November 25 is International Day for the Elimination of Violence Against Women. The Women’s Ministries Department will use this day to kick off 16 Days of Activism to end violence against women and girls. Below is a story from their “End It Now” campaign. For more information, you can visit their website. You can download a brochure on “Dating and Relationship Violence” here.
Health consequences of violence against women and girls.
Makila is one of 1,260 girls in Congo who die after undergoing genital mutilation each year. Thousands more will suffer infertility or horrible physical deformities that render them outcasts, living in pain for years.
Nancy was raped by her mother’s abusive boyfriend; this type of abuse occurs on average every 17 hours in the United States. Nancy—like thousands of other girls who have been abused—will suffer health problems throughout her life because of this trauma.
Abuse against women and girls causes physical health problems far beyond the primary or most obvious scars, either physical or psychological. Results of abuse will impact victims’ health for years. Violence against women is truly a public health concern.
According to the World Health Organization (WHO), violence against women (VAW) is a widespread experience worldwide with serious public health implications of epidemic proportions. Intimate Partner Violence (IPV) is the most common form of violence against women, and sexual violence, whether by partners, acquaintances or strangers, affects primarily women and girls. Other forms of violence against women include sexual harassment and abuse by authority figures, trafficking for forced labor or sex, and traditional practices such as forced or child marriages and dowry-related violence. Violence against women is often related to social and gender bias and, at its most extreme, may lead to violent death or female infanticide.
A Health Problem that’s Global
The consequences of this human rights violation bring major problems not only for the woman, but also for the family, the community and the world. For the community, VAW remains a hidden problem with great human and health-care costs as a result of underreporting. For each victim, VAW leads not only to bodily injury but also has serious health consequences that can lead to life-long disability or even death.1
Health Consequences for Women
In adult women, violence can lead to many health problems related to stress-induced physiological changes. Some are related to cardiovascular or metabolic problems that result from the chronic stress response that the body is subjected to. Other problems may include substance use, or lack of fertility control and personal autonomy as often seen in abusive relationships.
We know that compared to their non-abused peers, abused women have higher rates of reproductive problems such as:
- unintended pregnancies
- adverse pregnancies and neonatal and infant outcomes
- sexually transmitted infections (including HIV/AIDS)
Intimate Partner Violence (IPV) is the most common form of violence against women. A WHO study in 111 countries found that between 15% and 71% of women (depending on the country) who experienced physical or sexual violence by a husband or partner in their lifetime, had:
- high blood pressure
- high blood glucose
- overweight and obesity
- high cholesterol
- alcohol and substance abuse
- suicidal ideas and actions
These diseases often limit the ability of women to manage other chronic illnesses such as diabetes and hypertension.
Fatalities: Intimate Partner violence may also be fatal. Studies from several countries (Australia, Canada, Israel, South Africa and the United States) show that between 40% and 70% of female murders were carried out by intimate partners.
Additionally, in a recent Center for Disease Control (CDC) report2 in the United States, when compared to men and to women who did not experience abuse, women who experienced rape or stalking by any perpetrator or physical violence by an intimate partner in their lifetime were more likely to report:
- frequent headaches
- chronic pain
- difficulty with sleeping
- activity limitations
- poor physical health
- poor mental health
- irritable bowel syndrome
Health Consequences during Pregnancy
Among pregnant women with a history of abuse, there is a significantly higher rate of complications during pregnancy, such as:
- low weight gain
- first and second trimester bleeding
- suicidal tendencies
- use of tobacco and/or alcohol
- illicit drug use
Health Consequences for Girls
Prevalence of child abuse also has epidemic proportions. Many children of both sexes suffer from physical and emotional maltreatment, sexual abuse, neglect, and commercial or other exploitation. According to the WHO1, the evidence available indicates that girls are far more likely than boys to suffer sexual abuse.
Worldwide, child abuse has both immediate and long-term consequences for the health of women and contributes significantly to:
- alcohol and drug use and dependence
- panic disorder
- post-traumatic stress disorder
- suicide attempts
Harm to Children
In the US, a study of low-income pre-school children in Michigan found that nearly half (46.7%) of the children in the study had been exposed to at least one incident of mild or severe violence in the family.3 Another study shows that fifty percent (50%) of men who frequently assault their wives frequently assault their children also, and the U.S. Advisory Board on Child Abuse and Neglect suggests that domestic violence is likely the single major precursor to child abuse and neglect fatalities.3 In the United States, an important group of studies shows the link between adverse childhood experiences (ACE)5,6 such as abuse, neglect, and witnessed abuse, to negative physical and mental health outcomes later in adulthood.
Compared to kids with no abuse history, kids exposed to abuse had higher risk for:
- cardiovascular disease,
- type 2 diabetes
- disregulated immune system
- substance abuse
- premature mortality
Also noted in US studies were changes in brain structure, such as evidence of smaller frontal lobes, negative psychological consequences and poor mental health outcomes which further influence the body’s stress load, impacting the physical health and quality of life of the trauma survivor.6
Victims and child witnesses of violence often experience fear, shame, guilt, and stigma. These negative emotions contribute to severe burdens of mental and emotional problems, particularly depression and post traumatic stress disorder (PTSD) as noted above.7
Witnessing Domestic Violence
Witnessed abuse is considered by some as serious as child abuse. Certainly, the physical and mental health consequences do testify to that. Children who witness domestic violence are more likely to exhibit behavioral and physical health problems3 including:
- suicide attempts
- drug and alcohol abuse
- post-traumatic stress disorder (such as bed-wetting or nightmares)
- gastrointestinal problems
The above health consequences offer strong evidence that violence against women and girls is a serious public health problem. Prevention strategies and the development of protective factors in women and girls can have a positive impact to reduce these health consequences.
It is important to be aware of the many long-term harmful effect of abuse on the health of women and girls. It is important to recognize how, as a health problem, violence against women weakens our communities and our nations. It is vital to do all in our power to make known the health consequences and the high cost of abuse.
1. World Health Organization (2009). Women and Health Report. Geneva, Switzerland. http://whqlibdoc.who.int/publications/2009/9789241563857_eng.pdf.
2. Center for Disease Control (2011). The National Intimate Partner and Sexual Violence Report. Washington, DC.
3. Futures Without Violence. The Facts on Health Care and Domestic Violence. http://www.futureswithoutviolence.org/userfiles/file/Children_and_Families/HealthCare.pdf
4. Felitti VJ., Anda RF., Nordenberg D., Williamson, DF., Spitz, AM., Koss, MP., Marks, JS. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine 14(4,) 245-58.
5. Shonkoff, JP., Boyce, WT., McEwen, BS.(2009) Neuroscience, molecular biology and the childhood roots of health disparities: Building a new framework for health promotion and disease prevention. JAMA, 301(21):2252-9.
6. Danese, A., McEwen, BS.(2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiology & Behavior, 106(1), 29-39.
7. World Health Organization (2010). UN(DESA): WHO Policy Analysis. allianceforchildrensrights.org/wp-ontent/uploads/2010/09/who_policyanalysis_who_undesa.pdf