Why domestic violence is a leading health risk factor for women.

Barely a week passes without a media report of the suffering or tragic death of a woman at the hands of a partner. Typically, these accounts focus on the individuals involved. While important, in isolation, such a focus can belie the fact intimate partner violence is a wider social problem, obscuring both the factors contributing to it and opportunities to prevent it.

A study being launched today by Australia’s National Research Organisation for Women’s Safety confirms the serious impacts of intimate partner violence. The analysis, undertaken by the Australian Institute of Health and Welfare, provides estimates of the impact of intimate partner violence on women’s health.

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Data from the Personal Safety Survey, Australia’s most reliable violence prevalence survey, was used as a key input.

Since the age of 15, one in four women in Australia have experienced at least one incident of violence by a partner. This includes violence perpetrated by a live-in partner as well as boyfriends, girlfriends or dates. This is based on a definition of violence, used by the Personal Safety Survey, which includes physical and sexual assault, as well as face-to-face threats the victim believed were likely and able to be carried out.

Listen: We chat to former Australian of the year and domestic violence campaigner Rosie Batty. Post continues after audio.

When emotional abuse by a live-in partner is included, (defined as controlling behaviours aimed at causing fear or emotional harm), it is estimated one in three women have experienced violence or abuse by an intimate partner.

Serious impacts on women’s health.

Drawing on Australian and international studies, the Australian Institute of Health and Welfare found an association between women experiencing partner violence and a wide range of health impacts. Particularly compelling evidence was found linking partner violence to:

• Anxiety
• Depression
• Suicide and self-inflicted injuries
• Alcohol use disorders
• Homicide and violence
• Early pregnancy loss. (Post continues after gallery.)

• Mental health services in Australia

These factors were used in calculating the burden of disease of partner violence.

The burden of disease is a calculation of the impact of particular diseases and risk factors on an entire population. It is a measure of both fatal and non-fatal health impacts, which take into account the severity and duration of health conditions. (Post continues after gallery.)

The study found partner violence was among the top ten risk factors contributing to disease burden among all adult women, regardless of whether partner violence was defined broadly (violence by both live-in and non-live-in partners, and emotional abuse by live-in partners) or narrowly (only physical and sexual violence in live-in relationships).

Among women 18 to 44 years, it was the biggest single risk factor when violence in all intimate relationships was included, bigger than smoking, alcohol use or being overweight or obese. When considering only violence by live-in partners, in this age group, partner violence ranked second only to alcohol use.

The study found there had been no change in the burden since 2003.

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Burden even larger for Indigenous women.

Physical and sexual partner violence is the leading risk factor contributing to disease burden in Indigenous women aged 18 to 44 years. The rates of burden of physical and sexual violence in both cohabiting and non-cohabiting relationships were compared between Indigenous and non-Indigenous women. Rates for Indigenous women were:

• 6.3 times greater among women 18-44 years; and
• 5.3 times greater among women of all ages.

This burden was the leading contributor to the gap in burden between Indigenous and non-Indigenous women aged 18 to 44; and the sixth largest contributor to the gap among women of all ages.

A preventable burden.

Front-line services, such as the police, women’s refuges and counselling and support services play a vital role, reducing exposure to violence and its health consequences by helping women to secure safety, supporting their recovery, and holding men who use violence accountable. Recent inquiries in Victoria and Queensland show that although such services have improved, much more needs to be done.

Another effective way to reduce the burden is to prevent “new cases” of partner violence, by tackling its underlying causes. These are increasingly well understood, along with the means to address them.

Among these factors is inequality between men and women, an influence made particularly potent when coupled with poverty, social exclusion and other forms of discrimination.

A sustained, coordinated approach is needed which extends beyond affected individuals, and engages a wide range of sectors – not just front-line services - to shift social, community and organisational norms, practices and policies known to increase the likelihood of violence. A similar approach, often referred to as a public health approach, has been used very successfully in Australia to tackle other prevalent risk factors such as tobacco use and road safety hazards.

Dr Peta Cox, Senior Research Officer for ANROWS co-authored this article. Dr Cox will participate on the expert panel at the launch of the study on 1 November 2016.

For 24-hour crisis support and counselling, please call the national domestic violence hotline on 18000 RESPECT (1800 737 732) or visit the website at 1800respect.org.au.

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