Family violence is quite literally making New Zealanders sick, according to new research from the University of Auckland, Waipapa Taumata Rau.
Women who have experienced intimate partner violence are almost three times as likely to have a diagnosed mental health condition and almost twice as likely to have a chronic illness, compared with those who have not experienced intimate partner violence, according to a paper published in leading journal JAMA Network Open.
The researchers surveyed a representative sample of 1,464 women in three regions across the country to gauge the prevalence of partner abuse and its health impacts.
“This is the first time we’ve been able to demonstrate how intimate partner violence contributes to the burden of ill health in the country,” says Associate Professor Janet Fanslow, key author and violence researcher at Waipapa Taumata Rau, the University of Auckland.
Earlier research published by Dr Fanslow showed that one in three women experience physical or sexual violence from a partner. This figure persists, but this new study investigated five different types of intimate partner violence and their impact on health.
“Repeated exposure to physical violence, sexual violence, psychological abuse, controlling behaviour and economic abuse substantially increases the risk of ill health for women, in terms of both chronic physical disease, and mental health problems,” says Dr Fanslow.
“And violence is not happening to small proportions of women in the population,” she says.
More than half, 794, (54.7%) of the 1,431 women surveyed, who had a current or previous intimate partner, reported they had experienced one or more of these types of abuse over their lifetime.
One in five women reported three or more types of partner abuse.
There were 11% of women who had experienced four or five types of abuse. These women were four times more likely to have a diagnosed mental health condition, such as depression, anxiety or substance abuse.
The same group had double the risk of a chronic health problem, such as heart disease, cancer, stroke, diabetes, or asthma, compared with women who did not experience violence.
Women who reported food insecurity had the highest prevalence of intimate partner violence at more than two thirds (69.9%).
By ethnicity, Māori women reported the highest likelihood of any lifetime intimate partner violence at 64.1%.
“It’s really important that the health community begin to understand intimate partner violence as a determinant of health,” Dr Fanslow says.
“People expect healthcare providers to talk to them about smoking, obesity and alcohol consumption, but this study shows us that the quality of people’s relationships, whether now or in the past, has a fundamental impact on their health.
“So, we need healthcare professionals to be equipped to assess for violence and abuse within relationships and to link people into support services.
“This goes beyond a simple process of referral to actively supporting people to find the type of help that they need. Where complex problems exist, such as violence in the presence of poor food security and mental health problems, complex solutions are also required.”
Dr Fanslow says that Manatū Hauora, the Ministry of Health has developed an excellent evidence-based violence intervention programme but has so far failed to embed it into the health system. This research should inform policy for Te Whatu Ora,Health New Zealand to roll out and resource this programme.
Another paper published as part of the same research project assessed men’s experience of partner violence, see JAMA.
“While men do report intimate partner violence, it is less frequent, less severe and is not leading to significant health effects on a population basis,” Dr Fanslow says.
That doesn’t mean individual men are not experiencing serious and prolonged abuse and need care, she adds.
“In general, prevention programmes need to be targeting men and boys’ understanding of power and control in relationships,” she says.
Dr Fanslow would like to see international evidence-based programmes informing home-grown violence-prevention programmes in Aotearoa New Zealand.
The research was funded by the Ministry of Business, Innovation and Employment.