into Perceived Contraceptive Pressure

Intimate Partner Violence Experiences Among Men Living with HIV in Rural Appalachia

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