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Jacquelyn Campbell, PhD, RN; Alison Snow Jones, PhD; Jacqueline Dienemann, PhD, RN; Joan Kub, PhD, RN; Janet Schollenberger, MHS; Patricia O'Campo, PhD; Andrea Carlson Gielen, PhD; Clifford Wynne, MD

Arch Intern Med. 2002;162:1157-1163.

Background  Domestic violence results in long-term and immediate health problems. This study compared selected physical health problems of abused and never abused women with similar access to health care.

Methods  A case-control study of enrollees in a multisite metropolitan health maintenance organization sampled 2535 women enrollees aged 21 to 55 years who responded to an invitation to participate; 447 (18%) could not be contacted, 7 (0.3%) were ineligible, and 76 (3%) refused, yielding a sample of 2005. The Abuse Assessment Screen identified women physically and/or sexually abused between January 1, 1989, and December 31, 1997, resulting in 201 cases. The 240 controls were a random sample of never abused women. The general health perceptions subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey measured general health. The Miller Abuse Physical Symptom and Injury Scale measured abuse-specific health problems.

Results  Cases and controls differed in ethnicity, marital status, educational level, and income. Direct weights were used to standardize for comparisons. Significance was tested using logistic and negative binomial regressions. Abused women had more (P<.05) headaches, back pain, sexually transmitted diseases, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, urinary tract infections, appetite loss, abdominal pain, and digestive problems. Abused women also had more (P.001) gynecological, chronic stress–related, central nervous system, and total health problems.

Conclusions  Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems, with women sexually and physically abused most likely to report problems. Routine universal screening and sensitive in-depth assessment of women presenting with frequent gynecological, chronic stress–related, or central nervous system complaints are needed to support disclosure of domestic violence.

From the School of Nursing (Drs Campbell, Dienemann, and Kub and Ms Schollenberger) and the Departments of Family and Population Sciences (Dr O'Campo) and Health, Policy, and Management (Dr Gielen), School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Md; the Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (Dr Jones); and the Department of Obstetrics and Gynecology, Kaiser Permanente, Washington, DC (Dr Wynne). Dr Dienemann is now with the College of Health and Human Services, The University of North Carolina at Charlotte; and Ms Schollenberger is now with the Department of Environmental Health Sciences, School of Hygiene and Public Health, The Johns Hopkins University.

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