180644 Interpersonal violent victimization precedes substance abuse among women on welfare: A longitudinal study

Tuesday, October 28, 2008

Rachael A. Korcha, MA , Alcohol Research Group, Emeryville, CA
E. Anne Lown, DrPH , Alcohol Research Group, Emeryville, CA
Laura A. Schmidt, PhD , Institute for Health Policy Studies and Department of Anthropology, History and Social Medicine, University of California, San Francisco, San Francisco, CA
Background: Temporary Assistance to Needy Families (TANF) welfare reform laws emphasize economic independence to combat welfare reliance. This study examines the extent to which interpersonal violence, including domestic violence, rape, physical assault, and child abuse, predicts substance abuse over the course of the study. The combination of violence and substance abuse may inhibit women's ability to function and thereby achieve independence.

Methods: Applicants (N=1235 women) for TANF and local General Assistance (GA) were surveyed in a northern California county during 2002 as part of the Welfare Client Longitudinal Study. Those granted benefits were re-interviewed each year for 4 more years. Interpersonal violent victimization, demographic, work, and health factors were assessed.

Results: Adult violence was reported by 44.8% of women during the five year study. Cumulative partner violence and severe violence (rape or severe physical assault) during the five years was reported by 37.9% and 27.2% respectively. Physical or sexual child abuse was reported by 36.5%. In longitudinal analyses, women reporting severe violence were more likely to report substance use in each subsequent year. Substance abuse was predicted by moderate (OR=1.7; 95% CI 1.0-2.8) and severe child abuse (OR=2.4; 95% CI 1.5-3.8) and severe adult violence (OR=1.8, 95% CI 1.2-2.6). In multivariate analyses child abuse, young age and psychological distress predicted later substance abuse. Discussion: A reported history of violence was associated with subsequent substance abuse. Some of the relationship between adult violence and substance abuse may be accounted for by the strong association between child abuse and substance abuse.

Learning Objectives:
1) Describe the prevalence and pattern of cumulative adult violence among women on welfare in this California county. 2) Understand how adult violent victimization predicts subsequent alcohol use, drug use and substance abuse in general.

Keywords: Welfare, Violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I carried out all analysis and developed the idea for the presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.