A new study this month in The Lancet examined the health impact of domestic violence (of women by men). This was a very large WHO-funded study looking at multiple physical and mental health problems in abused vs. non-abused women. This is necessarily an observational study, but appears to be well done, and included a large and diverse sample of women.
A few findings are worth a specific mention.
First, intimate partner violence is very common across cultures, with numbers ranging from 15-71% of women who had ever been partnered with a man.
Next, mental health problems, which were self-reported using standardized measures, were much more common in abused women.
Finally, physical injury, including loss of consciousness, as a result of intimate partner violence was very common (about 22-80% of respondants).
It is impossible to entirely prove causation rather than correlation in this type of study, but the authors have done a good job trying to parse this out in the discussion section.
In their own words:
…violence is not only a substantial health problem by virtue of its direct effects, such as injury and mortality, but also…might contribute to the overall burden of disease as a risk factor for several other serious health problems. The extent to which the associations between partner violence and reported ill health in women are consistent across sites both within and between countries in striking. This observation suggests that experiences of physical or sexual violence, or both, by a partner are associated with increased odds of reports of poor physical and mental health, irrespective of where a woman might live, her cultural or racial background, or the extent to which violence might be tolerated or accepted in her society or by herself. In addition to being a breach of human rights, the high prevalence of partner violence and its associations with poor health–including implied costs in terms of health expenditures and human suffering–highlight the urgent need to address partner violence in national and global health-sector policies and programmes.
This is not the first study done on domestic violence, but the size and quality of the study are a damning. One of the biggest public health problems in the world is domestic violence. They correctly frame this as a human rights issue. If half the human population is suffering mental and physical ill health due to preventable actions by members of the other half, we are doing something terribly wrong.
Despite the lessons of the holocaust, genocides continue. But we recognize them as genocides, and sometimes we actually do the right thing. This study screams out for action. The health and welfare of half the human population is at risk due to violence in their own home. Even if we can’t eradicate domestic violence, we can elevate it to the level of malaria, AIDS, and genocide as one the world’s most urgent public health problems.
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Ellsberg, M., Jansen, H., et al, . (2008). Intimate partner violence and women\’s physical and mental health in the WHO multi-country study on women\’s health and domestic violence: an observational study. The Lancet, 371(9619), 1165-1172.
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