Recently in 1. What is IPV? Category

The CDC defines IPV as "physical, sexual, or psychological harm by a current or former partner or spouse." [3]

The CDC also separates IPV into four categories: [3]

• Physical violence: This is the intentional use of physical force with the potential for causing death, disability, injury, or harm. Physical violence includes, but is not limited to, scratching; pushing; shoving; throwing; grabbing; biting; choking; shaking; slapping; punching; burning; use of a weapon; and use of restraints or one's body, size, or strength against another person.


• Sexual violence is divided into three categories: 1) use of physical force to compel a person to engage in a sexual act against his or her will, whether or not the act is completed; 2) attempted or completed sex act involving a person who is unable to understand the nature or condition of the act, to decline participation, or to communicate unwillingness to engage in the sexual act, e.g., because of illness, disability, or the influence of alcohol or other drugs, or because of intimidation or pressure; and 3) abusive sexual contact.


• Threats of physical or sexual violence use words, gestures, or weapons to communicate the intent to cause death, disability, injury, or physical harm.


• Psychological/emotional violence involves trauma to the victim caused by acts, threats of acts, or coercive tactics. Psychological/emotional abuse can include, but is not limited to, humiliating the victim, controlling what the victim can and cannot do, withholding information from the victim, deliberately doing something to make the victim feel diminished or embarrassed, isolating the victim from friends and family, and denying the victim access to money or other basic resources. It is considered psychological/emotional violence when there has been prior physical or sexual violence or prior threat of physical or sexual violence. In addition, stalking is often included among the types of IPV. Stalking generally refers to "harassing or threatening behavior that an individual engages in repeatedly, such as following a person, appearing at a person's home or place of business, making harassing phone calls, leaving written messages or objects, or vandalizing a person's property"

From the Centers for Disease Control and Prevention [4], here are four categories of risk factors that increases the chances of an individual becoming a victim of IPV. Risk factors are not causes of IPV but can create an environment where IPV is likelier to develop.

Individual Risk Factors
• Low self-esteem
• Low income
• Low academic achievement
• Young age
• Aggressive or delinquent behavior as a youth
• Heavy alcohol and drug use
• Depression
• Anger and hostility
• Antisocial personality traits
• Borderline personality traits
• Prior history of being physically abusive
• Having few friends and being isolated from other people
• Unemployment
• Emotional dependence and insecurity
• Belief in strict gender roles (e.g., male dominance and aggression in relationships)
• Desire for power and control in relationships
• Perpetrating psychological aggression
• Being a victim of physical or psychological abuse (consistently one of the strongest predictors of perpetration)
• History of experiencing poor parenting as a child
• History of experiencing physical discipline as a child

Relationship Factors
• Marital conflict-fights, tension, and other struggles
• Marital instability-divorces or separations
• Dominance and control of the relationship by one partner over the other
• Economic stress
• Unhealthy family relationships and interactions

Community Factors
• Poverty and associated factors (e.g., overcrowding)
• Low social capital-lack of institutions, relationships, and norms that shape a community's social interactions
• Weak community sanctions against IPV (e.g., unwillingness of neighbors to intervene in situations where they witness violence)

Societal Factors
• Traditional gender norms (e.g., women should stay at home, not enter workforce, and be submissive; men support the family and make the decisions)

Risk Factors for Immigrant & Refugee Communities
In addition to the list by the CDC, these are additional or key risk factors identified for immigrant and refugee communities. [9]
• Both young and old are considered risk factors. The older the victim, the increased risk of lifetime IPV.
• Marital status
• Urban residence
• Low income or financial strain
• Partners' use of substances, especially heavy alcohol consumption

Additionally, the Lifetime Spiral of Gender Violence shows forms of violence against women during their lifetime that specifically ring true to APIs.

• Female victims of IPV report lower levels of health-related QOL than non-abused women.
• IPV victims with post-traumatic stress disorder (PTSD) report significantly more impairment in health-related QOL across various dimensions: physical functioning, role limitations due to emotional problems, vitality, social functioning, and mental health aspects of QOL.[12]

There are a many physical consequences of IPV victims. IPV increases 50 to 70 percent of problems women have with gynecological, central nervous system, and stress-related problems.[3]

Increased occurrences of headaches, back pain, STDs, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, UTIs, appetite loss, abdominal pain and digestive problems were seen in abused women. [3]

From the National Network to End Domestic Violence (NNEDV)[6], here are some facts on the cost of domestic violence.

• The cost of intimate partner violence annually exceeds $5.8 billion, including $4.1 billion in direct health care expenses.
• Between one-quarter and one-half of domestic violence victims report that they lost a job, at least in part, due to domestic violence.
• Women who experienced domestic violence were more likely to experience spells of unemployment, have health problems, and be welfare recipients.
• Domestic violence has been estimated to cost employers in the U.S. up to $13 billion each year.
• In the U.S., rape is the most costly crime to its victims, totaling $127 billion a year including medical costs, lost earnings, pain, suffering and lost quality of life.
• New research shows that intimate partner violence costs a health plan $19.3 million each year for every 100,000 women between the age of 18 and 64 enrolled.

According to our lecture by Susan M. Hadley MPH* on domestic violence, it mandatory to report child and elder abuse. All health care providers can report if they suspect a person is being abused. They are protected under the law if they "report in good faith & exercise due care."

Ms. Hadley also stated that reporting requirements for IPV vary by jurisdiction and states and should be checked with the state attorney general.

*Hadley MPH, Susan M. "Domestic Violence: The Health Provider's Response." PubH 6123. University of Minnesota, Minneapolis. 22 Mar. 2010. Lecture.