The Devastating Impact of Domestic Violence on Total Health

Young child with her back turned

By Cori McMahon, PsyD, NCCE
Vice President of Clinical Services, Tridiuum

According to the National Coalition Against Domestic Violence (NCADV), on average, nearly 20 people per minute are physically abused by an intimate partner in the United States. This equates to more than 10 million women and men annually or one woman being assaulted every 9 seconds in our country. We’re taking the opportunity during Domestic Violence Awareness Month to shed light on the destructive consequences that not only impact the victim but are intergenerational.

How do we define domestic violence?
There are various forms that domestic violence (DV) or intimate partner violence (IPV) may take, including physical violence, sexual assault, stalking, or psychological abuse. Based on U.S. Department of Justice Bureau of Justice Statistics, 1 in 4 women and 1 in 9 men experience intimate partner severe physical violence (beating, burning, strangling), intimate partner sexual violence, and/or intimate partner stalking with impacts such as injury, fearfulness, PTSD, use of victim services, and contraction of sexually-transmitted infections. The National Intimate Partner and Sexual Violence Survey reveals that 1 in 7 women and 1 in 25 men have been injured by an intimate partner and 1 in 10 women have been raped by an intimate partner. One in 7 women and 1 in 18 men have been stalked during their lifetime to a point where they felt very fearful or believed that they or someone close to them would be harmed or even killed.

Who is at greatest risk?
Domestic violence is prevalent across communities, affecting those from all groups regardless of race/ethnicity, socioeconomic status, sexual orientation or gender identity, age, religion, nationality, etc. While there are more than 20,000 calls to domestic violence hotlines on a typical day, most incidents go unreported. Eighty-five percent of victims are women and a quarter of women globally will experience domestic or dating violence in their lifetime. Women between the ages of 20–24 are at greatest risk and over 300,000 women annually experience intimate partner violence during pregnancy. Based on statistics reported by the NCADV, 45% of Black women and 40% of Black men have been victims of intimate partner violence, sexual violence or stalking in their lifetime and over half from each group report psychological aggression by a partner. In addition, an astounding number (51%) of Black adult female homicides are related to intimate partner violence.

Age is another factor to consider as 57% of teens know someone who has been physically, sexually, or verbally abusive in a dating relationship (Teenage Research Unlimited) and a 2013 study found 26% of teens in relationships were victims of cyber dating abuse, with females twice as likely as males. (Journal of Adolescent Health) Further, 43% of college women in dating relationships reported experiencing violent or abusive behaviors from their partners. (Knowledge Networks). Abuse in later life includes adults over 50 and is distinguished from elder abuse, which commonly focuses on those over 65. Abuse in later life is characterized by willful abuse, neglect, abandonment, or financial exploitation by someone in an on-going, trust-based relationship with the victim. This type of abuse can also include sexual abuse or power and control over the victim. Crimes against older adults are significantly underreported with estimates between only 1 in 14 and 1 in 24 cases being reported.

What is the impact on overall health?
There are often multiple devastating consequences for not only the victim of domestic violence but those closest to them. One in 15 children are exposed to IPV and 90% of these children experience the violence themselves. This can have long-lasting emotional impact that affects all areas of life including relationships, success in work, and physical and psychological health.

A 2005 Michigan study found that children exposed to IPV are more likely to have health problems, including frequent illness, headaches or stomach aches, and feeling tired or lethargic; all of which can impact school performance and social relationships. Further, boys who witness DV are twice as likely to abuse their own partners and children in the future. Considering the victims themselves, not surprisingly, there are various negative impacts to consider, including economic, physical, and psychological impact. According to a study in the Journal of Occupational Health Psychology, victims of IPV lose a total of 8 million days of paid work each year and between 21–60% of victims lose their jobs due to reasons stemming from abuse.

Women who are abused by their partners are more vulnerable to HIV or other STIs; both due to forced intercourse and to the impact of prolonged exposure to stress. Further, research suggests that there is a relationship between IPV and depression and suicidal behavior. Given the inextricable link between psychological and physical health, there is a long list of medical problems associated with IPV, including gastrointestinal problems, neurological disorders, chronic pain, hypertension, cancer, cardiovascular diseases, anxiety and PTSD, and unintended pregnancy or problems with pregnancy. Victims are also at higher risk for developing substance use problems.(WHO Violence Against Women) From a public health and community perspective, according to the U.S. Department of Housing and Urban Development, DV is the third leading cause of homelessness among families and costs more than $37 billion annually in law enforcement, legal work, medical and mental health treatment as well as lost productivity for organizations. (New Hope)

How can we help?
The National Coalition Against Domestic Violence is an excellent resource for information as well as connection to the many hotlines, groups, and websites available to support victims of IPV, including those specific to subsets of the population based on age, sex, race and ethnicity, and sexual or gender identity.