Health status and health care use of Massachusetts women reporting partner abuse. American Journal of Preventive Medicine, 19(4), 302-307

Bureau of Family and Community Health, Massachusetts Department of Public Health, Boston, Massachusetts, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 12/2000; 19(4):302-7. DOI: 10.1016/S0749-3797(00)00236-1
Source: PubMed


Studies indicate that women abused by their intimate partners are at increased risk for a number of health problems and have increased rates of health care utilization. However, these findings are based mainly on studies using clinic or health plan populations. In this study, we examined the association between intimate partner abuse (IPA) and health concerns and health care utilization in a population-based sample of adult women.
We analyzed data on 2043 women aged 18 to 59 who participated in the 1998 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey that included questions on IPA. IPA was defined as experiencing physical violence by, fear of, or control by an intimate partner. Consequences of IPA and self-rated health status and health care utilization of women experiencing IPA were examined.
A total of 6.3% of Massachusetts women aged 18 to 59 reported IPA during the past year. Women experiencing IPA were more likely than other women to report depression, anxiety, sleep problems, suicidal ideation, disabilities, smoking, unwanted pregnancy, HIV testing, and condom use. Women experiencing IPA were less likely to have health insurance, but received routine health care at similar rates as other women.
These results indicate that women in the general population experiencing IPA are at increased risk for several serious emotional and physical health concerns. Most of these women are in routine contact with health care providers. These findings also suggest that the BRFSS may provide a valuable mechanism for tracking state-based IPA prevalence rates over time.

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    • "List of studies: a (Loxton et al. 2009): 7312 middle-aged Australian women (45–50 years old) b (Gandhi et al. 2010): 371 women (21–40 years old) in 4 urban primary care settings c (Lemon et al. 2002): 1643 women, 18–54 years old from BRFSS d (Cronholm and Bowman 2009): 6285 women aged 18–96 years with a usual source of care e (Hathaway et al. 2000): 2043 women aged 18–59 years from the Massachusetts-BRFSS f (Modesitt et al. 2006): 101 women with breast, cervical, endometrial, or ovarian cancer from an oncology clinic g (Ramaswamy et al. 2011): 204 women in Kansas City jails h (Tello et al. 2010): 200 women receiving gynecologic services in an urban HIV clinic i (Coker et al. 2006): 470 women with low-grade cervical lesions interviewed at baseline and offered follow-up at 4-month and 6-month intervals for up to 24 months. "
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    ABSTRACT: The purpose of this paper is to critically examine the literature and present a comprehensive model of three pathways through which IPV increases the risk for cervical cancer. The first pathway is increased exposure to cervical cancer risk factors among IPV victims, including smoking, psychosocial stress, risky sexual behaviors, and sexually transmitted infections (STDs/STIs), particularly human papillomavirus infection. The second pathway is poor compliance with cervical cancer screening. The third pathway is delay/discontinuation in treatment for cervical dysplasia and neoplasia. Control imposed by the abusive partner, competing life priorities, and limited access to financial/support resources restrict a woman’s ability to seek cancer services. Higher rates, severity, and duration of IPV among low-income, Black, and Hispanic women may explain the pervasive cervical cancer disparities.
    Journal of Family Violence 05/2015; DOI:10.1007/s10896-015-9733-7 · 1.17 Impact Factor
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    • "Growing evidence of the substantial and often disabling health problems experienced by women with histories of IPV led to studies focused on health service use in this population. In U.S. based studies, women have been found to use a variety of health services to cope with the impact of IPV (Goodman et al. 2003; Hathaway et al. 2000; Shannon et al. 2006) and to make more visits to health care providers than women without an IPV history (Bonomi et al. 2009; Duterte et al. 2008; Plichta 2007; Rivara et al. 2007; Snow-Jones et al. 2006). Furthermore, women who have experienced recent or current abuse have been found to use more services (Bonomi et al. 2009; Rivara et al. 2007; Snow-Jones et al. 2006). "
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    ABSTRACT: Using baseline data from a survey of 309 Canadian women recently separated from an abusive partner, we investigated patterns of access to health, social, legal, and violence-specific services and whether abuse history and social and health variables predict service use. We compared rates of service use to population rates, and used logistic regression to identify determinants of use. Service use rates were substantially higher than population estimates in every category, particularly in general and mental health sectors. Although women were confident in their ability to access services, they reported substantial unmet need, difficulty accessing services, and multiple barriers. The strongest unique predictors of use varied across service type. Health variables (high disability chronic pain, symptoms of depression and PTSD), low income, and mothering were the most consistent predictors. Service providers and policy makers must account for social location, abuse history, and health status of Intimate Violence (IPV) survivors. Strategies to enhance access to primary health care services, and to create a system of more integrated, accessible services, are required.
    Journal of Family Violence 05/2015; 30(4):419-431. DOI:10.1007/s10896-015-9688-8 · 1.17 Impact Factor
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    • "Although there are numerous negative psychological outcomes associated with experiences of domestic abuse, one of the most robust and reliable positive associations to emerge involving domestic abuse is with depressive symptomatology (e.g., Campbell, Sullivan, & Davidson, 1995; Ersoy & Yildiz, 2011). For example, Hathaway et al. (2000) found women who had experienced domestic abuse from their partner in the past year were more than three times as likely as women who reported no domestic abuse to have developed depression. Importantly, in a large sample study of female workers, La Flair, Bradshaw, and Campbell (2012) found that abused females (e.g., experienced abuse from a partner), when compared with nonabused females, reported greater depressive experiences over an 18-month period, independent of initial depression . "
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    ABSTRACT: This study examined the relationship between domestic abuse, belongingness, and depressive symptoms in a community sample of 71 female primary care patients. As expected, domestic abuse was associated with greater depressive symptoms. Results from conducting mediation analyses, including bootstrapping techniques, provided strong convergent support for a model in which the hypothesized effect of domestic abuse on depressive symptoms in women is mediated by a loss of belongingness. Noteworthy, even after controlling for content overlap between measures of belongingness and depressive symptoms, the mediation model remained significant. Some implications of the present findings are discussed. © The Author(s) 2015.
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