15 April 2002
Binge drinking, sensible drinking, adstinence after alcohol-related vehicular crashes: the role of intervention versus screening.
- Sommers MS, Dyehouse JM, Howe SR. Proc Assoc Adv Automot Med Conf 2001;45:317-328.
Correspondence: MS Sommers, College of Nursing and Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA.
Brief interventions have been shown to reduce problem drinking in a variety of populations and settings. The hypothesis for our randomized trial was that individuals injured in alcohol-related crashes who received a more intensive intervention (brief counseling) would have reduced binge drinking as compared to those with a less intensive intervention (simple advice) and controls. Non-alcohol dependent, seriously injured individuals (N=186) were enrolled in the protocol. At baseline, mean binges/month (b/m) were 5.88 and at 12 months were 2.02 b/m. Although there was no significant difference by condition, at 12 months the brief counseling group had the lowest rate of binge drinking (1.97 b/m). Whether these drinking patterns were a result of the crash, injury, screening for alcohol use, or combination of these factors is difficult to determine.
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No reports this week
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State level estimates of the incidence and economic burden of head injuries stemming from non-universal use of bicycle helmets.
- Schulman J, Sacks J, Provenzano G. Inj Prev 2002; 8(1):47-52.
Correspondence: Jane Schulman, Battelle Memorial Institute, Centers for Public Health Research and Evaluation, Atlanta, GA 30341, USA (email: schulman@battelle.org).
OBJECTIVE: To develop national and state level estimates for preventable bicycle related head injuries (BRHIs) and associated direct and indirect health costs from the failure to use bicycle helmets.
METHODS: Information on the effectiveness and prevalence of use of bicycle helmets was combined to estimate the avoidable fraction, that is, the proportion of BRHIs that could be prevented through the use of bicycle helmets. The avoidable fraction multiplied by the expected number of BRHIs gives an estimate of the number of preventable cases. Direct and indirect health costs are estimated from a social perspective for the number of preventable BRHIs to assess potential cost savings that would be achieved if all riders wore helmets.
RESULTS: Approximately 107,000 BRHIs could have been prevented in 1997 in the United States. These preventable injuries and deaths represent an estimated $81 million in direct and $2.3 billion in indirect health costs. Estimates range from 200 preventable BRHIs and $3 million in health costs in Wyoming (population 480,000) to 13,700 preventable BRHIs and $320 million in health costs in California (population 32.3 million).
CONCLUSIONS: A number of successful approaches to increasing bicycle helmet use exist, including mandatory use laws and community based programs. The limited use of these strategies may be related to the fact that too little information is available to state agencies about the public health and economic burden of these preventable injuries. In conjunction with information on program costs, our estimates can assist state planners in better quantifying the number of preventable BRHIs and the costs and benefits of helmet promotion programs.
Effects of state helmet laws on bicycle helmet use by children and adolescents.
- Rodgers GB. Inj Prev 2002; 8(1):42-46.
Correspondence: Gregory B. Rogers, Directorate for Economic Analysis, US Consumer Product Safety Commission, Washington, DC 20207, USA (email: grodgers@cpsc.gov).
OBJECTIVE: To evaluate the effectiveness of state helmet laws in increasing the use of bicycle helmets by children and adolescents under age 16.
METHODS: A cross sectional study of factors associated with the likelihood of helmet use by children and adolescents. Data were derived from a national (USA) random digit dial telephone survey of bicycle riders. A multiple logistic regression analysis was used to quantify the independent effect of the state helmet laws on helmet use.
RESULTS: Helmet use was systematically related to the presence of state helmet laws (odds ratio 2.65; 95% confidence interval (CI) 1.29 to 5.44). The increase in the average probability of helmet use attributable to state helmet laws was 18.4% (95% CI 17.8% to 19.0%).
CONCLUSIONS: State helmet laws significantly increase helmet use by children and play an important part in any comprehensive effort designed to achieve this goal.
See abstract under Reports of Injury Occurrence and Costs
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Snowmobile injuries in Svalbard--a three spare year study.
- Ytterstad B, Norheim J. Int J Circumpolar Health 2001; 60(4):685-695.
Surgical Department, Harstad hospital, Norway (email: borgey@online.no).
OBJECTIVE: To survey snowmobile injury events treated in Longyearbyen hospital, Svalbard and to report the injury distribution and characteristics for Svalbard residents and visitors driving snowmobiles. DESIGN- Prospective injury recording.
METHODS: SETTING- The Norwegian arctic archipelago, Svalbard during three years from 8 March 1997. PARTICIPANTS- The person years of the study, estimated from yearly census data on Svalbard residents, were 4211. In 1998 the number of registered snowmobiles were 1342, of which about 250 were available for use to visitors. MEASUREMENTS- The variables were selected and coded according to the Nordic system.
RESULTS: Of 107 snowmobile injuries recorded, 85 occurred during March-May (79.4%). Nine out of ten injuries occurred during leisure driving. Visitors (N=51) had peak injury frequency in the agegroup 30-39 and an injury rate of 68.0 per 1000 registered vehicles per year. Residents had a corresponding peak in the 20-29 agegroup and injury rate four times lower. The upper (23.4%) and lower (22.5%) extremities were the most commonly injured. 32 injuries were non-minor. Of these, 7 had multiple injuries.The most seriously injured had ruptured abdominal organs (spleen, kidney) or fractures of long bones. There were no fatalities.
CONCLUSION: The snowmobile injury rate per 1000 registered vehicles in Svalbard is three times higher for residents (17.4) than in Swedish Lappland. The injury rate for Svalbard visitors is four times higher than the resident rate. Eight out of ten snowmobile injuries occurred during March-May. Continuous prospective hospital recording of snowmobile injuries continues in Svalbard and will enable evaluation of preventive measures targeted as a result of the present study.
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No reports this week
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State level estimates of the incidence and economic burden of head injuries stemming from non-universal use of bicycle helmets.
- Schulman J, Sacks J, Provenzano G. Inj Prev 2002; 8(1):47-52.
Correspondence: Jane Schulman, Battelle Memorial Institute, Centers for Public Health Research and Evaluation, Atlanta, GA 30341, USA (email: schulman@battelle.org).
OBJECTIVE: To develop national and state level estimates for preventable bicycle related head injuries (BRHIs) and associated direct and indirect health costs from the failure to use bicycle helmets.
METHODS: Information on the effectiveness and prevalence of use of bicycle helmets was combined to estimate the avoidable fraction, that is, the proportion of BRHIs that could be prevented through the use of bicycle helmets. The avoidable fraction multiplied by the expected number of BRHIs gives an estimate of the number of preventable cases. Direct and indirect health costs are estimated from a social perspective for the number of preventable BRHIs to assess potential cost savings that would be achieved if all riders wore helmets.
RESULTS: Approximately 107,000 BRHIs could have been prevented in 1997 in the United States. These preventable injuries and deaths represent an estimated $81 million in direct and $2.3 billion in indirect health costs. Estimates range from 200 preventable BRHIs and $3 million in health costs in Wyoming (population 480,000) to 13,700 preventable BRHIs and $320 million in health costs in California (population 32.3 million).
CONCLUSIONS: A number of successful approaches to increasing bicycle helmet use exist, including mandatory use laws and community based programs. The limited use of these strategies may be related to the fact that too little information is available to state agencies about the public health and economic burden of these preventable injuries. In conjunction with information on program costs, our estimates can assist state planners in better quantifying the number of preventable BRHIs and the costs and benefits of helmet promotion programs.
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Elderly suicide rates in Asian and English-speaking countries.
- Pritchard C, Baldwin DS. Acta Psychiatr Scand 2002; 105(4):271-275.
Department of Mental Health, Faculty of Medicine, Health and Biological Sciences, University of Southampton, Southampton, UK.
OBJECTIVE: Asian culture venerates elderly people. It was hypothesized that elderly suicides would be proportionately lower in Asian societies than in English-speaking countries (ESC).
METHODS: Elderly (i.e. aged 75 years or more) to general population suicide ratios were compared for six Asian societies and six ESC, based upon the latest 5-year suicide rates.
RESULTS: Males: The general population suicide rate was highest in rural China (227 per million) and third highest in Japan (217 per million), but other countries with high rates were all ESC (ranging from 224 to 198 per million). Asian countries had the six highest elderly suicide rates, 1327-1373 per million, whilst the highest ESC elderly rate was in the United States (507 per million). Asian societies had the widest range of elderly/general ratios, ranging from 6.62 to 2.6. Females: The overall suicide rates were higher in Asian countries (57-95 per million) than in ESC (40-56 per million). Asian elderly suicide rates differed (932 per million in rural China to 154 per million in Korea) but the highest ESC rate was in Australia (76 per million). The Asian countries elderly/general ratios ranged from 5.82 : 1 to 2.70 : 1, but the widest ESC ratio was 1.71 : 1, in the United Kingdom.
CONCLUSIONS: There is a need for country-specific prevention measures in elderly people, and particularly for older women in Asian countries.
The Youth Self-Report (YSR) and the Depression Self-Rating Scale (DSRS) as measures of depression and suicidality among adolescents.
- Ivarsson T, Gillberg C, Arvidsson T, Broberg AG. Eur Child Adolesc Psychiatry 2002; 11(1):31-37.
Correspondence: Tord Ivarsson, Department of Child- and Adolescent Psychiatry, Goteborg University, Sweden (email: tord.ivarsson@vgregion.se).
Two hundred and thirty-seven adolescents from a junior high school in a small community outside Goteborg, Sweden, completed the Youth Self Report (YSR) and the Depression Self Rating Scale (DSRS). Self-reported suicidality and biographical data were also recorded. The school doctor and nurse assessed the adolescents' somatic, psychological and behavioural problems using school health-records. The convergent validity of the YSR total problems scale and syndrome scales were tested against the DSRS. Discriminant validity was assessed by the two measures' ability to predict suicidality and school health problems. The Internalising (r = 0.65**) and Anxious/Depressed (r= 0.61**) syndrome scales of the YSR had the highest correlations with the DSRS. However, all YSR syndrome scales were significantly, though more modestly, correlated with the DSRS. Using stepwise logistic regression analysis, four YSR sub-scales [Social Withdrawal, Anxious/Depressed, Attention problems and Delinquency] predicted mild-severe self-reported depression (DSRS scores 12 and above). The YSR syndrome scales Anxious/Depressed and Delinquency predicted suicide ideation whereas the Self-destructive/Identity problem and Social Withdrawal (low scores) scales predicted Suicide attempts. The YSR Anxious/Depressed sub-scale and the DSRS total score seem to measure a similar dimension. However, the Anxious/Depressed and Selfdestructive/Identity problem scales were superior in predicting suicidality.
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Three year injury crash records of new licensees with suspensions or invalidity periods lasting 90 days or more.
- Maag U, Laberge-Nadeau C, Desjardins D, Messier S, Morin I. Proc Assoc Adv Automot Med Conf 2001;45:387-401.
Laboratory on Transportation Safety, Center for Research on Transportation, Universite de Montreal, Montreal, Quebec, Canada.
A subset of new licensees, namely the ones with suspensions or invalidity periods of at least 90 days are studied. This subpopulation is comprised of 3,550 men and 1,295 women for whom the study file contains age, gender, licensing exam performance, and the dates all police reported crashes for the first three years after licensing. This group is compared with the complementary subpopulation of 53,069 men and 58,464 women. The average injury crash rate per year, not prorated, is 0.057 for men and 0.033 for women, about twice the rate for those without lengthy suspensions. These licensees are older, have lower success rates at licensing exams, and have a longer learning period than the others. Separate logistic-normal regression models for men and for women are estimated for the probability of a collision in a year using the available explanatory variables.
Toll road crashes of commercial and passenger motor vehicles.
- Braver ER, Solomon MG, Preusser DF. Accid Anal Prev 2002; 34(3):293-303.
Correspondence: E.R. Braver, Insurance Institute for Highway Safety, Arlington, VA 22701-4751, USA. ebraver@iihs.org
Revenue-collection data from toll roads allow for accurate estimates of miles driven by vehicle type and, when combined with crash data, valid estimates of crash involvements per mile driven. Data on vehicle-miles traveled and collisions were obtained from toll road authorities in Florida. Kansas, and New York. In addition, state crash files and published vehicle-miles of travel were obtained for toll roads in Illinois. Indiana, Ohio, and Pennsylvania. Large commercial motor vehicles were significantly underinvolved in single-vehicle crashes on all state toll roads. In five states, commercial motor vehicles were significantly overinvolved in multiple-vehicle crashes relative to passenger vehicles; the exceptions were Kansas, where they had significantly lower multiple-vehicle involvement rates, and Indiana. where there were no significant differences in multiple-vehicle involvements by vehicle type. The risk of commercial motor vehicle involvement in multiple-vehicle crashes resulting in deaths or serious injuries was double that of passenger vehicles in the two states (Ohio and Pennsylvania) that identified serious injuries. Whether crash rates, on toll roads of commercial motor vehicles are higher or lower than those of passenger vehicles appears to depend on the type of crash, specific toll road. and traffic density.
Male and female car drivers - differences in collision and injury risks.
- Welsh R, Lenard J. Proc Assoc Adv Automot Med Conf 2001;45:73-91.
Correspondence: R. Welsh, Vehicle Safety Research Centre, Loughborough University, UK.
Crash data from two UK resources were examined for differences between male and female passenger car drivers in collision circumstances and injury outcomes. The proportion of female car licence holders is growing, women are more likely to be the driver in a collision and are more vulnerable to injury particularly neck strain. Women drive smaller, lighter cars compared to men and are more often the driver of the smaller vehicle in a multivehicle collision. Vehicle design, crash testing programmes and regulation, currently based heavily on the average male, should give more balanced consideration to female characteristics in future activities.
The effect of seat positioning on risk of injury for children in side impact collisions.
- Durbin DR, Elliott M, Arbogast KB, Anderko RL, Winston FK. Proc Assoc Adv Automot Med Conf 2001; 45:61-72.
Correspondence: D.R. Durbin, The Department of Pediatrics, The Children's Hospital of Philadelphia, The Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine.
The objective of this study was to evaluate the effect of seating position on risk of injury to children in side impact crashes. 5,632 children under age 16 in side impact crashes were enrolled as part of an on-going crash surveillance system which links insurance claims data to telephone survey and crash investigation data. Children seated in the front seat were at higher risk of significant injury than children seated in the rear (OR = 2.2 95% CI (1.2-3.8)). After adjusting for age, restraint use, and vehicle damage, children in the front seat were more likely to be injured (OR 2.6 95% CI (1.1-6.2)) than children seated in the rear when the child was sitting near the side of the impact. These results highlight the importance of evaluating the safety performance of both vehicles and restraint systems for children in side impact crashes.
Rear seating and risk of injury to child occupants by vehicle type.
- Winston FK, Durbin DR, Kallan MJ, Elliott MR. Proc Assoc Adv Automot Med Conf 2001; 45:51-60.
Correspondence: F.K. Winston, TraumaLink and the Department of Pediatrics, The Children's Hospital of Philadelphia, The University of Pennsylvania School of Medicine.
The safety of rear-seated child passengers was evaluated across vehicle types. 113,887 children under age 16 in crashes were enrolled as part of an on-going crash surveillance system which links insurance claims data to telephone survey and crash investigation data. Children in the second row suffered less significant injuries than those in the front in all vehicle types except compact extended cab pickup trucks in which the risk for children in the rear was 13% as compared to 2.8% for front-seated occupants. Further research is needed to identify the child and vehicle characteristics which might explain this increased injury risk.
Factors influencing the access of severely injured children and elderly patients involved in motor vehicle collisions to trauma center care.
- Lane P, Sorondo B, Baez AA. Proc Assoc Adv Automot Med Conf 2001; 45:251-267.
Correspondence: P. Lane, Albert Einstein Medical Center, Department of Emergency Medicine, Philadelphia, PA, USA.
This study was undertaken to determine factors that influence the access to trauma center care of pediatric and geriatric patients injured in motor vehicle collisions (MVC). Hospital discharge records for 1997 were obtained from the Pennsylvania Health Care Cost Containment Council and were analyzed. Of cases with an Injury Severity Score of >15, 52.6% of elderly cases and 48.6% of pediatric cases were transported to and received their care in non-trauma center hospitals. These very high "mis-triage" rates could not be explained by differences in injury severity, body region or population density. In order to assess potential out-of-hospital factors, a file containing matched records from Emergency Medical Services (EMS) calls and hospital discharges from MVC cases across Pennsylvania for the year 1996 was constructed and analyzed. There were no significant vital signs differences between trauma center and non-trauma center cases, with the single exception of the Glasgow Coma Scale score, for both the pediatric and geriatric age groups. A reevaluation of out-of-hospital trauma triage is needed.
Can police car colored flash light induce electroencephalographic discharges and seizures?
- Gadoth N, Vainstein G, Yoffe V. Clin Electroencephalogr 2002; 33(1):48-50.
Correspondence: N. Gadoth, Department of Neurology, Sapir Medical Center, Meir General Hospital, Kfar-Saba, Israel.
BACKGROUND: To explore the epileptogenic potential of a newly introduced police car flash light device (930 Heliobe Lightbar).
METHODS: A 930 Heliobe Lightbar was installed in the EEG laboratory. Thirty patients with known epilepsy, 30 subjects with chronic headache who were otherwise healthy and 15 healthy volunteers were examined.
RESULTS: All the subjects signed an informed consent and underwent an EEG during which photostimulation was performed with the standard stroboscope and later with the Police lightbar. In all 75 examined the lightbar did not induce clinical or electrographic seizures. In a single patient with epilepsy the lightbar enhanced epileptiform activity induced by standard photic stimulation.
CONCLUSION: In this study the new Police lightbar was found to be non-epileptogenic.
Preliminary evaluation of wheelchair occupant restraint system usage in motor vehicles.
- van Roosmalen L, Bertocci GE, Hobson DA, Karg P. J Rehabil Res Dev 2002; 39(1):83-93.
Correspondence: Linda van Roosmalen, Department of Rehabilitation Science and Technology, University of Pittsburgh, PA 15260, USA (email: lvanroos@pit.edu).
Individuals using wheeled mobility devices (WMDs) often use them as motor vehicle seats during transportation. Wheelchair occupant restraint systems (WORSs), consisting of upper torso and pelvic restraints, are usually mounted to the structure of transit vehicles to secure individuals within their wheelchair seats. This preliminary study attempts to evaluate the use and satisfaction of currently installed vehicle-mounted WORSs for individuals using WMD as seats in motor vehicles. A survey was conducted among 33 adults who use their WMD to travel in motor vehicles. Results from the survey showed that upper torso and pelvic restraints installed in private vehicles are quick, comfortable, and easy to use. However, WORS installed in mass transit and paratransit are often uncomfortable to wear, difficult to reach, and time-consuming to use. This preliminary study documents the growing need for developing alternative WORS that are safe, comfortable, and that allow independent usage for wheelchair occupants while traveling in a motor vehicle.
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Prevalence and patterns of intimate partner violence among adolescent mothers during the postpartum period.
- Harrykissoon SD, Rickert VI, Wiemann CM. Arch Pediatr Adolesc Med 2002 Apr;156(4):325-330.
Correspondence: C.M. Wiemann, Department of Pediatrics, Section of Adolescent and Sports Medicine, Baylor College of Medicine, 6621 Fannin St, CC610.01, Houston, TX 77030-2399 USA (email: cwiemann@bcm.tmc.edu).
OBJECTIVE: To examine prevalence, frequency, severity, and patterns of intimate partner violence (IPV) during the first 24 months' post partum within a multiethnic cohort of adolescents.
METHODS: DESIGN- A prospective study of adolescent girls followed up for 24 months into the postpartum period. Follow-up surveys were completed at 3, 6, 12, 18, and 24 months' post partum. Overall, 74% completed at least 4 of the 5 follow-up surveys. SETTING- Postpartum unit at a university teaching hospital in Galveston, Tex. PARTICIPANTS- A total of 570 adolescents (18 years or younger; 219 Mexican Americans, 182 African Americans, and 169 European Americans) completed face-to-face interviews within 48 hours of delivery and returned at least 4 of 5 follow-up surveys. MAIN OUTCOME MEASURES- Prevalence of IPV and frequent and severe IPV.
RESULTS: Prevalence of IPV was highest at 3 months' post partum (21%) and lowest at 24 months (13%). The percentage of assaulted mothers who experienced severe IPV increased from 40% to 62% across this period. Seventy-five percent of mothers reporting IPV during pregnancy also reported IPV within 24 months following delivery. Of importance, 78% who experienced IPV during the first 3 postpartum months had not reported IPV before delivery. Ethnic differences in IPV were observed at 3, 6, and 18 months' post partum.
CONCLUSIONS: Adolescents are at high risk for experiencing IPV during the postpartum period. Frequent screening for IPV by health care practitioners is critical to maximize detection.
Intimate Partner Violence and Women of Color: A Call for Innovations.
- Lee RK, Thompson VL, Mechanic MB. Am J Public Health 2002; 92(4):530-534.
Correspondence: Roberta K. Lee, Barnes College of Nursing and Health Studies, University of Missouri, St Louis MO, USA (email: bobbie_lee@umsl.edu).
In this commentary, we focus on violence against women of color. Although African American women experience higher rates of intimate partner homicide than White women, the cumulative rates for nonfatal intimate partner violence are similar and do not vary between urban and rural locations (though access to services may vary by location). Much of the research about intimate partner violence is based on women with low socioeconomic status and on interventions that were developed by and for White women. Current primary prevention strategies focus on violence that is perpetrated by strangers rather than their primary perpetrators-intimate partners. We recommend the development and rigorous evaluation of prevention strategies that incorporate the views of women of color and attention to primary prevention.
Missed opportunities: intimate partner violence in family practice settings.
- Coker AL, Bethea L, Smith PH, Fadden MK, Brandt HM. Prev Med 2002; 34(4):445-454.
Correspondence: A.L. Corker, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA.
BACKGROUND: For women experiencing partner violence, women health care visits represent opportunities for physicians and patients to address intimate partner violence (IPV), a significant health threat for women.
OBJECTIVES: The objectives were to estimate rates of physician documentation of IPV in medical records; characterize IPV+ women most likely to have IPV documented; and determine whether IPV screening increased IPV documentation.
METHODS: Subjects were women ages 18-65 receiving primary care in two large family practice clinics. All were screened for IPV by study staff using a modified Index of Spouse Abuse and the Women's Experience with Battering scales. We selected and abstracted medical records for all women experiencing current IPV (N = 144) and a random sample of women never experiencing IPV (N = 147).
RESULTS: Of 144 women screened as currently experiencing IPV, 14.7% were documented. Women most likely to have IPV documented were Caucasian, with higher WEB scores, and more likely to have an event that could trigger posttraumatic stress syndrome. Although the majority (41/56) of women currently in physically violent relationships did not plan to disclose IPV, those disclosing were significantly more likely to have IPV documented and documentation occurred after screening for 60% of women experiencing IPV.
CONCLUSIONS: IPV screening increased documentation. IPV screening can provide the opportunity for patients to disclose IPV. Physicians then have the opportunity to compassionately connect patients with appropriate resources.
Acceptability of asking patients about violence in accident and emergency.
- Howe A, Crilly M, Fairhurst R. Emerg Med J 2002; 19(2):138-140.
Correspondence: A. Howe, East Lancashire Health Authority, Nelson, UK North Liverpool PCT, Liverpool, UK Lancashire Ambulance Service and NHS Direct, Lancashire, UK.
OBJECTIVES: To assess the acceptability to patients attending accident and emergency (A&E) of routine questioning about violence.
METHODS: A questionnaire survey (15 questions; 5 point Likert scale) was distributed to a representative sample of all adult patients attending a district general hospital A&E department, Lancashire, England over a seven day period.
RESULTS: 303 questionnaires were distributed and 281 returned questionnaires were available for analysis. Some 67% (95%CI 60% to 74%) of patients agreed that people attending A&E should routinely be asked about whether they have been assaulted. Altogether 89% (95%CI 85% to 93%) thought that health care staff should encourage victims of abuse or violence to inform the police, while 74% (95%CI 68% to 80%) thought that health care staff should routinely inform the police. While only 45% (95%CI 36% to 54%) of patients thought that people who had been assaulted would be likely to tell if asked, 81% (95%CI 76% to 86%) thought that if they themselves were victims they would tell if asked directly.
CONCLUSIONS: Patients attending A&E departments support routine questioning by doctors and nurses about violence. They also support health professionals routinely informing the police in cases of violence. Further research is required into the outcomes of routine and direct questioning in A&E of patients about their exposure to violence.
Multistate analysis of factors associated with intimate partner violence.
- Vest JR, Catlin TK, Chen JJ, Brownson RC. Am J Prev Med 2002; 22(3):156-164.
Correspondence: Saint Louis University School of Public Health, Department of Community Health, St. Louis, Missouri, USA
BACKGROUND: Reports on prevalence estimates and risk factors of intimate partner violence (IPV) are limited in that they (1) focus on specific subgroup populations that are not representative of all women or (2) involve long questionnaires that are not useful as surveillance tools.
OBJECTIVES: To report prevalence estimates and identify demographic and lifestyle factors associated with IPV in a large population-based sample of U.S. women using surveillance data.
METHODS: Behavioral Risk Factor Surveillance System (BRFSS) data from eight U.S. states were analyzed individually and as a pooled sample (N=18,415). Multivariate logistic regression models were used to examine associations between IPV and the factors of interest.
RESULTS: Factors consistently associated with IPV across the majority of states and in the pooled analysis included young age (pooled adjusted odds ratio [aOR], 3.07), single marital status (pooled aOR, 2.89), divorced/separated marital status (pooled aOR, 4.67), and annual household income < $25,000 (pooled aOR, 1.89). In addition, lack of health insurance, receipt of Medicaid, cigarette smoking, presence of children in the home, self-reported fair/poor health, and frequent mental distress were associated with IPV after adjustment for covariates.
CONCLUSIONS: This study provides population-based estimates of IPV prevalence and factors associated with IPV using surveillance data. By pooling BRFSS data from individual states, the resulting large sample has adequate power to detect significant associations and has increased precision in the estimates of IPV risk. In addition, this study identifies high-risk populations to target for education and intervention programs and demonstrates the need for improved IPV surveillance.
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