Attributing Selected Costs to Intimate Partner Violence in a Sample of Women Who Have Left Abusive Partners: A Social Determinants of Health Approach
ABSTRACT Selected costs associated with intimate partner violence were estimated for a community sample of 309 Canadian women who left abusive male partners on average 20 months previously. Total annual estimated costs of selected public- and private-sector expenditures attributable to violence were $13,162.39 per woman. This translates to a national annual cost of $6.9 billion for women aged 19–65 who have left abusive partners; $3.1 billion for those experiencing violence within the past three years. Results indicate that costs continue long after leaving, and call for recognition in policy that leaving does not coincide with ending violence.
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- "For instance, USD $5.8 billion is spent annually in the United States to assist IPV cases, 70% of this amount is directed to medical and mental health care services (National Center for Injury Prevention and Control, 2003). In Canada, Varcoe et al. (2011) estimated that $6.9 billion (CAD) is spent annually to support abused women aged 19 to 65 after they leave abusive situations. Over the last few decades, the complex and chronic nature of IPV has led to the emergence of several services. "
ABSTRACT: Intimate partner violence (IPV) is a crucial public health concern with substantial detrimental effects, including poorer physical and mental health as well as increased difficulties accessing formal services. Most research to date has focused on frequencies, barriers, and facilitators of service use among IPV survivors. However, what remains poorly understood is the perspectives of IPV survivors on their experiences of accessing multiple services after leaving the abusive situations. To answer this, six one-on-one semi-structured interviews were conducted with survivors using expanded definition of "services," which included social services, shelters, health care, police, legal assistance, and so forth. Data were analyzed using Constant Comparison. Four resulting themes were (a) Positive Aspects, (b) Negative Aspects, (c) Impact of Experiences With Services, and (d) Contextual Factors. Within each of these categories, several sub-categories emerged and are discussed within the context of the literature and recommendations are made for improving services for IPV survivors.Journal of Interpersonal Violence 02/2014; 29(14). DOI:10.1177/0886260513520506 · 1.64 Impact Factor
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- "Focusing on the health effects of inequities necessitates attention to the concept of trauma. Trauma is increasingly used to frame the health, social, and psychological effects of structural inequities and structural violence [21,23-35]. Research shows that trauma histories are highly prevalent among marginalized populations . "
ABSTRACT: Introduction International evidence shows that enhancement of primary health care (PHC) services for disadvantaged populations is essential to reducing health and health care inequities. However, little is known about how to enhance equity at the organizational level within the PHC sector. Drawing on research conducted at two PHC Centres in Canada whose explicit mandates are to provide services to marginalized populations, the purpose of this paper is to discuss (a) the key dimensions of equity-oriented services to guide PHC organizations, and (b) strategies for operationalizing equity-oriented PHC services, particularly for marginalized populations. Methods The PHC Centres are located in two cities within urban neighborhoods recognized as among the poorest in Canada. Using a mixed methods ethnographic design, data were collected through intensive immersion in the Centres, and included: (a) in-depth interviews with a total of 114 participants (73 patients; 41 staff), (b) over 900 hours of participant observation, and (c) an analysis of key organizational documents, which shed light on the policy and funding environments. Results Through our analysis, we identified four key dimensions of equity-oriented PHC services: inequity-responsive care; trauma- and violence-informed care; contextually-tailored care; and culturally-competent care. The operationalization of these key dimensions are identified as 10 strategies that intersect to optimize the effectiveness of PHC services, particularly through improvements in the quality of care, an improved 'fit' between people's needs and services, enhanced trust and engagement by patients, and a shift from crisis-oriented care to continuity of care. Using illustrative examples from the data, these strategies are discussed to illuminate their relevance at three inter-related levels: organizational, clinical programming, and patient-provider interactions. Conclusions These evidence- and theoretically-informed key dimensions and strategies provide direction for PHC organizations aiming to redress the increasing levels of health and health care inequities across population groups. The findings provide a framework for conceptualizing and operationalizing the essential elements of equity-oriented PHC services when working with marginalized populations, and will have broad application to a wide range of settings, contexts and jurisdictions. Future research is needed to link these strategies to quantifiable process and outcome measures, and to test their impact in diverse PHC settings.International Journal for Equity in Health 10/2012; 11(1):59. DOI:10.1186/1475-9276-11-59 · 1.71 Impact Factor
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- "Only 16% of women accessed a shelter in the first 6 months after separating from their abusive partners. Our sample is similar to the general population of Canadian women with respect to educational attainment and percentage reporting aboriginal or racialized status, but women were more economically challenged (i.e., higher rates of unemployment and social assistance, and lower incomes) . After obtaining informed consent, a registered nurse conducted an in-depth structured interview and health assessment to assess women's resources, abuse history, health, service use, and demographic characteristics, supported by computer-assisted data entry (CADE). "
ABSTRACT: Relationships have both positive and negative dimensions, yet most research in the area of intimate partner violence (IPV) has focused on social support, and not on social conflict. Based on the data from 309 English-speaking Canadian women who experienced IPV in the past 3 years and were no longer living with the abuser, we tested four hypotheses examining the relationships among severity of past IPV and women's social support, social conflict, and health. We found that the severity of past IPV exerted direct negative effects on women's health. Similarly, both social support and social conflict directly influenced women's health. Social conflict, but not social support, mediated the relationships between IPV severity and health. Finally, social conflict moderated the relationships between social support and women's health, such that the positive effects of social support were attenuated in the presence of high levels of social conflict. These findings highlight that routine assessments of social support and social conflict and the use of strategies to help women enhance support and reduce conflict in their relationships are essential aspects of nursing care.09/2012; 2012:738905. DOI:10.1155/2012/738905