14% of Women in Emergency Rooms Reported Being Abused in Last Year
Roughly one in seven women admitted to emergency rooms reported having been physically abused within the last year, according to one of the largest surveys ever completed on the subject.
Estimates on how many women are subject to abuse have varied widely in recent years--in part because of problems in defining exactly what constitutes abuse and in part because of problems with gathering data on the subject.
The new survey, which involved more than 3,400 women admitted to 11 hospital emergency wards in California and Pennsylvania, illustrates how much the definition of abuse can affect the numbers.
As many as one in three women in the survey reported either physical or emotional abuse in her lifetime--with the rate somewhat higher in California than on the East Coast.
When the question was limited to physical or sexual abuse in the last year, 14% of the women reported abuse.
But a far smaller number--just over 2% of those admitted--were actually in the hospital because of injuries from abuse, the study found.
The new study, published in today’s issue of the Journal of the American Medical Assn., provides more concrete data than many previous studies of women in emergency rooms. However, because the researchers studied women at emergency rooms, it is difficult to estimate what the study may mean for women in the general population.
“We think that there’s a slightly higher prevalence in emergency departments than there would be overall,” said Jacquelyn Campbell, the study’s lead investigator. “Battered women’s health is generally poor, so you’d expect to see a higher percentage of them in emergency rooms.”
Still, experts on domestic abuse note that because this study moves beyond urban teaching hospitals--where previous studies had been based--to hospitals in rural and suburban areas, it is a better indicator of how widespread the problem is.
“This is not just an inner-city problem,” said Dr. Deirdre Anglin, associate professor of emergency medicine at USC. “There is a substantial number of people going to emergency departments due to domestic abuse, and it’s not just at big referral hospitals.”
Researchers were unsure why California women reported higher rates of abuse over their lifetimes, even when age and income were taken into account.
People in California may have a heightened awareness of domestic abuse and thus be more apt to report it, said Dr. Jeffrey Coben, co-author of the study. But “there might also be an increased prevalence [of domestic abuse] in California,” said Coben, director of the Center for Violence and Injury Control at Allegheny University of the Health Sciences in Pittsburgh.
Female nurses at the hospitals collected the data while the women were alone in the emergency department.
The study confirmed several previously known risk factors for domestic abuse. For example, women with household incomes below $12,000 a year were twice as likely to report being in the hospital because of injuries from abuse than were other women. Women between the ages of 18 and 39 also had higher rates of abuse than older women.
Moreover, the study found that women who had ended a relationship within the last year were seven times more likely than others to be victims of physical and sexual abuse. Previous figures from the U.S. Bureau of Justice Statistics had estimated that separated or divorced women were 14 times more likely than married women to report having been a victim of violence by a spouse or ex-spouse.
“One of the things we have to do as health care providers, is if a woman says she is planning to leave, to make sure she does so safely,” said Campbell, professor at Johns Hopkins University School of Nursing. “We need to tell her that it’s a time of increased danger.”
But part of the problem identified in the study was that many battered women seem to be slipping through the cracks. Half of the women who reported coming to the hospital for injuries due to abuse had not been previously identified by the emergency staff as abuse victims.
Coben said the underlying goal of the research is to develop effective training programs so that emergency department staff can provide help for abuse victims when they are most accessible.
“The attitudes of health care providers in emergency rooms are to treat the physical problems,” said Sharon Valente, assistant professor of USC’s Department of Nursing. “They don’t look under that. They think, OK, I’ve got a fractured rib and we’ll treat it.”
“When asked in an appropriate manner--when the person is alone, in a nonjudgmental way with direct questions--most women will tell us” about abuse, said Coben.
* DEATHS SPUR NEW POLICY: County adopts program to notify people when their abusers or stalkers are released. B3
