More than half (54.7%) of women in New Zealand have experienced violence or abuse by an intimate partner in their lifetime. As we show in our , this increases their risk of developing a mental health disorder almost three times (2.8 times) and a chronic physical illness almost twice (1.5 times).
Author
Janet Fanslow
Associate Professor in Violence Prevention and Mental Health Promotion, University of Auckland
More than 1,400 women from a nationally representative sample from the 2019 New Zealand He Koiora Matapopore told us about their experiences of intimate partner violence and their health. We asked them about chronic health problems (heart disease, cancer, stroke, diabetes and asthma) as well as mental health conditions (depression, anxiety or substance abuse).
We also asked women about their lifetime experiences of physical violence, sexual violence, psychological abuse, controlling behaviour and economic abuse by any partner. We used questions from the World Health Organization – the international gold standard for measuring the prevalence of violence against women.
In addition to the physical and mental health problems described above, women who had experienced any of these types of intimate partner violence had increased risk of poor general health (2 times more likely), recent pain or discomfort (1.8 times more likely) and recent healthcare consultations (1.3 times more likely).
Physical and sexual violence hurts people, but it wasn’t just this type of violence that was associated with increased health problems. Women who experienced psychological abuse, controlling behaviours and economic abuse also had greater risk of adverse health outcomes.
Partner violence increases health risks
It is common for women to experience multiple types of intimate partner violence. One in five women reported experiencing three or more types of partner abuse, and these women had a much higher risk of poor health.
More than one in ten (11%) had experienced four or more types of abuse and these women were over four times more likely to have a mental health condition and double the risk of chronic health problems, compared with women who had not experienced violence by a partner.
Our study reports on lifetime rates of intimate partner violence, but new and recurring violence keeps happening. There were recorded by police in the year to June 2022. People who require police intervention may have even worse health than the women we talked to.
Our findings provide an even stronger rationale for supporting and strengthening strategies to counter the national scourge of intimate partner violence.
Our recommendations
The Manatū Hauora/Ministry of Health’s needs to receive more attention and funding, and Te Whatu Ora/Health New Zealand needs to prioritise implementation.
The programme has developed an infrastructure to provide evidence-based strategies for family violence assessments and intervention. However, it is not well embedded in the health system and needs strong policy, leadership and resourcing to achieve its potential. It also needs to be supported by the health infrastructure to .
Fundamentally, healthcare professionals need to recognise violence experience as a health issue. Effective, regular training about the prevalence and health consequences of intimate partner violence is essential to enable healthcare professionals to help women who have experienced abuse.
This education needs to be embedded in core practitioner training. Universities need to step up to ensure healthcare professionals have the they need to address the issue.
Healing and prevention
We also need to expand our suite of responses. These must include referral options to help women in times of acute danger and crisis, but also to support long-term recovery and healing from abuse.
Increasing capacity to support healing is one of the key shifts recommended by Te Aorerekura, the .
We need to invest in evidence-based prevention strategies and ensure they have comprehensive and equitable coverage across the nation. Prevention is one of the recommendations from Te Aorerekura, but the effectiveness of local efforts could get a significant boost if they tapped into .
Prevention initiatives need to be brave enough to address unhealthy forms of masculinity and discrimination against women and girls. Targeting men’s and boys’ understanding of power and control in relationships and engaging them in violence prevention is both .
Developing and sustaining evidence-based prevention and response programmes to address intimate partner violence will require long-term investment and implementation. However, we are already paying for the health and social costs of intimate partner violence. This money could instead be spent fixing it.
Funding work that leads to healthy, respectful relationships could be the “win” we are all looking for. It would yield multiple benefits, including a healthier population, , better educational outcomes and a .
Our study also looked at . It
showed that while the experience can affect men’s health, it did not consistently contribute to men’s poor health at the population level. However, men who experience partner abuse still need care and support options.
Janet Fanslow has authored the Ministry of Health Family Violence Assessment and Intervention Guideline for Child Abuse and Intimate Partner Violence, and the Ministry of Health Intervention Guideline for Elder Abuse and Neglect.
The research described in this article was funded by the Ministry of Business, Innovation and Employment.
