Intimate partner violence: A major public health problem

Intimate partner violence refers to behavior by an intimate partner or ex-partner -- including physical aggression, sexual coercion, psychological abuse and controlling behaviors -- that causes physical, sexual or psychological harm.¹ Although women can be violent in relationships with men, often in self-defense, and violence sometimes occurs in same-sex partnerships, the most common perpetrators of violence against women are male intimate partners or ex-partners.²

An analysis of data from 2000-2018 across 161 countries and areas, conducted by the World Health Organization on behalf of the United Nations Interagency Working Group on Violence Against Women, found that worldwide, nearly

one in three, or 30%, of women have been subjected to physical and/or sexual violence by an intimate partner or non-partner sexual violence, or both.¹

Domestic violence can occur in any relationship - gay/straight, old/young. Victims can be men or women, and perpetrators can be men or women.³

Data from the British Home Office statistical bulletins and the British Crime Survey show that men made up about 40% of domestic violence victims each year between 2004-05 and 2008-09, the last year for which figures are available.⁴ The 2008-09 bulletin states: "More than one in four women (28%) and around one in six men (16%) had experienced domestic abuse since the age of 16. These figures are equivalent to an estimated 4.5 million female victims of domestic abuse and 2.6 million male victims." In addition, 6% of women and 4% of men reported having experienced domestic abuse in the past year, equivalent to an estimated one million female victims of domestic abuse and 600,000 male victims.

Impact

Intimate partner violence causes adverse physical, psychological and social effects, including adolescent and unintended pregnancy, miscarriage, stillbirth, intrauterine hemorrhage, nutritional deficiency, abdominal pain and other gastrointestinal problems, neurological disorders, chronic pain, disability, anxiety and post-traumatic stress disorder (PTSD), as well as noncommunicable diseases such as hypertension, cancer and cardiovascular diseases.⁵

Head injuries often accompany intimate partner violence. Abusers target a person’s head, neck, or face more than anywhere else on the body.⁶ Concussions appear with regularity among victims of intimate partner violence. The estimated number of annual brain injuries among survivors of domestic abuse is 1.6 million.⁷

People who put their hands around their partner’s neck are particularly dangerous.⁸ Even if there are no marks around the neck, serious injuries can be sustained, worsen over the next few days, and cause long-term damage and even death. For these reasons, choking victims should stay with someone safe for 24 to 72 hours to watch for red flags, including headache, one pupil larger than the other, loss of memory of what happened, slurred speech, repeated vomiting, etc. In any of those cases, medical attention is needed.

Coercive control

Intimate partner violence isn’t always physical or sexual in nature. Coercive control ⁹ is an act or pattern of assault, threats, humiliation, and intimidation used to harm, punish or frighten someone. It creates invisible chains and a sense of fear that pervades all elements of the victim’s life. Common examples are:

Isolating the victim from friends and family.
Withholding basic needs, such as food.
Monitoring the victim’s time.
Monitoring via online communication tools or spyware.
Taking control over aspects of the person’s everyday life, such as where they can go, who they can see, what they can wear and when they can sleep.
Depriving access to support services, such as medical services.
Repeatedly putting the person down, such as saying they’re worthless.
Humiliating, degrading, or dehumanizing.
Controlling finances.
Making threats or intimidating comments.

Children at risk

Children who are exposed to intimate partner violence are victims themselves. In 2010, one in 15 children in the United States was exposed to intimate partner violence, for a total of more than 5 million children.¹⁰ (One in three of those children were also child abuse victims.) Children who have been exposed to domestic violence can become fearful and anxious, and concerned for themselves, siblings and their parents. They may begin to feel worthless and powerless, find it difficult to focus, and display depression and withdrawal. They are more likely than their peers to be in abusive intimate partner relationships in the future, either as victims or perpetrators. They are also at greater risk for adult health problems, including obesity, cancer, heart disease, depression, substance abuse, tobacco use and unintended pregnancies.

Prevention

Ideally, intimate partner violence is addressed by preventing it from occurring in the first place, according to the U.S. Centers for Disease Control and Prevention.¹¹ The agency recommends that communities implement six strategies to promote healthy, respectful, nonviolent relationships:

Teach safe and healthy relationship skills with social/emotional learning programs for youth and healthy-relationship programs for couples.
Engage influential adults and peers. Recruit men and boys as allies in prevention, and promote bystander empowerment and education as well as family-based programs.
Disrupt the developmental pathways toward partner violence by providing early childhood home visitation; preschool enrichment with family engagement; programs on parenting skills and family relationships; and treatment for at-risk children, youth and families.
Create protective environments in schools, organizations, neighborhoods and workplaces.
Strengthen economic supports for families.
Support survivors through victim-centered services, housing programs, first-responder and civil legal protections, etc.