Media release

From: University of Auckland

Abused women at higher risk of serious conditions

New research finds women who have experienced interpersonal violence and abuse are 1.6 times more likely to visit hospital with cancer and almost three times as likely to be hospitalised for respiratory diseases. See the Scandinavian Journal of Public Health. (Link won’t work until embargo lifted.)

About two-thirds of New Zealand women have experienced violence or abuse over the course of their lives.

These women are also:

• twice as likely to be hospitalised for pregnancy complications
• 1.6 more likely to be hospitalised for digestive disorders, and
• 1.5 times more likely to be hospitalised for injuries (not necessarily resulting directly from the violence).

Experiences of childhood sexual abuse and multiple types of intimate partner violence were strongly associated with hospitalisation for these diseases.

“We are talking about a range of diseases that are serious enough to require hospital-level treatment,” says lead author Professor Janet Fanslow from the University of Auckland’s School of Population Health.

“Results also signal that we need to get serious about violence prevention, because the experience of violence is a cost to our health system. We know the country is struggling to pay for health services. So, supporting people to have healthy relationships and doing effective violence prevention up front is going to keep people safer, help them be healthier, and save us money.”

The researchers took reliable data on New Zealand women’s exposure to violence from earlier research and, with their permission, matched that group of women to their hospital records over 31 years from 1988 to 2019, then aggregated the figures.

“As far as we are aware, this is the first time researchers internationally have been able to reliably match hospitalisation data and solid data on women’s experience of violence,” Fanslow says.

“In our previous papers, we have had good assessments of violence from surveys, but then we have been reliant on people’s ability to remember and describe all of their health problems and their diagnoses, which can lead to inaccuracies.”

The study used gold-standard measures to find out about women’s experience of multiple types of violence, including childhood sexual abuse, physical or sexual violence by non-partners, and five types of intimate partner violence – physical violence, sexual violence, psychological abuse, controlling behaviours, and economic abuse.

More than 1,000 (1,151) ever-partnered women who were surveyed gave consent for linkage of their survey data with information on their use of hospital services from the New Zealand National Minimum Data Set on Hospital Discharges      .

The new study explored the associations between each interpersonal violence type and hospitalisation for health conditions, after adjusting for the influence of age and ethnicity.

Experience of violence was common, with 62.6 percent of women reporting experience of interpersonal violence in their lifetime, including high rates of childhood sexual abuse (21 percent), sexual violence by non-partners (9.2 percent), and/or multiple types of intimate partner violence (21 percent).

Men also surveyed

More than 1,000 (1,054) ever-partnered men were also surveyed. Of these, 68.4 percent reported some experience of interpersonal violence, with the majority of this (43 percent) coming from non-partner physical violence, mainly perpetrated by other men.

Men who experienced interpersonal violence were twice as likely as other men to be hospitalised for injuries or non-disease specific symptoms.

Childhood sexual abuse was reported by 7.5 percent of men in the survey.

Men who experienced childhood sexual abuse were seven times more likely to be hospitalised for nervous system disorders compared with men who had not experienced child sexual abuse.

“All interpersonal violence can have health consequences. However, the fact that experience of any interpersonal violence is associated with hospitalisation for a greater range of conditions among women than men is likely because the violence perpetrated against them is more frequent and/or more severe,” Fanslow says.

Implications 

“The whole point is that violence and the effects of violence are appearing in our health systems, but we're often not recognising it, and therefore we're not responding appropriately,” Fanslow says.

“If clinicians are aware violence could be contributing to the health problem, they could link people to appropriate support services, whether it's around immediate safety or long-term recovery and trauma-informed care,” Fanslow says.

She says health leaders need to prioritise and resource implementation of existing protocols and procedures, such as the national Violence Intervention Programme, if we are to respond effectively to violence. There needs to be proactive screening and routine inquiries about violence exposure.

The research was funded by the Ministry of Business, Innovation and Employment.