Domestic violence against women. Incidence and prevalence in an emergency department population

TLDR

The study population comprised mostly young, unemployed women with low incomes, and domestic violence was defined as assault, threat, or intimidation by a male partner. The study aimed to determine the incidence, 1‑year prevalence, and cumulative prevalence of domestic violence among female emergency department patients. The authors conducted a descriptive written survey of 648 women across five Denver EDs, assessing acute and past domestic violence to calculate incidence and prevalence rates. Incidence of acute domestic violence was 11.7% among partnered women, yet only 23% sought trauma care and 13% disclosed it to staff; overall lifetime prevalence was 54.2%, with DV exposure linked to higher suicide attempts and alcohol use, and ED professionals rarely identified affected patients.

Abstract

To determine the incidence, 1-year prevalence, and cumulative prevalence of domestic violence (DV) among female emergency department (ED) patients.Descriptive written survey.Two teaching EDs, two hospital walk-in clinics, and one private hospital ED in Denver, Colo.Of 833 women presenting during 30 randomly selected 4-hour time blocks, 648 (78%) agreed to participate. Most respondents were young (median age, 34 years) and unemployed (62%); half (49%) had annual household incomes less than $10,000.Domestic violence was defined as an assault, threat, or intimidation by a male partner. Acute DV (incidence) and past DV exposure (1-year prevalence and cumulative prevalence) were determined.The incidence of acute DV among the 418 women with a current male partner was 11.7% (95% confidence interval [CI], 8.7% to 15.2%). Only 11 (23%) of these 47 women subjected to acute DV presented for care because of trauma, and only six (13%) either told staff about DV or were asked about DV by ED professionals. Among 230 women without current partners, 13 (5.6%) reported an episode of DV within the previous 30 days. For the entire sample, the cumulative lifetime prevalence of DV exposure was 54.2% (95% CI, 50.2% to 58.1%). Women exposed to acute or prior DV were more likely than unexposed women to have made suicide attempts (26% vs 8%; P < .001) and to report excessive ethanol use (24% vs 13%; P = .001).The incidence of acute DV is not as common among women visiting an ED as previously reported, although the cumulative prevalence of DV is strikingly high. Women who have experienced DV are seldom identified by ED professionals.