Abused women disclose partner interference with health care: An unrecognized form of battering

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. © 2007 Society of General Internal Medicine.