In CHICAGO, IL -- More than one out of three women treated in community hospital emergency departments say they have experienced domestic abuse during their lifetimes, according to an article in tomorrow's issue of The Journal of the American Medical Association, a theme issue on violence.

Stephen Dearwater, M.S., of the Allegheny University of the Health Sciences in Pittsburgh, and colleagues surveyed 3,455 adult women anonymously in 11 community hospital emergency departments in California and Pennsylvania to determine the prevalence of domestic violence. The survey, which was administered to all consenting women over age 18 who came into the emergency departments for varying health concerns, inquired about physical, sexual and emotional abuse from 1995 to 1997. The researchers found that 36.9 percent of the women surveyed said they have experienced emotional or physical abuse during their lifetime by an intimate partner; 14.4 percent said they have experienced physical or sexual abuse in the past year; and 2.2 percent said they came to the hospital as a result of injuries they suffered from abuse from an intimate partner. The researchers also found that the reported rates of domestic abuse was higher in California than in Pennsylvania.

The researchers also identified four risk factors for physical or sexual injury from abuse within the past year: women between the ages of 18 and 39, who report a monthly income of less than $1,000, who have children younger than 18 years old living in the home and who have ended a relationship within the past year.

Heightened awareness of domestic abuse is needed in hospital emergency departments because these may be the only contacts that many abused women have with health care professionals, according to the researchers. The identification and treatment of abused women by emergency department personnel has received increased attention because of their potential to prevent further abuse. However, past research has shown that only five percent of battered women are detected by emergency departments staff.

"Findings from this study support evidence from previous studies that a significant number of women are seen in [emergency departments] who have experienced [domestic abuse], both during the past year and at any point in their lifetime and that the problem is not limited to large, urban or tertiary care hospitals," the researchers write. "They also illustrate that although community hospitals are encountering significant numbers of abused women, they are not identifying or documenting the abuse.

"Emergency care providers in all health care settings should understand the widespread prevalence of this problem and establish protocols that initiate appropriate screening for [domestic abuse] and address timely plans of action for the treatment, documentation and referral of [domestic abuse] cases to prevent [further abuse] and further health care problems."

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