Physical and Sexual Violence Among North Carolina Women: Associations with Physical Health, Mental Health, and Functional Impairment
Received 26 April 2007; accepted 28 December 2007.
Objective
This study examines links between women’s experiences of violence during adulthood (including physical and sexual violence) and women’s physical health, mental health, and functional status.
Methods
Data were analyzed from a representative sample of 9,830 North Carolina women surveyed by the North Carolina Behavioral Risk Factor Surveillance System (BRFSS).
Results
One-quarter of the women experienced violence as adults, with current or ex-partners being the most common perpetrators. Logistic regression analyses that controlled for the sociodemographic characteristics of the women found that women who experienced violence were significantly more likely than other women to have poor physical health, poor mental health, and functional limitations. Moreover, these negative health outcomes were most prevalent among the women who experienced a combination of both physical and sexual violence.
Conclusions
These findings underscore the need for trauma-informed women’s health services and policies.
aDepartment of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
bDepartment of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
cInjury and Violence Prevention Branch, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina
dDepartment of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
eInjury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
fSchool of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Correspondence to: Dr. Sandra L. Martin, Department of Maternal and Child Health, CB# 7445, University of North Carolina, Chapel Hill, NC 27599-7445.
Supported by Cooperative Agreement VF1/CCV419917-03 and U17/CCU422231-0 from the Centers for Disease Control and Prevention through the NC Department of Health and Human Services.
1 Sandra L. Martin, PhD, is the Associate Dean for Research in the School of Public Health and a Professor and Associate Chair for Research within the Department of Maternal and Child Health at the University of North Carolina in Chapel Hill. She is also a core faculty member of the UNC Injury Prevention Research Center. Dr. Martin’s research, teaching, and public health service focus on the health of women and children, with particular attention paid to the role that violence plays in their lives. Dr. Martin’s studies have been funded by a variety of sources, including the National Institute of Mental Health, the Centers for Disease Control and Prevention, and the Maternal and Child Health Bureau, and she has published the results of her studies in a variety of scientific journals.
2 E. Danielle Rentz, PhD, is an environmental epidemiologist in the Epidemic Intelligence Service at the Centers for Disease Control and Prevention and she is an Adjunct Faculty member in the Department of Epidemiology at the University of North Carolina at Chapel Hill, where she received her doctoral degree. Dr. Rentz has studied family violence, child maltreatment, sports injuries, and occupational epidemiology. She is currently leading international and domestic research on a variety of environmental public health issues.
3 Ronna L. Chan, MPH, is a doctoral candidate in the Department of Maternal and Child Health at the University of North Carolina at Chapel Hill School of Public Health. Her research focus is perinatal and reproductive epidemiology. She is currently involved with an epidemiologic study that evaluated maternal exposures and adverse pregnancy outcomes. Additionally, her research experience includes studies of the impact of women’s experience with violence and family planning, and environmental exposures and male reproductive health. Ms. Chan has served as a co-instructor for a required course in epidemiology for second year UNC medical school students and as a teaching assistant for a graduate course in the School of Public Health. She is currently an active member of the Society of Pediatric and Perinatal Epidemiologic Research and the Society of Epidemiologic Research.
4 Jeanne Givens, MSSW, is the manager of the Prevention Programs Unit in the North Carolina Division of Public Health’s Injury and Violence Prevention Branch. Ms Givens has developed and managed violence prevention programs in public health for many years. She has worked extensively with researchers to increase knowledge about the impact of violence and to integrate these findings into improved prevention programming.
5 Catherine P. Sanford, MSPH, is the retired head of the Epidemiology Unit of the NC Division of Public Health Injury and Violence Prevention Branch and the former director of the NC Violent Death Reporting System for the NC Department of Health and Human Services. Ms. Sanford’s area of expertise is in the development of integrated injury surveillance systems, and the translation of injury statistics into injury prevention and public health preparedness and response programs and policies.
6 Lawrence L. Kupper, PhD, is Alumni Distinguished Professor of Biostatistics in the School of Public Health at the University of North Carolina in Chapel Hill. Dr. Kupper’s area of expertise concerns the development and application of statistical methods for the analysis of public health research data, with particular emphasis on the areas of environmental health and women’s health. Dr. Kupper is a Fellow of the American Statistical Association, and he has received several University and national awards for his research and teaching accomplishments.
7 Mariana Garrettson, MPH, is a health educator and independent consultant in injury and violence prevention. She received her MPH from the University of North Carolina in Chapel Hill in 2005 and has worked for the Injury Prevention Research Center there since 2003. She has worked on violence prevention research and interventions with a wide variety of organizations: local nonprofits serving victims of domestic violence, sexual assault and child maltreatment; the Pennsylvania state department of health injury and violence program; statewide violence prevention taskforces; and university based research centers. She has a particular interest in the role of health care providers in preventing violence.
8 Rebecca J. Macy, PhD, ACSW, LCSW, is an Assistant Professor at the School of Social Work at the University of North Carolina at Chapel Hill where she teaches courses on social work practice and family violence. She joined the faculty in 2002, after receiving her doctoral degree in social welfare from the University of Washington in Seattle. In 1993, she received her MSW from Tulane University in New Orleans. She is a licensed social worker with practice experience in community mental health where she worked with violence survivors. Her current research activities focus on the health consequences of violent victimization, repeated victimizations across the life span, coping with traumatic events, and the use of advanced statistical methods to investigate violent victimization. She is also a core faculty member of the UNC Injury Prevention Research Center.