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Abused Women Disclose Partner Interference with Health Care: An Unrecognized Form of Battering

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Abstract

BACKGROUND

Some providers observe that partners interfere with health care visits or treatment. There are no systematic investigations of the prevalence of or circumstances surrounding partner interference with health care and intimate partner violence (IPV).

OBJECTIVE

To determine whether abused women report partner interference with their health care and to describe the co-occurring risk factors and health impact of such interference.

DESIGN

A written survey of women attending health care clinics across 5 different medical departments (e.g., emergency, primary care, obstetrics–gynecology, pediatrics, addiction recovery) housed in 8 hospital and clinic sites in Metropolitan Boston.

PARTICIPANTS

Women outpatients (N = 2,027) ranging in age, 59% White, 38% married, 22.6% born outside the U.S.

MEASUREMENT

Questions from the Severity of Violence and Abuse Assessment Scale, the SF-36, and questions about demographics.

RESULTS

One in 20 women outpatients (4.6%) reported that their partners prevented them from seeking or interfered with health care. Among women with past-year physical abuse (n = 276), 17% reported that a partner interfered with their health care in contrast to 2% of women without abuse (adjusted odds ratios [OR] = 7.5). Further adjusted risk markers for partner interference included having less than a high school education (OR = 3.2), being born outside the U.S. (OR = 2.0), and visiting the clinic with a man attending (OR = 1.9). Partner interference raised the odds of women having poor health (OR = 1.8).

CONCLUSIONS

Partner interference with health care is a significant problem for women who are in abusive relationships and poses an obstacle to health care. Health care providers should be alert to signs of patient noncompliance or missed appointments as stemming from abusive partner control tactics.

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Acknowledgments

The research was supported with a grant to the first author from the Agency for Healthcare Research Quality (AHRQ R01-HS1-1088).

Conflicts of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Merrill Palmer Skillman Institute, Wayne State University, 71 East Ferry Street, Detroit, MI, 48202, USA

    Laura A. McCloskey PhD

  2. Center for Disease Control, Rockville, MD, USA

    Corrine M. Williams ScD

  3. Department of Public Health, Portland, Maine, USA

    Erika Lichter ScD

  4. University of Southern Maine, Portland, ME, USA

    Erika Lichter ScD

  5. Harvard Vanguard, Harvard Medical School, Boston, MA, USA

    Megan Gerber MD, MPH

  6. Abt Associates, Lexington, MA, USA

    Michael L. Ganz PhD

  7. Harvard University School of Public Health, Boston, MA, USA

    Michael L. Ganz PhD

  8. New England Medical Center, Tufts University Medical School, Boston, MA, USA

    Robert Sege MD, PhD

Authors
  1. Laura A. McCloskey PhD
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  2. Corrine M. Williams ScD
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  3. Erika Lichter ScD
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  4. Megan Gerber MD, MPH
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  5. Michael L. Ganz PhD
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  6. Robert Sege MD, PhD
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Corresponding author

Correspondence to Laura A. McCloskey PhD.

Appendix

Appendix

Appendix A

  1. 1.

    In the last 12 months, has a partner:

    1. A.

      Threatened to hurt you?

    2. B.

      Pushed or shoved you?

    3. C.

      Slapped you around your face and head?

    4. D.

      Punched you?

    5. E.

      Threatened you with a gun?

    6. F.

      Physically forced you to have sex?

  2. 2.

    At any time in your life has any partner:

    1. G.

      Hit, slapped, kicked or otherwise physically hurt you?

    2. H.

      Forced you to have sexual activities?

    3. I.

      Made you feel stressed or afraid through threats or violent behavior?

    4. J.

      Made you fear for your safety during arguments?

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McCloskey, L.A., Williams, C.M., Lichter, E. et al. Abused Women Disclose Partner Interference with Health Care: An Unrecognized Form of Battering. J GEN INTERN MED 22, 1067–1072 (2007). https://doi.org/10.1007/s11606-007-0199-z

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  • DOI: https://doi.org/10.1007/s11606-007-0199-z

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