Warwick research uncovers toll domestic abuse has on survivors

As if the human, philosophical case to eliminate domestic abuse from our society was not enough, there is now new research to shed light on the toll that domestic abuse takes on the physical health of survivors.

Domestic abuse consists of physical, psychological, sexual, financial and emotional abuse. It is thought to be extremely common and an estimated 1 in 3 women globally face domestic abuse at some point in their lives. The damages to the mental health of survivors are likely to be more obvious to the general population but there is a lot that we do not understand about how this may affect the physical health of the survivors.

Domestic abuse consists of physical, psychological, sexual, financial and emotional abuse. It is thought to be extremely common and an estimated 1 in 3 women globally face domestic abuse at some point in their lives

A study jointly led by the University of Warwick and the University of Birmingham has concluded that women who face domestic abuse are 44 per cent more likely to die from any cause compared to the general population. It is not fully understood why ‘all-cause mortality’ is higher in domestic abuse survivors, however, the group suspects that this is due to the enhanced cardiovascular risk, which follows the acute and chronic stress in survivors.

Specifically, the team has found that the risk of developing cardiometabolic diseases such as cardiovascular disease and type 2 diabetes is increased by 31 per cent and 51 per cent respectively in domestic abuse victims. Again, it is not established whether this is a causal link or whether domestic abuse leads to incidences of increased alcohol consumption, smoking or a poor diet which in turn leads to cardiometabolic diseases in women. Regardless, there is a connection between the two, although no link was found with hypertension.

It is not fully understood why ‘all-cause mortality’ is higher in domestic abuse survivors

For this study, the researchers used medical records from GP surgeries in the UK and matched women who faced domestic abuse at any point in their lives with those who did not, accounting for factors such as age, body mass index, deprivation levels and smoking status. The researchers then followed the two groups and used their contribution to reach the above-stated findings. The researchers emphasise that the number of patients who died during the study was relatively few, potentially because of the young age of the cohort of 37 years. It was found that the risk of death is 6 per 1,000 women who faced domestic abuse as opposed to 3.1 per 1,000 in groups who did not report any incidents of domestic abuse during their lives.

Not only are the statistics unsettling but there is also a concern regarding the reporting of the incidences of domestic abuse. A discrepancy was found in the reports of domestic abuse in GP surgery records and the national survey data, with an estimated 1 in 4 women having experienced domestic abuse according to the survey data, as opposed to 0.5% coded in GP data. If this is the case, then there is significant under-reporting of domestic abuse.

Not only are the statistics unsettling but there is also a concern regarding the reporting of the incidences of domestic abuse

Not only is this the case for women but for men as well. The researchers mention that records of solely female patients were reviewed because there were very few records available of male domestic abuse survivors. It is not understood whether this is due to a lack of recording of male abuse by clinicians or whether this is due to under-reporting by men.

This research is part of a wider research agenda into the health impacts of domestic abuse and the researchers have welcomed many government-led approaches and also encourage further research and public policy initiatives.

The researchers have applauded the current work of GPs to identify domestic abuse and welcome the recently formed Violence Reduction Units and the Domestic Abuse Bill. They say that these could play a role in supporting survivors as well as providing them with the rights and support that they require. The Violence Reduction Units will bring together different organisations such as the police, local government and other key partners to identify what is driving violent crime and coming up with co-ordinated responses. The Domestic Abuse Bill specifically aims to improve the protection of victims and their children to ensure them the support they require, and to bring offenders to justice.

The Violence Reduction Units will bring together different organisations such as the police, local government and other key partners to identify what is driving violent crime

However, there are also changes that the researchers have called for, but for which robust policies are not yet in place. For example, senior co-author Dr Krish Nirantharakumar, based at the University of Birmingham, emphasises that not only should the government continue to fund and support initiatives that prevent domestic abuse but also additionally invest in initiatives and organisations that provide support to the domestic abuse survivors so they are set on a path to recovery from their terrible ordeal. The researchers have also called for more public health policies to ensure men feel able to come forward and seek support. For an improved understanding of the depth and the dynamics of the problem, it is recommended to have better linkage and sharing of data between public services, such as the NHS and the police, to ensure that the GPs are informed and can support the physical and mental health needs of their patients.

Evidently, there is a great deal of work to be done. The difficulty with domestic violence is that it takes place behind closed doors and does not always display visible scars. Where we are now as a society is working towards creating a culture where everyone can come forward and speak up about domestic abuse. This research sheds light on the economic and public health reasons for taking domestic violence seriously.