Wendy Verhoek-Oftedahl

Neighborhood Environment, Racial Position, and Risk of Police-Reported Domestic Violence: A Contextual Analysis

Objectives. The purpose of this study was to examine the contribution of neighborhood socioeconomic conditions to risk of police-reported domestic violence in relation to victims race. Data on race came from police forms legally mandated for the reporting of domestic violence and sexual assault. Methods. Using 1990 U.S. census block group data and data for the years 1996–1998 from Rhode Islands domestic violence surveillance system, the authors generated annual and relative risk of police-reported domestic violence and estimates of trends stratified by age, race (black, Hispanic, or white), and neighborhood measures of socioeconomic conditions. Race-specific linear regression models were constructed with average annual risk of police-reported domestic violence as the dependent variable. Results. Across all levels of neighborhood poverty (<5% to 100% of residents living below the federal poverty level), the risk of police-reported domestic violence was higher for Hispanic and black women than for white women. Results from the linear regression models varied by race. For black women, living in a census block group in which fewer than 10% of adults ages ≥25 years were college-educated contributed independently to risk of police-reported domestic violence. Block group measures of relative poverty (≥20% of residents living below 200% of the poverty line) and unemployment (≥10% of adults ages ≥16 years in the labor force but unemployed) did not add to this excess. For Hispanic women, three neighborhood-level measures were significant: percentage of residents living in relative poverty, percentage of residents without college degrees, and percentage of households monolingual in Spanish. A higher degree of linguistic isolation, as defined by the percentage of monolingual Spanish households, decreased risk among the most isolated block groups for Hispanic women. For white women, neighborhood-level measures of poverty, unemployment, and education were significant determinants of police-reported domestic violence. Conclusion. When data on neighborhood conditions at the block group level and their interaction with individual racial position are linked to population-based surveillance systems, domestic violence intervention and prevention efforts can be improved.

Preventive healthcare use, smoking, and alcohol use among Rhode Island women experiencing intimate partner violence

OBJECTIVE Intimate partner violence (IPV) poses major health threats to women, including increased risk for several chronic health conditions. The impact of IPV on use of preventive health services is not well understood. Although several studies indicate that female victims of IPV have higher rates of alcohol abuse, this has not been replicated in population-based studies. The association of IPV with smoking has not been a major research focus. The purpose of this study was to examine the association between physical and psychological IPV in the past 12 months and preventive healthcare use, smoking, and alcohol use among women. METHODS Data on 1643 women aged 18-54 from the 1999 Rhode Island Behavioral Risk Factor Surveillance System were analyzed. Logistic regression, controlling for age, race, marital status, education, insurance status, and functional disability, was used to model the associations of IPV with (1) checkups, (2) clinical breast examinations (CBEs), (3) Pap smear screening, (4) cigarette smoking, and (5) high-risk alcohol use. RESULTS Prevalence of physical IPV was 4.1%. The prevalence of psychological IPV, in the absence of physical IPV was 4.5%. Physical IPV was associated with receiving regular Pap smears odds ratio ([OR] = 2.39, 95% confidence interval [CI] 1.01-5.70), current smoking (OR = 2.07, 95% CI 1.03-4.18), and high-risk alcohol use (OR = 4.85, 95% CI 2.02-11.60). Psychological IPV was associated with high-risk alcohol use (OR = 3.22, 95% CI 1.46-7.09). CONCLUSIONS Women experiencing IPV regularly access preventive healthcare, providing healthcare providers with opportunities to assess and counsel women for IPV in addition to smoking and high-risk alcohol use.

Improving surveillance of intimate partner violence by use of multiple data sources

BACKGROUND Intimate partner violence (IPV) is a significant public health problem in the United States. Estimates of incidence and prevalence vary widely, depending on the data source used. Combining information from different sources can enhance our understanding of IPV. METHODS In this paper, we used 1998 data from the Rhode Island (RI) Department of Health Violence Against Women Public Health Surveillance System to describe the prevalence of IPV reported to police, the demographic characteristics and help-seeking efforts of women reporting IPV, and characteristics of IPV incidents. We used data from the 1998 RI Department of Health Behavioral Risk Factor Surveillance System survey to examine associations between health care use and health outcomes of victims and nonvictims of IPV, and to explore the correlates of IPV. We also discuss the use of both narrow and broad definitions of IPV. RESULTS Our findings show that the definition of IPV and the source used to identify IPV victims can produce a markedly different picture of IPV victims, and that combining information from different data sources can enhance our understanding of IPV. An important finding for health care providers is that IPV victims do not appear to be significantly different from nonvictims in their access to and utilization of routine health care, and that more than 60% of victims at highest risk for injury reported seeing a health care provider because of IPV. CONCLUSIONS Our findings underscore the importance of health care providers addressing IPV and its consequences among their patients.

Domestic violence incidents with children witnesses: findings from Rhode Island surveillance data.

In this study we analyze factors associated with children witnessing police-reported domestic violence (DV) and determine the age distribution of children witnessing. Rhode Island Department of Health surveillance data (1996-1998) from police forms were used to assess demographic characteristics of victims, characteristics of incidents, whether children were present, and childrens ages. Victim gender, age, race/ethnicity, relationship to suspect, and whether the victim was assaulted were all strong predictors of children witnessing a DV incident. Almost half (48%) of the children who witnessed DV incidents were less than 6 years old. To reach these young children, prevention and intervention programs will need to target parents and caretakers of young children and/or pediatricians.

The Consequences of Violence on the Mental Health of the Elderly

This chapter reviews the prevalence and risk factors associated with violence during the life course of the elderly, including its short and long-term consequences. As violence is highly prevalent in many societies individuals who have been exposed to violence have also grown old. There is limited knowledge about the long-term implications of early exposure into late life. Elder abuse has become a major issue in public health; however, the elderly are also victims to crime, war, atrocities in society, and trauma from disasters. The mental health implications of exposure to violence are reviewed, in particular post-traumatic stress disorder. Controlled studies on treatment of older individuals exposed to violence are rare. The findings suggest that exposure to violence in childhood, as a young adult or as an elder all have adverse effects on mental health in old age. The trajectory of these mental health outcomes suggests that the elderly may have a path of resilience.