Sherry Lipsky

The Role of Intimate Partner Violence, Race, and Ethnicity in Help-Seeking Behaviors

Objective . Women experiencing intimate partner violence (IPV) have multiple health and social service needs but many, especially Hispanic, women may not access these resources. This research sought to examine the relationship between IPV and health and social services utilization (help-seeking behaviors), with a focus on racial and ethnic disparities. Design . Case-control study from an urban US emergency department population in which cases (women with IPV) and controls (women without IPV) were frequency matched by age group and race/ethnicity. Logistic regression analyses were performed to examine the relationship between IPV and help-seeking behaviors and between help-seeking behaviors and race/ethnicity among abused women. In addition, a stratified analysis was conducted to examine the relationship between acculturation and help-seeking behaviors among Hispanic women. Results . The sample included 182 cases and 147 controls. Among the health services, alcohol program, emergency department, and hospital utilization were significantly increased among IPV victims compared to non-victims after taking demographic and substance use factors into account. Similarly, IPV victims were more likely to access social/case worker services and housing assistance compared to non-victims. Specific help-seeking behaviors were significantly associated with race and ethnicity among IPV victims, with non-Hispanic white and black women more likely to use housing assistance and emergency department services and black women more likely to use police assistance compared to Hispanic women. Among all Hispanic women, low acculturation was associated with decreased utilization of social services overall and with any healthcare utilization, particularly among abused women. Conclusions . Social service and healthcare workers should be alerted to and screen for IPV among all clients. The need for increased outreach and accessibility of services for abused women in Hispanic communities in the USA should be addressed, with cultural and language relevance a key component of these efforts.

The role of alcohol use and depression in intimate partner violence among black and Hispanic patients in an urban emergency department.

OBJECTIVESnThe primary objective of this study was to assess the role of alcohol use and depression in intimate partner violence (IPV) victimization and perpetration among Blacks and Hispanics in an underserved urban emergency department population.nnnMETHODSnThis cross-sectional study surveyed male and female patients presenting to an urban emergency department. The outcome measures were physical or sexual IPV victimization and perpetration in the previous 12 months. The independent predictors included demographic variables, alcohol and drug use, and depressive symptoms. Logistic regression analyses calculated the adjusted odds ratio (AOR) and 95% confidence interval (CI) for predictors of IPV victimization and perpetration in separate models.nnnRESULTSnThe prevalence of IPV victimization among Blacks and Hispanics were similar (14% and 10%, respectively) but blacks were nearly twice as likely to report IPV perpetration (17% vs. 9%, respectively). Predictors of IPV perpetration were Black race, married or living with a partner, heavy drinking, illicit drug use, and current depression. Depression, but not substance use, also predicted IPV victimization, in addition to Black race, married or living with a partner, and younger age. Screening for substance abuse and depression in an inner city emergency department population may help to identify individuals at high risk of IPV, particularly IPV perpetration.

Violence-related injury and intimate partner violence in an urban emergency department

BACKGROUNDnTo facilitate the identification of ED patients at risk for intimate partner violence (IPV), we assessed the relationship of acute violence-related injury and history of IPV victimization or perpetration.nnnMETHODSn: This cross-sectional study systematically sampled patients presenting to an urban ED. Reason for visit, past year history of IPV victimization and perpetration, alcohol and drug use and abuse, and sociodemographic factors were assessed. We hypothesized that violence-related injury would be positively associated with a history of IPV victimization and with IPV perpetration.nnnRESULTSnThe odds of violence-related injury was increased three-fold among persons with a history of IPV victimization and nearly two-fold (although not statistically significant) among those with IPV perpetration history. Male gender, younger age, and problem drinking were independent risk factors in both models.nnnCONCLUSIONnScreening for IPV among individuals presenting with a violence-related injury may be helpful in identifying individuals at risk of partner violence.

The Role of Race/Ethnicity in the Relationship Between Emergency Department Use and Intimate Partner Violence: Findings From the 2002 National Survey on Drug Use and Health

OBJECTIVESnWe examined the relationship between intimate partner violence victimization among women in the general population and emergency department use. We sought to discern whether race/ethnicity moderates this relationship and to explore these relationships in race/ethnic-specific models.nnnMETHODSnWe used data on non-Hispanic White, Non-Hispanic Black, and His-panic married or cohabiting women from the 2002 National Survey on Drug Use and Health. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were calculated using logistic regression.nnnRESULTSnWomen who reported intimate partner violence victimization were 1.5 times more likely than were nonvictims to use the emergency department, after we accounted for race/ethnicity and substance use. In race/ethnic-specific analyses, only Hispanic victims were more likely than their nonvictim counterparts to use the emergency department (AOR = 3.68; 95% CI = 1.89, 7.18), whereas substance use factors varied among groups.nnnCONCLUSIONSnOur findings suggest that the emergency department is an opportune setting to screen for intimate partner violence victimization, especially among Hispanic women. Future research should focus on why Hispanic victims are more likely to use the emergency department compared with nonvictims, with regard to socioeconomic and cultural determinants of health care utilization.

Police-reported intimate partner violence during pregnancy: who is at risk?

The objective of this retrospective cohort study was to determine risk factors for police-reported intimate partner violence (IPV) during pregnancy among Seattle residents with a registered live birth or fetal death in Washington State. Logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals for the association between demographic, behavioral, and obstetric history risk factors and any, physical, and non-physical police-reported IPV. Significant risk factors for any police-reported IPV during pregnancy included unmarried status (aOR 2.36), public health program use (aOR 1.33), smoking or alcohol use during pregnancy (aORs 1.45 and 1.80, respectively), previous live birth (aOR 1.39), and previous spontaneous or induced abortion (aORs 1.39 and 1.34, respectively). Risk factors for physical IPV varied only slightly from those for any IPV, and fewer factors were associated with nonphysical IPV. Demographic, behavioral, and obstetric history risk factors are potential markers of IPV risk during pregnancy.

Intimate Partner Violence Perpetration Among Men and Emergency Department Use

BACKGROUNDnIntimate partner violence (IPV) perpetration and emergency department (ED) use share common risk factors, such as risk-taking behaviors, but little is known about the relationship between IPV perpetration and ED use or the effect of risk-taking on this relationship.nnnSTUDY OBJECTIVESnThis study examined the relationship between IPV perpetration, risk-taking, and ED utilization among men in the general U.S. population.nnnMETHODSnThis cross-sectional study utilized data from the 2002 National Survey on Drug Use and Health, focusing on non-Hispanic white, non-Hispanic black, and Hispanic male respondents 18-49 years of age cohabiting with a spouse or partner. Logistic regression was used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI).nnnRESULTSnApproximately 38% of IPV perpetrators reported ED use in the previous year, compared to 24% of non-perpetrators. Several risk-taking factors (e.g., perception of risk-taking, transportation-related risk-taking, and aggression-related arrest), alcohol and illicit drug use and abuse or dependence, and serious mental illness were positively associated with IPV perpetration. Men reporting IPV were 1.5 times (AOR 1.47, 95% CI 1.01-2.13) more likely than non-perpetrators to utilize the ED, after taking all factors into account. Drug abuse or dependence, transportation-related risk behaviors, and serious mental illness also were independently associated with ED use.nnnCONCLUSIONSnThe results indicate that men who perpetrate IPV are more likely than non-perpetrators to use ED services. These findings suggest that screening for IPV, as well as risk-taking and mental illness among men accessing ED services may increase opportunities for intervention and referral.