Measuring the impact of intimate partner violence on the health of women in Victoria, Australia

Abstract

Objective Using burden of disease methodology, estimate the health risks of intimate partner violence (IPV) among women in Victoria, Australia. Methods We calculated population attributable fractions (from survey data on the prevalence of IPV and the relative risks of associated health problems in Australia) and determined health outcomes by applying them to disability-adjusted life year estimates for the relevant disease and injury categories for Victoria, Australia for 2001. Findings For women of all ages IPV accounted for 2.9% (95% uncertainty interval 2.4-3.4%) of the total disease and injury burden. Among women 18-44 years of age, IPV was associated with 7.9% (95% uncertainty interval 6.4-9.5%) of the overall disease burden and was a larger risk to health than risk factors traditionally included in burden of disease studies, such as raised blood pressure, tobacco use and increased body weight. Poor mental health contributed 73% and substance abuse 22% to the disease burden attributed to IPV. Conclusion Our findings suggest that IPV constitutes a significant risk to women's health. Mental health policy-makers and health workers treating common mental health problems need to be aware that IPV is an important risk factor. Future research should concentrate on evaluating effective interventions to prevent women being exposed to violence, and identifying the most appropriate mental health care for victims to reduce short-and long-term disability. Voir page 743 le résumé en français. En la página 743 figura un resumen en español. IntroductionReliable and comparable analysis of risks to health is essential for informing efforts to prevent disease and injury. 1 The burd d den of disease methodology provides a tool for estimating the impact of health problems and risky behaviours across a population, taking into account both illness and premature death. 2 Previous burden of disease studies have been criticized for failing to provide an accurate and comprehensive picture of the burden of disease and injury among women by excluding some red d productive health conditions associated with significant rates of morbidity, and by omitting to measure the contribution of important risk factors, such as intid d mate partner violence (IPV), to burden of disease. 3,4 Increasing evidence indicates that IPV is highly prevalent globally and has serious and longdlasting health consed d To decrease gender disparities in health outcomes it is essential that the associd d ated risk factors be clearly identified, measured and recognized as a priority for intervention.Globally, evidence on the prevad d lence and the health consequences of IPV is growing steadily but, to date, the contribution of IPV to the burden of disease has not been estimated. The overall aim of our study was to estimate the contribution of IPV to the total burden of disease for women living in Victoria, Australia, in 2001. We were able to carry out this study due to the availability of good prevalence data on exposure to IPV and survey data on the health consequenc...

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“…The authors of an Australian study estimated, on the basis of disability-adjusted life years (DALYs), that women's burden of disease was mainly attributable to mental illness [50]. Seventy-three per cent of the burden of disease was attributed to issues such as depression, anxiety and suicide, while 22 per cent were attributable to harmful health behaviours, such as smoking tobacco and misuse or abuse of alcohol and illegal drugs.…”

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“…and (4) How often does your partner scream or curse at you? Participants answered each question using a 5-point scale ranging from "never" (1) to "frequently" (5). Answers were summed to form a total HITS score, which could range from 4 to 20.…”

“…1 Women are particularly vulnerable to the harmful effects of IPV; they are 7 to 14 times more likely than men to suffer severe physical injury from an assault by an intimate partner. 2 A history of being the target of violence puts women at increased risk of physical injury, chronic pain syndromes, irritable bowel syndrome, gastrointestinal disorders, sexually transmitted diseases, [3][4][5] depression, suicide attempts, psychosomatic disorders, reproductive health consequences, and other comorbidities. 6 Victims also reported more risky behaviors, including smoking, heavy drinking, and drug use.…”

The impact of a referral card-based intervention on intimate partner violence, psychosocial health, help-seeking and safety behaviour during pregnancy and postpartum: a randomized controlled trial

“…A cohort study of women aged 18-44 years suggested that IPVv was responsible for 7.9% of the overall burden of disease, which was more prominent than other risk factors such as high blood pressure, tobacco, and obesity [29,30]. IPVv is hence considered an important contributor to the global burden of disease for women of reproductive age.…”