| Impact of
Violence Against Women on Their Physical Health
Terri Weaver, Ph.D.
St. Louis University
St. Louis, Missouri
Heidi Resnick, Ph.D.
National Violence Against Women Prevention Research Center
Medical University of
Increasingly, we are learning that violence significantly effects women’s physical and psychological health. The text below outlines the conceptual model relating violence and health. The model is also depicted in a figure entitled "The Direct and Indirect Health Impact of Violence Against Women."
Immediate Physical Injury
Types of Injury
Genital Injury Data
Genital Injuries/Special Population/Elderly Women
A number of studies have consistently found that older rape victims experience significantly more severe genital injury than younger victims, even after controlling for the severity of nongenital injury.
A study by Muram, Miller, and Cutler (1992) compared fifty-three older rape victims (average age 68.8 years) with fifty-three younger rape victims (average age 28.3 years). Both the types of genital injuries and characteristics of the sexual assaults were examined.
A significantly greater number of older victims (50.9%) experienced genital injuries (i.e. 15 vaginal lacerations, 7 hematomas, 5 abrasions, and 2 anal injuries) compared with the younger victims (13.2%). Given that there were not significant differences in the frequency of nongenital injuries, these findings suggest that the increased rate of genital injury is not the result of increased use of force within the population of older rape victims (Muram, Miller, & Cutler, 1992).
Sexually Transmitted Diseases/Overview
Determining whether the disease occurred as a result of the assault or from consensual sexual activity can be difficult. It is important for women to have initial and follow-up sexual assault examinations. See section on Recommended Health Care Guidelines.
One report found higher rates of STDs among women raped in the previous year (38.7%) compared with demographically comparable non-victims (18.7%) (Irwin, Edlin, Wong, et al., 1995).
In spite of the relatively low risk of infection, rape should be considered as a possible source of exposure. Rape victims’ concerns about exposure are important and require attention. See section on Health-Related Concerns.
Direct Health Effects Rape
Indirect Health Effects of Rape
Chronic Stress-Related Physical Complaints
These increased rates continued to be significant even after controlling
for the student's age, parent's education, race or ethnicity, and sorority
While there are studies documenting overuse of health care by victims, there is also information that some victims avoid seeking appropriate health care, particularly important treatment like Pap smears (Springs & Friedrich, 1992). This avoidance may be related to avoidance of distress or anxiety evoked by the medical exam.
Research notes the association between psychological distress and difficulties
with physical health. There are mental health factors that have been proposed
as mediating negative physical health outcomes. They are reviewed in detail
in Resnick, Acierno, and Kilpatrick (1997) and summarized below.
Disorders like substance abuse also have negative implications on health. These disorders also may negatively affect general functioning (e.g. social and occupational). Diminished functioning can lead to a spiral of poverty, unemployment, underemployment, and possible exposure to other high-risk situations.
Psychological distress can be misinterpreted as physical illness, particularly
when certain types of psychological problems include physiological reactions.
These misinterpretations can lead to inappropriate use of medical care
and failure to receive appropriate treatment (figure
one - Adobe
Acrobat required to view or print this document).
Payment for follow-up care varies across states. Sources for state or third party payment include sources such as Crime Victims Compensation. However, often these sources may be used only if victims report the assault to police. This provision excludes many victims from receiving subsidized medical care.
Model programs that provide follow-up by personnel trained in dealing with sexual assault have been developed. One of these programs is the Sexual Assault Follow-up Evaluation (SAFE) at the Medical University of South Carolina in Charleston, South Carolina. This program addresses the medical needs of victims and provides information about mental health and social service resources.
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