Elsevier

Women's Health Issues

Volume 13, Issue 1, January–February 2003, Pages 16-22
Women's Health Issues

Intimate partner violence and substance abuse among minority women receiving care from an inner-city emergency department

https://doi.org/10.1016/S1049-3867(02)00142-1Get rights and content

Abstract

A woman’s drug and alcohol use has been found to increase her risk of experiencing intimate partner violence (IPV).

Objective

The study describes the rates of lifetime and current IPV among women awaiting care in an emergency department and explores the association between IPV and having a drug abuse problem, and IPV and having an alcohol abuse problem, after controlling for demographic factors and history of childhood victimization.

Methods

Face-to-face interviews were conducted with 143 low-level triaged women recruited from an inner-city emergency department.

Results

Nearly one-half reported ever experiencing IPV, and over 18% reported IPV during the year before the interview. A higher proportion of abused women reported a history of regular crack, cocaine, or heroin use and visiting shooting galleries or crack houses. Participants who were physically abused by their partner during the past year (15%, n = 21) were more likely than nonabused women (85%, n = 122) to report higher scores on the Alcohol Use Disorders Identification Test (AUDIT) (4.9 vs. 2.4), a measure of alcohol-related problems, and the Drug Abuse Severity Test (DAST) (3.0 vs. 1.3), a measure of drug-related problems. Sexually abused women (6%, n = 9) were more likely than their counterparts (94%, n = 134) to have significantly higher AUDIT scores (6.4 vs. 2.5). The findings have implications for how the intersecting public health problems of IPV and substance abuse should be taken into consideration in research and patient care protocols in emergency departments.

Introduction

Emergency departments (EDs) serve a disproportionate number of women seeking medical care for injuries or symptoms related to intimate partner violence (IPV).1, 2 However, rates of IPV among samples of women treated in EDs vary considerably. The lifetime prevalence of IPV among studies of women seeking emergency medical care ranges from 22% to 55%, with higher rates among low-income, inner-city populations.3, 4

Examination of substance abuse has increasingly become a focus of research with victims of IPV. Some studies have suggested that a victim’s substance abuse leads to IPV,5, 6 whereas others have suggested that IPV leads to substance abuse,7, 8, 9, 10 or that the relationship between the two phenomena is reciprocal.7, 11 Although the victim’s substance abuse has recently been recognized as being related to the experience of IPV among women receiving care from EDs,3, 12 this topic has not been researched systematically.

To the best of our knowledge, the study presented herein is the first investigation into the relationship between IPV victimization and drug use among Latina and African-American women receiving care from EDs. The study uses a cross-sectional design to investigate the association between the victim’s substance abuse and IPV when demographic factors and history of victimization are controlled statistically.

The purpose of the present study is: 1) to describe the rates of lifetime and current partner abuse among women in an ED; 2) to examine through univariate and bivariate analysis the relationship between recent IPV and having a drug problem, and recent IPV and having an alcohol problem; and 3) to examine through multivariate analysis the associations among having a drug problem, having an alcohol problem, and IPV while also controlling for demographic factors and history of victimization.

Section snippets

Sample recruitment and selection

This study was conducted between January and August 1996 as part of another study examining the relationship between IPV, substance use, and human immunodeficiency virus (HIV) risk. Women were recruited from the waiting room of the ED at a New York hospital. More than half of the hospital’s patient base is Latino/a, most of whom are Puerto Rican. Two bilingual recruiters approached all female patients who had been assigned to the lowest nonacute triage level by the ED staff. This hospital’s ED

Demographics

The mean age was 32.0 years (SD = 9.0), and the mean level of education was 11.7 years (SD = 2.4). Of those who self-reported ethnicity, there were 81 Latinas (57%), 55 African-Americans (39%), and six others (4%) in the sample. Twenty-five (18%) were married; 35 (25%) were either separated, divorced, or widowed; 83 (58%) were never married. Of the total sample, 102 (72%) indicated that they had children under the age of 18. Over one-third of the women (35%, n = 50) had been employed in the

Discussion

As in other studies in EDs, this study found high prevalence of IPV among women seeking emergency care. Substance abuse was more prevalent among battered women than their counterparts. Using bivariate analysis, abused women were more likely than nonabused women to report higher scores on the AUDIT and the DAST, although the DAST scores of sexually abused women were not significantly different from those of their counterparts. Using multivariate analysis, women who had a higher level of alcohol

Acknowledgements

This study was supported by an NIMH grant (MH 54669) awarded to Dr. El-Bassel.

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