HEALTH EFFECTS OF
DOMESTIC VIOLENCE
The effects of violence on a victim’s
health are severe. In addition to the immediate injuries from the assault,
battered women may suffer from chronic pain, gastrointestinal disorders, psychosomatic
symptoms, and eating problems. Although psychological abuse is often considered
less severe than physical violence, health care providers and advocates around
the world are increasingly recognizing devastating mental health effects of
domestic violence, including anxiety, post-traumatic stress disorder, and
depression. Women who are abused suffer an increased risk of unplanned or
early pregnancies and sexually transmitted diseases, including HIV/AIDS. As
trauma victims, they are also at an increased risk of substance abuse. Women
are particularly vulnerable to attacks when pregnant, and thus may more often
experience medical difficulties in their pregnancies.
Battering imposes significant costs
on the community. According to the National Center for Injury Prevention and
Control in the United States, the estimated annual direct medical cost of
caring for battered women in the United States is $1.8 billion dollars. Another
study, reported by UNICEF, estimates the direct cost in the United States
to be between five and ten billion dollars annually. From UNICEF, Domestic
Violence Against Women and Girls,
6 Innocenti Digest 1, 12 (2000).
As the World Health Organization notes,
domestic violence also has significant indirect costs for society. A survey
on violence against women in Canada revealed that 30% of battered women had
to cease regular activities because of the violence, and 50% had to take sick
leave from work because of injuries. A Nicaraguan study found that even after
controlling for other factors that could affect earnings, women who were abused
earned 46% less than women who were not abused. UNICEF reports that a study
in Santiago, Chile, estimates that women who suffer physical violence earn,
on average, less than half of the income of women who do not face violence
at home.
Domestic violence can be fatal; women
are both intentionally murdered by their partners and lose their life as a
result of injuries inflicted by them. In particular, recent studies in the
United States have focused on choking or strangulation, a tactic often used
by batterers. Because choking or strangulation rarely leaves vivid external
physical marks, police may not recognize the victim’s need for medical
assistance or the seriousness of the violence. Injuries resulting from choking
or strangulation
can often be lethal; such injuries “may
appear mild initially but they can kill the victim within 36 hours.” From
When Abusers Choke Their Victims, Violence Against Women 22-5 (Joan Zorza
ed., 2002).
In addition to the danger of death
from injury or intentional homicides, research also indicates that women
who are abused may be more likely to commit suicide. The Family
Violence Prevention
Fund, reporting
on a 1995 study, stated that 29% of all women in the United States who attempted
suicide were battered. UNICEF reports that a “close correlation between domestic
violence and suicide has been established based on studies in the United States,
Fiji, Papua New Guinea, Peru, India, Bangladesh and Sri Lanka. Suicide is
12 times as likely to have been attempted by a woman who has been abused than
by one who has not.” From UNICEF, Domestic
Violence Against Women and Girls,
6 Innocenti Digest 1, 4 (2000).
The secondary effects of domestic
violence involve the victim’s ability to function in daily life. Victims of
domestic violence often take more absences from work to visit the doctor.
Battering may lead to feelings of shame, embarrassment and humiliation, particularly
when beatings leave marks, which in turn may lead to further isolation from
friends and family and to absences from work. Because of increased absences
and substance abuse, battered women may find it difficult to maintain steady
employment. Escaping the violence may require a complete abandonment of job,
home and belongings. From Barbara Johnson, Reducing
Intimate Partner Abuse: A Look at National, State, and Local Strategies for
the Prevention
of Domestic Violence
(2002).
Other effects include the impact of
domestic violence on children, family, friends,
co-workers, and the community. Family and friends may themselves be targeted
by the abuser in retaliation for helping a woman leave a violent relationship
or find assistance.
Children in homes where domestic violence occurs may be
witnesses to abuse, may themselves be abused, and may suffer harm “incidental”
to the domestic abuse. Understanding the effect of domestic violence on children,
and particularly the correlation between spouse and child abuse, is a critical
part of an effective community response to violence. Without this basis, programs
designed to help children may have unintended and negative effects on battered
women, and may not be effective in helping children deal with and recover
from witnessing and experiencing abuse.
Domestic violence also contributes
to women’s vulnerability to other forms of violence against women.
Research conducted by Minnesota Advocates for Human Rights in Moldova
and Ukraine
revealed that domestic violence may increase women’s vulnerability to trafficking;
women who experienced violence at home were more willing to look for and
accept an uncertain and potentially risky job
abroad.
The World Health Organization’s Factsheet and Violence
Against Women: Health Consequences
detail the health consequences of violence against women around the world.
The National
Center for Injury Prevention and Control
and the Family
Violence Prevention Fund
provides an excellent overview of the health effects of domestic violence
on women and children.