Unit 11 epidemiology intrafamily violence

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  • Unit 11 epidemiology intrafamily violence

    1. 1. The Epidemiology of Intra-family Violence
    2. 2. Methodological Issues (1) <ul><li>Lack of consensus on definitions of family violence (inclusion of physical, emotional, sexual abuse, neglect) </li></ul><ul><li>Data sources </li></ul><ul><ul><li>Clinical data </li></ul></ul><ul><ul><ul><li>Tend to be small, non-representative samples </li></ul></ul></ul><ul><ul><li>Administrative data (child protective services, police departments, etc.) </li></ul></ul><ul><ul><ul><li>Abuse tends to be underreported </li></ul></ul></ul><ul><ul><ul><li>Substantiated cases may vary based on resources available to investigate </li></ul></ul></ul><ul><ul><ul><li>More frequent contact with public sector services (e.g., welfare, housing) may result in greater surveillance and disproportionate identification </li></ul></ul></ul>Source: Violence in Families: Assessing Prevention and Treatment Programs. R Chalk and PA King, eds; National Academy Press: Washington, DC, 1998.
    3. 3. Methodological Issues (2) <ul><li>Data sources ( ctnd .) </li></ul><ul><ul><li>Surveys </li></ul></ul><ul><ul><ul><li>May find higher rates of violence than administrative data </li></ul></ul></ul><ul><ul><ul><li>But sensitive and taboo nature of the topic may lead to underreporting </li></ul></ul></ul><ul><ul><ul><li>Results vary by question wording and context </li></ul></ul></ul>Source: Violence in Families: Assessing Prevention and Treatment Programs. R Chalk and PA King, eds; National Academy Press: Washington, DC, 1998.
    4. 4. Prevalence of Child Abuse and Maltreatment <ul><li>Reported abuse rates: 1,180 per 100,000 children (1999) </li></ul><ul><ul><li>Highest rates for children ≤3 years </li></ul></ul><ul><ul><li>1.62 deaths per 100,000 children </li></ul></ul><ul><li>Child maltreatment in the past year: 41.6 per 1,000 (NIS-3 government survey) </li></ul>Source: US Department of Health and Human Services. Child Maltreatment 1999: Reports from the States to the National Child Abuse and Neglect Data System. Washington, DC: US Department of Health and Human Services, 2001. Source: Violence in Families: Assessing Prevention and Treatment Programs. R Chalk and PA King, eds; National Academy Press: Washington, DC, 1998.
    5. 5. Risk Factors for Child Abuse <ul><li>Low income </li></ul><ul><li>Low maternal education </li></ul><ul><li>Young maternal age </li></ul><ul><li>Nonwhite ethnicity </li></ul><ul><li>Large family size </li></ul><ul><li>Single parent household </li></ul><ul><li>Parental psychiatric disturbance </li></ul><ul><li>Presence of a step-father </li></ul>Source: Nygren P, Nelson HD, Klein J. Screening children for family violence: A review of the evidence for the US Preventive Services Task Force.
    6. 6. Prevalence of Intimate Partner Violence Against Women <ul><li>Lifetime prevalence: 25-30% </li></ul><ul><li>Annual prevalence: 2-12% </li></ul><ul><li>31% of female homicide victims were killed by intimate partners (Federal Bureau of Investigation, 1993) </li></ul>Source: Wathen CN, MacMillan HL. Interventions for violence against women: Scientific review. JAMA 2003;289:589-600.
    7. 7. Prevalence of Family Violence <ul><li>Against men: </li></ul><ul><ul><li>Past year rate: 1.4 per 1,000 </li></ul></ul><ul><li>Against the elderly: </li></ul><ul><ul><li>Past year rate: 20 per 1,000 </li></ul></ul>Source: Wathen CN, MacMillan HL. Interventions for violence against women: Scientific review. JAMA 2003;289:589-600.
    8. 8. Risk Factors for Perpetrators of Family Violence <ul><li>Young age (18-30 years) </li></ul><ul><li>Low socioeconomic status </li></ul><ul><li>Personality disorders (especially antisocial personality and borderline personality disorder, post-traumatic stress disorder) </li></ul><ul><li>High levels of marital conflict and stress </li></ul><ul><li>Social isolation </li></ul><ul><li>Alcohol use </li></ul>Source: Violence in Families: Assessing Prevention and Treatment Programs. R Chalk and PA King, eds; National Academy Press: Washington, DC, 1998.
    9. 9. Risk Factors for Victims of Family Violence <ul><li>History of violence between spouses </li></ul>Source: Violence in Families: Assessing Prevention and Treatment Programs. R Chalk and PA King, eds; National Academy Press: Washington, DC, 1998.

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