The epidemiology of domestic violence
1 / 37

The Epidemiology of Domestic Violence - PowerPoint PPT Presentation

  • Updated On :

The Epidemiology of Domestic Violence. Thomas Songer, PhD Cristie Glasheen, MPH University of Pittsburgh. Key Points. What is being measured? What is NOT being measured? How does this affect the results?. Definition of Violence. …...To understand violence, you need to define violence.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'The Epidemiology of Domestic Violence' - gryta

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
The epidemiology of domestic violence l.jpg

The Epidemiology of Domestic Violence

Thomas Songer, PhD

Cristie Glasheen, MPH

University of Pittsburgh

Key points l.jpg
Key Points

What is being measured?

What is NOT being measured?

How does this affect the results?

Definition of violence l.jpg
Definition of Violence

…...To understand violence, you

need to define violence

How would you define

domestic violence?

Defining domestic violence l.jpg
Defining Domestic Violence

domestic violencenoun: violence committed by one member of a family or household against another

The National Research Council defines violence as:

- behaviour by individuals that intentionally threaten, attempt, or inflict physical harm on others

Who is affected by domestic violence l.jpg
Who is Affected by Domestic Violence?


Intimate Partners (IP)


Data sources l.jpg
Data Sources

You are planning to do a study of domestic violence using pre-existing data.

Where would you look?

Medical sources

State sources

Government surveys

Surveillance in domestic violence l.jpg
Surveillance in Domestic Violence estimates for domestic violence?

  • Hospital Admissions

  • Trauma Center Admissions

  • Emergency Department Admissions

  • State-based Reporting Systems

  • Government Surveys

    • National Criminal Victimization Survey

    • National Incidence Survey

    • Behavioral Risk Factor Survey

    • National Violence Against Women Survey

Medical sources l.jpg
Medical Sources estimates for domestic violence?

Hospital Records

Trauma Center Records

Emergency Department

Recommended: Rudman WJ. Coding and Documentation of Domestic Violence.

December, 2000. Available at:

Definition of health care events related to domestic violence l.jpg
Definition of Health Care Events Related to Domestic Violence

  • Based on N-codes and E-codes

    • 995.80 to 995.85 adult physical abuse

    • 995.50 child abuse

    • E coding to distinguish domestic violence is relatively poor

    • E967.x

State based reporting l.jpg
State Based Reporting Violence

  • State-based Reporting

    • Child Protective Services

    • Uniform Crime Reports

    • National Incident-Based Reporting System (NIBRS)

    • Supplementary Homicide Report (SHR)

State based programs related to domestic violence l.jpg
State-based Programs Related to Domestic Violence Violence

  • Based on reporting to state agencies

    • most frequently for child maltreatment

    • definition of violence is not standard across the states

    • reporting is subject to knowledge of the issues to medical, educational, and legal personnel

Government surveys l.jpg
Government Surveys Violence

  • Government Surveys

    • National Crime Victimization Survey (NCVS)

    • National Violence Against Women Survey (NVAW)

Surveys related to domestic violence l.jpg
Surveys Related to Domestic Violence Violence

  • Self-report of violence based upon interviews

    • Aside from the NCVS, these surveys are not regularly collected

    • Definition of violence in surveys is not standard

    • There may be extensive under-reporting of violence

What do we know about child maltreatment l.jpg
What do we know about ViolenceChild Maltreatment?

Epidemiology of child abuse l.jpg
Epidemiology of Child Abuse Violence

  • Maltreatment

    • “behavior towards another person, which a) is outside the norms of conduct, and b) entails a substantial risk of causing physical or emotional harm”

      • Physical Abuse

      • Sexual Abuse

      • Emotional & Psychological Abuse

      • Neglect

Types of maltreatment l.jpg
Types of Maltreatment Violence

  • Physical abuse: physical acts by a parent, guardian or caretaker that caused physical injury to the child.

  • Neglect (including medical neglect): the failure by the caretaker to provide needed, age-appropriate care (or provide for the health care) of the child.

  • Sexual abuse: the involvement of a child in incest, or sexual assault by a relative or caretaker, includes fondling and exposure to indecent acts.

Slide18 l.jpg

Substantiated Cases of Child Maltreatment, Violence

Pennsylvania, 1976-1994

The pyramid of child maltreatment in pennsylvania 1994 l.jpg

The Pyramid of Child Maltreatment in Pennsylvania, 1994 Violence

53 deaths

33 head injuries

56 trauma center admissions

177 hospital admissions

2115 ED visits

7,038 substantiated cases

64,560 maltreatment events

Terminology of ipv l.jpg
Terminology of IPV Violence

Intimate Partner Violence (IPV) – relatively new term

Also called: domestic violence, domestic abuse, spousal abuse, battery, violence against women

Slide23 l.jpg

Estimates of the Frequency of Domestic Violence Violence

Against Women seen in Medical Settings



One year



Definition and Method


from Abuse



Physical and sexual abuse reported





in physician practices

Physical and sexual abuse and



threats by current partner reported



in internal medicine clinics

Physical abuse reported in an urban




emergency department

Physical or sexual abuse reported in






community hospital emergency


Physical abuse identified in trauma



patients in urban emergency



Physical abuse or threats reported in






urban, acute care emergency

departments and clinics

Physical trauma identified in ten




emergency departments

Slide24 l.jpg
IPV Violence

Source: American Journal of Preventive MedicineVolume 34, Issue 2, February 2008, Pages 112-118

Slide26 l.jpg

The Pyramid of Violence Against Women, U. S. Violence against Women

1418 murders

7% treated in emergency department

10% sought medical care

32% not treated for injury

51% had physical injuries

50% reported to police

1992-96 NCVS

960,000 women victimized

Trends in the rates of violent victimizations by intimates united states 1992 1996 l.jpg
Trends in the rates of violent victimizations by intimates Violence against Women*, United States, 1992 - 1996

Possible risk factors l.jpg
Possible Risk Factors Violence against Women

Intimate Partner Violence

  • Gender

  • Ethnicity

  • Socio-Economic Status

  • Age ?

  • Alcohol ?

  • Pregnancy ?

  • Psychiatric problems ?

What do we know about elder abuse l.jpg

What do we know about Elder Abuse? Violence against Women

Research methods l.jpg
Research Methods Violence against Women

You have decided that existing data sources are not adequate to answer your research question.

You want to design a new study.

What do you need to consider?

Slide31 l.jpg
Who Violence against Women

Who are you going to measure?



What is your outcome l.jpg
What is Your Outcome? Violence against Women

Physical Injury?

Psychological Injury?

Physical injury l.jpg
Physical Injury Violence against Women

Easiest to identify

Severity of injury

What are you missing?

Exposed with no injury

Psychological injury l.jpg
Psychological Injury Violence against Women

What is the threshold?

When is it a psychological “bruise” and when is it a “trauma”?

What does this mean for prevention




What is your exposure l.jpg
What is your exposure? Violence against Women

Experienced or potential for abuse?

Officially reported, unreported, or both

Suspected or confirmed

Attempts or completions

Type of exposure

Physical and/or Neglect



How are you going to measure it l.jpg
How are You Going to Measure It? Violence against Women

Domestic Violence is wrought with ethical considerations unique to this field of research

Key lecture points l.jpg
Key Lecture Points Violence against Women

  • Surveillance for the frequency of domestic violence is not at the same level of development as for other unintentional injuries and for criminal violence

  • Several limitations, including differing definitions, poor coding, and under-reporting influence our knowledge of the frequency of domestic violence

  • Risk factor analysis in this area is just starting