Women Veterans who Experience Intimate Partner Violence are at Higher Risk for Some Medical and Mental Health Conditions
BACKGROUND:
Intimate partner violence (IPV) includes physical attacks, sexual assault or coercion, threats of violence, verbal assaults, and stalking by a current or former intimate partner. Studies have shown that IPV victimization is associated with a variety of health conditions, including mental health problems, as well as greater healthcare utilization. Yet while the population of women Veterans is at a historic high and the number of women Veterans using VA healthcare services has nearly doubled in the last decade, little is known about the IPV experiences of contemporary women Veterans. This study sought to fill gaps in knowledge by examining demographic and clinical characteristics of women Veterans who have disclosed IPV victimization to a VA healthcare provider. Investigators conducted a five-year retrospective chart review (2005-2009) of women Veterans age 55 and younger (n=531) who had received primary care at one VAMC in 2009.
FINDINGS:
- Lifetime IPV was documented in about one-quarter (24%) of women Veterans' medical records and was associated with higher risk of many medical conditions and with increased healthcare use.
- Women Veterans with documented IPV had higher rates of military sexual trauma, injury/poisoning, mental health disorders, infectious or parasitic diseases, and digestive system disorders.
- More than 95% of women Veterans with documented IPV had a mental health diagnosis, including: 60% with episodic mood disorders, 57% with neurotic disorders, 48% with PTSD, and 72% with other depression. In addition, 45% reported military sexual trauma.
- Compared with women who had no documented IPV, those with documented IPV had a higher average number of healthcare encounters per month and were more likely to have visited the emergency department - and to have had a mental health/behavioral health/social work visit during the study period.
LIMITATIONS:
- From the data used in this study, investigators only know about conditions that were diagnosed and documented. However, IPV experiences are likely under-reported and under-documented.
IMPLICATIONS:
- Study findings, coupled with the redesign of VA clinical practice through Patient Aligned Care Teams and a focus on gender-specific care, suggest that it may be an optimal time to establish a comprehensive IPV assessment and response program within the VA healthcare system.
AUTHOR/FUNDING INFORMATION:
Dr. Dichter is supported by an HSR&D Career Development Award and is part of HSR&D's Center for Health Equity Research and Promotion at the Philadelphia VA Medical Center.
Dichter M and Marcus S. Intimate Partner Violence Victimization among Women Veterans: Health, Healthcare Service Use, and Opportunities for Intervention. Military Behavioral Health August 5, 2013;e-pub ahead of print.
