Violence by Women with Health Disparities

Journal of Multicultural Nursing & Health, Spring 2007 by Brackley, Margaret H, Williams, Gail B

PROBLEM/PURPOSE: Adult American women are abused by their spouse or intimate partner each year. In the United The purpose of this poster is to describe the lack of women's definitions of intimate partner violence (IPV) within a health disparities context in the literature. Approximately 4.4 million States domestic violence is the leading cause of serious injury to women and accounts for more than half of all female homicides. Intimate partner violence involves a pattern of abuse used to control a current or former partner with whom the abuser has had a marital or romantic relationship. The term intimate partner violence is used to broaden the issue to intimate relationships of all kind, married, dating, same sex, common law. The National Center for Injury Prevention and Control (2000) defines IPV as "actual or threatened physical or sexual violence or psychological/emotional abuse by a spouse, ex-spouse, boyfriend/ girlfriend, exboyfriend/ex-girlfriend, or date." The health consequences and outcomes of IPV are numerous and the violence may take many forms, from actual physical assault to threats and emotional abuse.

BACKGROUND: The Healthy People 2010, the nation's health objectives for the 21st century, state that the godal for domestic violence is that no more than 3.3 percent of the population will be victims of domestic violence in a five year period. Prevention should focus on developing safe intimate relationships, recognizing and avoiding dangerous ones. In our research, we have found that women often do not recognize themselves as having experienced violence. The women's definitions of violence are not like the ones adopted by the CDC. Definitions and the experience of violence seem to vary across cultures and with age and socioeconomic status, including education.

DISCUSSION: To communicate a health message of risk, it must be in a language familiar and understandable to the receiver; congruent with their cultural values; and delivered by non-judgmental people. (9) Culture can affect:

* what a person considers to be violence;

* comfort level with the way health care providers communicate about violence;

* belief that violence can be prevented through personal and collective effort;

* an individual/family's desire to keep the experience of personal abuse confidential;

* beliefs about the cause of violence (and perhaps about its prevention as well);

* tendencies toward accepting violence as inevitable; trust or distrust of medical advice or procedures;

* types of social support provided by family and community;

* individualistic versus collectivistic cultural approaches; and

* perception of the best method of treatment.

CONCLUSIONS: Calls for innovation in prevention in this area and a partnership model, where researchers are committed to understand and appreciate the "others" worldview, have been made. Differences based on region of the country, socioeconomic status, country of origin, generation, acculturation, fit of old and new culture, education level, and others factors make it impossible to use a standardized approach to prevent a health problem, such as IPV. Healthy People 2010 aims to eliminate health disparities in racial and ethnic groups. Health disparities, defined as unequal access and quality, have been identified in ethnic and racial minority groups, as well as gender groups. Primary barriers to access are from abusers stopping abused women from seeking care. Tertiary barriers to access and quality come from inadequately trained and/or culturally insensitive health care providers. When risk identification does not tap into a woman's perceived experience, unequal treatment may result. Primary (universal) prevention to address healthful lifestyles through health education or social marketing campaigns can encourage people to make life changes that will benefit their health and help those that are well, stay well. Many groups that are vulnerable, seek information about health from friends, community residents, and family members before seeking help from professionals. It is thus most important that all members of the community have accurate information to pass to these health seekers if we are to meet this goal.

Margaret H. Brackley, PhD, APRN, BC

Gail B. Williams, PhD, RN

The University of Texas Health Science Center at San Antonio School of Nursing

San Antonio, Texas