A new study has found that domestic violence tends to occur more often when a couple is experiencing financial stress. And while the findings don’t prove a specific cause-and-effect relationship, they do confirm that extreme stressors such as unstable housing and food insecurity should be addressed more often in health care settings.
“What we don’t know yet is whether financial stress makes a violent couple more violent, or is financial stress enough of a disruption in a relationship that violence begins?” saod Corinne Peek-Asa, Ph.D., a corresponding author and director of the Injury Prevention Research Center at the University of Iowa (UI) College of Health. “Both are plausible.”
Though researchers aren’t ready to identify specific interventions for couples that are struggling with finances and domestic abuse, they are beginning to see that stressors beyond health, such as financial strain or unstable housing, may be at the root of some health-related problems.
For the study, researchers looked at data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of adolescents that began in 1994, when participants were in grades seven through 12.
Researchers analyzed the connection between financial stressors and three levels of violence, as reported by 11,499 participants. The researchers gathered data for the UI study in 2008, when participants in the initial study were between the ages of 24 and 32.
Participants reported how often they had committed any level of violence on a scale ranging from “never” to “more than 20 times in the last year.” The three levels of violence were “making threats/minor physical abuse,” “severe physical abuse,” and “physical abuse causing injury.”
They also reported whether they had experienced six types of financial stressors at least once in the past 12 months: nonpayment of utilities, nonpayment of housing, fears of food unavailability, utilities turned off, and eviction.
One significant finding was that more women than men reported feeling stressed financially. More women than men also reported lashing out verbally and physically at their partners. This doesn’t mean, however, that women are more likely than men to react to financial stress with violence, assert the researchers.
Specifically, 27.7 percent of women and 22.9 percent of men experienced at least one type of financial stressor. A higher percentage of women than men also reported experiencing three of the six types of financial stressors.
Furthermore, a greater percent of women than men were unable to pay their utilities (17.6 percent vs. 12.7 percent), reported food insecurity (14 percent vs. 9.9 percent), and experienced disconnected phone service (10.4 percent vs. 7.8 percent).
A similar proportion of both men and women experienced the stressors of housing nonpayment, having utilities turned off, and eviction.
Regarding domestic violence, more women than men reported perpetrating threats/minor physical abuse (11.4 percent vs. 6.7 percent) and severe physical abuse (8.8 percent vs. 3.4 percent). But more men who did commit violence reported causing injury to their partner (32 percent vs. 21 percent). Overall, 92.9 percent of men and 86.7 percent of women reported they had committed no form of violence to their partner in the previous year.
Lead author Laura Schwab-Reese, Ph.D., of the Department of Community & Behavioral Health at the UI College of Public Health, said the data is helpful, but it isn’t conclusive enough to develop interventions.
“So, we know violence happened in the last year, and we know that financial stressors happened in the last year,” she says. “But what we haven’t been able to tease apart with this data is whether the financial stressor happened immediately before a violent episode, or did it exacerbate an already violent relationship? That is a really important point in terms of developing interventions.”
Getting down to the root cause will be key to creating helpful interventions, said Peek-Asa.
“When we are developing interventions, do we need to focus on reducing the event, such as reducing the financial stressor, or do we need to help people manage the stress that happens as a result of the financial stressor?” she said.
Peek-Asa said it’s good timing for these findings, just as more people than ever have access to health care because of the Affordable Care Act. This ruling requires all hospitals to perform a community needs assessment and increase efforts to refer patients to community resources.
The findings could help doctors expand their ideas of what they typically consider health-related stress, from factors such as being overweight, smoking, and drinking, to include such stressors as food insecurity, unpaid bills, and eviction.
“Although hospitals aren’t quite there yet, some of the most important health needs of patients are things like housing, employment services, and financial consulting — things that could reduce financial stress and potentially reduce intimate partner violence,” Peek-Asa said.
The study is published in the journal Injury Epidemiology.
Source: University of Iowa