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