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Intimate-Partner Violence: The Need for Primary Prevention in the Community
Intimate-partner violence is a serious problem, but it may be even more common than was previously believed. A 1999 report estimated that one third of women worldwide have been victims of intimate-partner violence (Heise L, Ellsberg M, Gottemoeller M. Ending Violence against Women. Population Reports. Baltimore: Johns Hopkins School of Public Health; 1999). Intimate-partner violence is the leading cause of injury to women 15 to 44 years of age—more common than automobile accidents, muggings, and rapes combined (The National Coalition against Domestic Violence Fact Sheet: Domestic Violence Is Under Reported. Office of the U.S. Surgeon General; 1 January 1994).
Abuse has been linked to gastrointestinal disorders, chronic pain syndromes, problem pregnancies, and substance abuse. In their most recent violent incident with an intimate partner, 39% of female victims sustained an injury and approximately one third of those required medical care. In the United States, about 1.5 million women each year are raped, physically assaulted, or both by an intimate partner (Tjaden P, Thoennes N. Prevalence, Incidence, and Consequences of Violence against Women: Findings from the National Violence against Women Survey. U.S. Department of Justice; November 1998).
Prevention
Vast resources have been channeled into tertiary prevention of intimate-partner violence, to the exclusion of primary prevention (Glossary). “I think it's been a real lost opportunity to perhaps prevent a health problem from materializing,” commented Lori Heise, director of Women's Health Exchange (a nonprofit research and advocacy group for international health policies and practice in Washington, D.C.). She explained that despite major strides made in recent years to address intimate-partner violence, treatment of the victims has been the primary focus. In the 1970s, advocates for women's rights, she said, played a major role in shaping the trend toward tertiary prevention because treatment for female victims presented the most urgent need; consequently, primary prevention efforts …
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