Violence and physical abuse a continuing threat


May 10, 1994|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Medical Tribune News Service

In the last five years, national attention has turned to the whole area of women's health. With the emphasis on cancer, however, health professionals have paid less attention to the sobering statistics regarding intentional and unintentional injuries in women.

Every year, 43,000 women die from injuries, and 1 million are hospitalized. Injuries represent the leading cause of death for females ages 1 to 34.

Physical abuse accounts for a significant percentage of injuries and deaths from homicide in women. Even with many cases of abuse going unreported and untreated, about 1 million women receive emergency medical treatment each year in the United States for abuse-related injuries.

Women seek medical treatment for abuse nearly three times more often than for injuries related to motor-vehicle crashes.

I asked Dr. Andrew Dannenberg and Susan Baker, researchers for the Injury Prevention Center at the Johns Hopkins School of Public Health, to outline the scope of this serious problem for women.

Q: Have any patterns emerged in incidents of domestic violence?

A: Husbands, acquaintances and former partners make up a significant percentage of those inflicting physical violence on women. Risk factors for violence may include prior episodes of physical abuse, alienation from family and friends, alcohol use and male unemployment or underemployment.

Residents of rural areas also seem disproportionately affected by domestic violence.

Even pregnant women are not immune to the dangers of domestic violence.

In one study of 290 randomly selected pregnant women, 24 women, or 8 percent, reported that they had been physically battered during pregnancy.

Twenty-one of these 24 women also said they had been abused prior to the pregnancy.

Thus, pregnancy and the potential risk to a fetus does not deter an abuser.

Another study indicated that substance abuse by one or both partners was associated with an increased risk of physical abuse during pregnancy.

Q: What about domestic violence deaths in relation to overall homicide in women?

A: Homicide is the fourth-leading cause of injury death in women, accounting for 12 percent of all injury deaths. In 1989, 5,223 females died from homicide in the United States.

Over half of the homicides are committed by a relative or acquaintance of the victim and are not the result of random acts of violence. From 1976 to 1987, among female homicide victims over age 15, 23 percent were killed by their spouse, 37 percent by another family member or an acquaintance, 31 percent by a person whose relationship to the victim was undetermined, and 9 percent by a stranger.

Q: What about the recent push for women to arm themselves? Would they necessarily find themselves any safer?

A: Firearms are the most common method used to murder both men and women.

Many health professionals believe widespread private ownership of guns is a major contributor to the markedly high homicide rates in the United States, rather than serving to lower the risk of death from this cause.

Gun manufacturers and the National Rifle Association have promoted an aggressive campaign recently to encourage women to purchase a handgun for self-protection.

However, one study indicated that a handgun kept in the home is 43 times more likely to be used for criminal homicide or suicide, or to unintentionally kill someone, than it is to be used to protect against a homicide.

Deaths that occur from handguns in the home most frequently involve family members or friends.

Q: What resources exist to aid victims of domestic violence? Are additional preventive strategies being examined?

A: A number of services exist or are being formed to help reduce domestic violence.

There are more than 1,200 organizations nationwide offering services for battered women, including 24-hour hot lines, emergency shelters, legal and social service assistance, peer counseling and community education.

Unfortunately, demand for the services seems to be outstripping present capacity.

It is hoped that continuing public education campaigns highlighting the vast scope of the problem and the community resources available for victims will help lower the number of incidents of domestic violence. Additionally, strategies to deal with workplace violence and prenatal programs to reduce the risk of intentional injury to pregnant women are being investigated and implemented.

If you are in a situation in which you are physically and/or sexually abused by your partner, take action now to change your life. Remember, you are the one who must take the first step.

If you need help or advice, call your local abuse crisis hot line. In Maryland, call the Maryland Network Against Domestic Violence at 1-800-634-3577 to be referred to services in your area. Elsewhere, consult your telephone book or call directory assistance for the hot line number in your area.

Dr. Genevieve Matanoski is a physician and epidemiologist at the Johns Hopkins School of Hygiene and Public Health. She is a founding director of the school's Institute for Women's Health Research and Policy.

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