The study's lead author, Dr. Megan Gerber, a practicing physician at Cambridge Health Alliance and Instructor of Medicine at Harvard Medical School, notes: "Our study hopes to raise physician awareness of how common domestic violence is in practice, especially among women who exhibit adverse health behaviors. Physicians regularly screen for tobacco and alcohol use in their practices, however routine assessment for domestic violence has been much more controversial, and many clinicians do not regularly ask their patients about it."
Intimate Partner Violence (IPV) is a major public health problem in the United States and victims are commonly encountered in medical settings. Many barriers exist to clinician-initiated screening for IPV. However, smoking and problem drinking are conditions that clinicians commonly screen for and both have been strongly associated with IPV in prior studies. By estimating the predicted probability of 12-month and lifetime IPV for a given patient based on whether she presents with these conditions, this study gives clinicians information that can help them identify patients at risk for IPV.
ABOUT THE STUDY
These findings were drawn from the Women and Family Life Project, a government-funded study that examines the health of battered women. A written survey was administered to 2386 female medical patients throughout the greater Boston area. The probabilities of 12-month and lifetime abuse by an intimate partner were estimated based on women's reports of their smoking and drinking behaviors. Women who neither smoked nor drank in the study still had a 10% likelihood of abuse in the preceding year and a nearly 40% chance of lifetime abuse, illustrating how common this problem is in medical populations.
Gerber and her colleagues concluded that the presence of smoking or problem drinking should raise clinicians' suspicion for IPV. This paradigm should not replace direct questioning about IPV, but may aid in detection of abuse in patient populations.
SOME BASIC FACTS ABOUT INTIMATE PARTNER VIOLENCE
- AN ESTIMATED 1.5 MILLION WOMEN ARE ASSAULTED ANNUALLY BY AN INTIMATE PARTNER.
- 25% OF WOMEN REPORT A LIFETIME HISTORY OF PARTNER ABUSE.
- AMERICAN WOMEN ARE KILLED BY INTIMATE PARTNERS MORE OFTEN THAN BY ANY OTHER TYPE OF PERPETRATOR.
AUTHORS
Megan R. Gerber, MD, MPH, Cambridge Health Alliance, Harvard Medical School
Michael L. Ganz, MS, PhD, Harvard School of Public Health
Erika Lichter, ScD, Harvard School of Public Health
Corrine M. Williams, MS, Harvard School of Public Health
Laura A. McCloskey, PhD, Harvard School of Public Health and University of Pennsylvania School of Social Policy and Practice, Philadelphia, PA
The research was funded by a grant from the Agency for Healthcare Research and Quality.
LEAD AUTHOR/PHYSICIAN
Dr. Megan Gerber earned her medical degree from the Pennsylvania State College of Medicine and holds a Masters in Public Health from the Harvard School of Public Health. She completed her Internal Medicine Internship and Residency at the University of Rochester and is currently a Post-doctoral Research Fellow at the Harvard School of Public Health in the laboratory of Dr. Laura A. McCloskey. Dr. Gerber is a practicing primary care physician with a strong interest in Women's Health. Dr. Gerber has worked closely with the Cambridge Health Alliance Domestic Violence Task Force since 1996 carrying out patient advocacy and program planning. Her research is focused on the healthcare response to patients who have experienced partner violence. Currently, she is the principal investigator on several projects at CHA which exam the healthcare response to victims of violence. Her fellowship research at HSPH focuses on the health effects of partner violence. Dr. Gerber has presented scientific abstracts and participated as workshop faculty at the Society for General Internal Medicine (SGIM) and the Family Violence prevention Fund's National Conference on Healthcare and Domestic Violence. In October 2003, Dr. Gerber was an invited lecturer at Queen's University College of Medicine, Kingston, Ontario, Canada.
CAMBRIDGE HEALTH ALLIANCE
Cambridge Health Alliance is a regional healthcare system with three hospitals and more than twenty primary care practices throughout Cambridge, Somerville, and Boston's metro-North communities. As a teaching affiliate of Harvard Medical School, Cambridge Health Alliance offers medical residency/training programs and undergraduate learning experiences in hospital and community settings.
Journal
Archives of Internal Medicine