The negative health effects of intimate partner violence (IPV) are diverse and epidemic. IPV, which is often interchangeably called domestic violence, spousal abuse, family violence, or wife beating, can significantly degrade the physical, sexual, reproductive, and mental health status of IPV survivors. Survivors of IPV have been shown to need more emergency room visits, physician visits, and prescriptions filled than individuals who have not experienced IPV. Not only does IPV cause immediate injury, but its effects also culminate over time and manifest as an array of health problems that prevail far after the abuse has ended. The complexity and duration of the negative health effects of IPV cause it to be difficult to identify, diagnose, and treat by medical professionals who have not been properly trained. The public health community has accordingly recognized IPV as a public health priority and has begun addressing its health consequences through position papers, changes in health care delivery, community partnerships, and medical trainings.
Long-Term Health Consequences of Physical Violence
In addition to the immediate injury that often results from physical violence, such as lacerations, bruises, broken bones, and concussions, victims of IPV also often suffer from related long-term physical health problems. The effects of ongoing or consistent abuse are cumulative and proportionate to the duration and severity of abuse. Consequently, routine violence has been shown to increase the likelihood of recurring physical ailments such as arthritis and chronic pain syndrome. When the violence is more focused around the head and neck, it can lead to neurological difficulties such as headaches, vision and hearing impairment, and an inability to concentrate.
Health Consequences of Sexual Violence
In addition to physical violence, the definition of IPV also often includes sexual assault by an intimate partner. The term sexual abuse refers to any sexual action that is committed to establish, maintain, or exploit an imbalance of power. This abuse includes but is not limited to the use or threat of physical violence for sex, degrading or cruel sex acts, and sex with the intention of emotional manipulation. While the immediate and chronic health consequences of sexual abuse include many of the effects of physical abuse, these consequences also encompass a set of problems characteristic to this type of violence.
Victims of sexual abuse are often not permitted to negotiate safer sex practices, and therefore are at a higher risk for unwanted pregnancies and sexually transmitted diseases. Possible cumulative effects of sexual violence include vaginal and anal tearing, gynecological infections, urinary tract infections, pelvic inflammatory disease, bladder infections, chronic pelvic pain, and cervical cancer.
Health Consequences of Psychological Violence
Psychological abuse and emotional abuse are also strong predictors of poor physical and mental health. Survivors of IPV are more likely to suffer from depression, posttraumatic stress disorder, insomnia, and panic attacks. A lack of agency, constant fear of safety for oneself and loved ones, verbal abuse, and psychological intimidation are only a few contributing causes of a survivor’s mental health ailments.
In addition to mental health problems, psychological abuse can also result in physical problems caused by emotional strain, often called psychosomatic effects. These effects can manifest themselves as gastrointestinal problems, such as irritable bowel syndrome, stomach ulcers, constipation, diarrhea, and chronic stomach pain. Survivors of IPV are also more likely to experience high blood pressure and poor heart health. Additionally, stress caused by violence most likely reduces immune system response, increasing the potential to contract communicable diseases.
Survivors of violence may also employ coping behaviors that are physically harmful in an effort to reduce psychological suffering. Individuals who have experienced IPV are more likely to have an eating disorder, abuse drugs, drink alcohol, and smoke cigarettes. The most detrimental health effect rooted in the psychological suffering caused by IPV is the increased likelihood to have thoughts of suicide and to commit suicide.
Health Care and Intimate Partner Violence
In addition to health problems caused directly by IPV, survivors of abuse also face difficulties in receiving effective health care. Batterers often employ controlling and isolating behavior that limits the people, institutions, and services with whom their partner has the ability to interact. In an effort to conceal the violence or to exert control in the relationship, perpetrators of IPV may not allow victims to seek prescriptive or preventive medical care. Thus survivors of IPV are less likely to visit medical professionals to treat injuries that have already occurred or to participate in regular health screenings such as pap smears and mammograms.
When survivors of IPV do receive screening and treatment from medical professionals, they may not receive care that is tailored to their experiences. Survivors are often reluctant to disclose experiences of abuse in hospitals because they fear for their safety, are embarrassed, or do not identify their abuse as a cause of their deteriorating health. Additionally, questions regarding abuse are typically not a routine part of screenings administered in medical settings. Therefore, the complexity of causes and effects of this type of violence may evade medical professionals who have not been appropriately trained to accurately and comprehensively identify, diagnose, and treat the health consequences of abuse.
Public Health Response to Intimate Partner Violence
In response to the far-reaching and distinctive health consequences of IPV, the United States’ public health community has been acknowledging domestic violence as a public health priority since the 1980s. In 1985, U.S. Surgeon General C. Everett Koop publicly recognized domestic violence as a pressing public health issue. In the following 15 years, a number of leading national health organizations issued position papers identifying violence against women, family violence, or domestic violence as a public health priority. These health organizations include the American College of Obstetrics and Gynecology, the American Nurses Association, the American Medical Association, the American Public Health Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American Psychological Association, and the American Academy of Nurse Practitioners.
In 2006 the World Health Organization (WHO) released the results of its multicountry study on the health effects of domestic violence. Through this investigation that interviewed over 24,000 women in urban and rural areas of 10 countries, WHO asserted that IPV is the most common type of violence in women’s lives and must be viewed as a key global health priority.
Bibliography:
- Campbell, J. C. (Ed.). (1998). Empowering survivors of abuse: Health care for battered women and their children. Thousand Oaks, CA: Sage.
- Chamberlain, L. (2006). Making the connection: Domestic violence and public health. San Francisco, CA: Family Violence Prevention Fund.
- Coker, A., Smith, P., Bethea, L., King, M., & McKeown, R. (2000). Physical health consequences of physical and psychological intimate partner violence. Archives of Family Medicine, 9(5), 451–457.
- Garcia-Moreno, C., Jansen, A. F. M. H., Ellsberg, M., Heise, L., & Watts, C. (2005). WHO Multi-country Study on Women’s Health and Domestic Violence Against Women: Initial results on prevalence, health outcomes, and women’s responses. Geneva: World Health Organization.
- Morewitz, S. J. (2004). Domestic violence and maternal and child health. New York: Kluwer Academic/Plenum.
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