Domestic Violence Global Health Problem

LONDON – Women who are physically abused by a partner face a similar legacy of health problems whether they live in a modern city in the industrialized world or a traditional village in a developing country, the first global study on domestic violence has found.

In interviews with 24,000 women in 10 countries, researchers found that while there are wide variations in the rate of women experiencing sexual or other physical abuse at the hands of their partners, victims are about twice as likely as other women to suffer ill health — and the effect seems to persist long after the violence has stopped.

The study — conducted by the World Health Organization in collaboration with the London School of Hygiene and Tropical Medicine, and PATH, a global health organization — is a landmark, said former U.N. Commissioner for Human Rights Mary Robinson.

"We don't actually know, unless we have studies like this, how serious and pervasive violence by intimate partners really is," said Robinson, who was not connected with the research. "For the first time, this study has used consistent means to measure violence across countries, so that we can now reasonably compare."

"It tells a story that unfortunately is universal," she said. "Violence by intimate partners is one of the most serious challenges to women's health."

Countries included in the study, released Thursday, were: Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia and Montenegro, Thailand, Bangladesh and Tanzania.

North America and Western Europe were not included because earlier studies had already examined the situation there.

In the WHO study, rates varied between 15 percent of women having been a victim of domestic violence during their lifetimes in Japan to 71 percent in Ethiopia.

Previous research has found rates of about 20 percent in the United States and Sweden and 23 percent in Canada and Britain, said one of the researchers, Lori Heise of PATH.

Even though the lifetime risk of violence was similar in many nations, women in developed countries were less likely to be currently suffering abuse than were women in developing countries.

The percentage of women who had been attacked by their partners in the preceding year was 4 percent in Japan and in Serbia and Montenegro, compared with between 30 percent and 54 percent in Bangladesh, Ethiopia, Peru and Tanzania.

"There are lots of ways you can interpret that. It might be that there's less violence in more industrialized settings now, but it also suggests that women in richer countries are able to get out of relationships," Heise said.

The study found that the health impact of domestic violence went well beyond injuries.

Women who had experienced physical or sexual violence by a partner at some point during their lives were more likely to report poor general health at the time of the interview, the study found.

They were more likely to have pain, dizziness, gynecological conditions and mental health problems. They were more likely to have considered or attempted suicide and they were more likely to have had a miscarriage or an induced abortion, said the study's coordinator, Dr. Claudia Garcia-Moreno of the World Health Organization.

"Overall, the likelihood that a woman who has been abused would experience one of these health outcomes was between 1.5 and 3 times higher than for women who had never been abused," she said.

One of the most striking findings of the study was how consistent this link was across all settings, Garcia-Moreno said.

"Whether you are a cosmopolitan woman in Sao Paolo or Belgrade, or you are a rural woman in Ethiopia or Bangladesh, the association between violence and poor health is there," she said.

In rural Ethiopia, where two-thirds of women experience domestic violence, the impact on health was very similar to that seen in Britain, where 4 percent of women are experiencing violence, Heise added.

The researchers said they hope the study will arm activists with new evidence and spur governments not only to take notice, but to take action.