Violence against women and consequent health problems: a register-based study

Abstract

Aims: This study set out to examine whether women victimized by domestic violence in a given year subsequently have more health problems measured by amount of hospital contacts due to disease than non-victimized women. Methods: A case control study was carried out, based on data in the Danish National Patient Register, which covers all hospital contacts, identified by the unique citizen number. Three age groups were included: 15—19, 20—29, and 30—49 years. Cases were women with any hospital contact as a result of intentional injuries, defined as domestic violence, in 1995, and controls were women with all other reasons for hospital contact in 1995. The Nordic Classification of External Causes of Injuries classified reason for contact, place of occurrence, and mechanism of injury. Domestic violence was defined as intentional injury by blunt force and occurring in a residential area. The rate of subsequent hospital contacts because of any disease, induced abortions, gynaecological diseases, and mental illness among cases and controls in 1996—98 was compared. Results: 1,815 women victimized by domestic violence and 388,366 controls were identified. In the entire period, the victims of violence presented significantly more health problems than the controls, as measured by hospital contacts due to any disease. The rate of contacts due to induced abortions, gynaecological diseases, and mental illness was significantly higher among the victims in all three age groups in the first year following the identified violence. In the entire period, victims of violence aged 20—49 presented a significantly higher rate of contacts due to mental illness, and victims aged 20—29 years a higher rate of induced abortions. Conclusions: Registration practice of all hospital contacts in Denmark facilitates nationally representative analyses of associations between violence and health problems. The observed differences among women victimized by domestic violence and controls point to violence against women as a major public health problem. Proper registration of hospital contacts due to intentional injury may both guarantee adequate follow-up of the individual victim, and serve as a useful tool in the monitoring of general violence prevention.

Keywords

Violence women health register study national Denmark.

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References

Shepherd JP , Sivarajasingam V. , Rivara FP Using injury data for violence prevention. Government proposal is an important step towards safer communities. Br Med J 2000 ; 321: 1481—2.

Letourneau EJ , Holmes M. , Chasedunn-Roark J. Gynecologic health consequences to victims of interpersonal violence. Women's Health Issues 1999; 9: 115—20.

Koss MP , Heslet L. Somatic consequences of violence against women. Arch Fam Med 1992; 1: 53—9.

Heise L. , Ellsberg M. , Gottemoller M. Ending violence against women. Population Reports 2001; Series L, no. 11.

Coker AL , Smith PH , McKeown RE , King MJ Frequency and correlates of intimate partner violence by type: physical, sexual, and psychological battering. Am J Public Health 2000; 90(4): 553—9.

Leserman J. , Li Z. , Drossman DA , Hu YJ Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits. Psychol Med 1998; 28(2): 417—25.

Schei B. , Bakketeig LS Gynaecological impact of sexual and physical abuse by spouse. A study of a random sample of Norwegian women. Br J Obstet Gynaecol 1989; 96: 1379—83.

McCauley J. , Kern DE , Kolodner K. , Derogatis LR , Bass EB Relation of low-severity violence to women's health. J Gen Intern Med 1998; 13: 687—91.

Krantz G. , Ostergren PO The association between violence victimisation and common symptoms in Swedish women. J Epidemiol Community Health 2000 54(11): 815—21.

10.

Schei B.

Physically abusive spouse — a risk factor of pelvic inflammatory disease?

Scand J Prim Health Care 1991; 9: 41—5.

11.

Hensing G. , Alexanderson K. , Allebeck P. , Bjurulf P. How to measure sickness absence? Literature review and suggestion of five basic measures. Scand J Soc Med 1998; 26: 133—44.

12.

Kernic MA , Wolf ME , Holt VL Rates and relative risk of hospital admission among women in violent intimate partner relationships. Am J Public Health 2000 90(9): 1416—20.

13.

Drossman DA , Talley NJ , Leserman J. , Olden KW , Barreiro MA Sexual and physical abuse and gastrointestinal illness. Review and recommendations . Ann Intern Med 1995; 123: 782—94.

14.

Hamberg K. , Johansson EE , Lindgren G. ``I was always on guard'' — an exploration of woman abuse in a group of women with musculoskeletal pain. Fam Pract 1999; 16: 238—44.

15.

Jamieson DJ , Steege JF The association of sexual abuse with pelvic pain complaints in a primary care population. Am J Obstet Gynecol 1997; 177: 1408—12.

16.

Evins G. , Chescheir N. Prevalence of domestic violence among women seeking abortion services. Women's Health Issues 1996; 6: 204—10.

17.

Diaz-Olavarrieta C. , Campbell J. , Garcia de la Cadena C, Paz F, Villa AR. Domestic violence against patients with chronic neurologic disorders. Arch Neurol 1999; 56: 659—60.

18.

Schei B. Psycho-social factors in pelvic pain. A controlled study of women living in physically abusive relationships. Acta Obstet Gynecol Scand 1990; 69: 67—71.

19.

McFarlane J. , Parker B. , Soeken K. Abuse during pregnancy: frequency, severity, perpetrator, and risk factors of homicide. Public Health Nurs 1995; 12: 284—9.

20.

Bergman B. , Larsson G. , Brismar B. , Klang M. Battered wives and female alcoholics: a comparative social and psychiatric study. J Adv Nurs 1989; 14: 727—34.

21.

Fischbach RL , Herbert B. Domestic violence and mental health: correlates and conundrums within and across cultures. Soc Sci Med 1997; 45: 1161—76.