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Domestic violence and abuse: The role of health

"On average 2 women in England and Wales are killed by a male partner or ex-partner every week" [1]

DVA is linked to a host of different health outcomes and is a risk factor for a wide range of both immediate and long-term conditions. The health impacts may show as physical symptoms, injuries, chronic pain, neurological symptoms, gastrointestinal disorders, gynaecological problems and increased cardiovascular risk. The patient may be depressed, self-harm, have post traumatic stress disorder (PTSD), anxiety, insomnia, increased substance use and have thoughts about suicide. Cessation of abuse does not necessarily mean that mental health problems cease as well. The influence of abuse can persist long after the abuse itself has stopped and the more severe the abuse, the greater its impact on physical and mental health. Less well recognised are dental problems and dental neglect (due to dental phobia).

DVA can start or escalate in pregnancy with the most serious outcome being the death of the mother or the foetus. It is also associated with low birth weight and premature birth, both of which have subsequent long term health effects. Less recognised are the impacts of unintended pregnancy and the risks for pre-school children.

The Adoption & Children Act 2002 definition of harm; "including, for example, impairment suffered from seeing or hearing the ill treatment of another" strengthens the case for significant harm through DV, or the abuse of another in the household [2]

If children do not feel safe in their own home this can have many negative physical, emotional and behavioural effects. These include physical health complaints, developmental delays, anxiety, depression, poor school performance, low self-esteem, difficult behaviours and nightmares. DVA may also directly or indirectly cause child mortality [3]. Children can be abused directly, indirectly and may also witness the health consequences that their parents experience.

75% of cases of domestic violence result in physical injury or mental health consequences to women. [4]

"Intimate partner violence is all too common, has severe and persistent effects on women's physical and mental health and carries with it an enormous cost in terms of premature death and disability. It is responsible for more ill-health and premature death in women from Victoria under the age of 45 than any other of the well-known risk factors, including high blood pressure, obesity and smoking. Intimate partner violence warrants attention at least equal to that of many other well-established diseases and risk factors, such as high blood pressure, cholesterol and obesity." [5]

  1. Povey D, Editor. Crime in England and Wales 2003/4: Supplementary Volume 1: Homicide and Gun Crime.  Home Office Statistical Bulletin No. 02/05. London: Home Office; 2005
  2. Government. http://www.legislation.gov.uk/ukpga/2002/38/contents
  3. Krug E et al. World Report on Violence and Health: Volume 1. Geneva, World Health Organisation, 2002
  4. Department of Health. Responding to domestic abuse: A handbook for health professionals. London, Department of Health, 2005
  5. VicHealth. The health costs of violence: Measuring the burden of disease caused by intimate partner violence. State Government Victoria, Department of Human Services, 2004