142nd APHA Annual Meeting and Exposition

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308944
Forgone healthcare and intimate partner violence: A study in six European urban centres

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 2:30 PM - 2:50 PM

Diogo Costa , Institute of Public Health of the University of Porto, Porto, Portugal
Eleni Hatzidimitriadou , Faculty of Health and Social Care Sciences, Kingston University and St George's, University of London, London, United Kingdom
Elli Ioannidi-Kapolou , Department of Sociology, National School of Public Health, Athens, Athens, Greece
Jutta Lindert , University of Emden, Emden, Germany and Brandeis University, Waltham, United States of America., Emdem, Germany
Joaquim Soares , Institution for Health Sciences, Mid Sweden University, Sundsvall, Sundsvall, Sweden
Örjan Sundin , Department of Psychology, Mid Sweden University, Östersund, Östersund, Sweden
Olga Toth , Institute of Sociology, Hungarian Academy of Sciences, Budapest, Budapest, Hungary
Henrique Barros , Institute of Public Health of the University of Porto, Porto, Portugal
Background: Victims of intimate partner violence (IPV) are known to refrain from seeking care when in need. Whether the impact on forgone care differs according to the victim-perpetrator role remains unexplored. We aimed to describe the relation between past-year IPV and forgone healthcare according to victims, perpetrators or both (bidirectional).

Methods: Adult men and women (n=3496, aged 18-64), randomly sampled from the general population of Athens, Porto, London, Budapest, Östersund and Stuttgart were assessed using a common questionnaire. IPV was ascertained with the Revised-Conflict-Tactics-Scales. The association between IPV and forgone healthcare (“Have you been in need of a certain care service in the past year, but did not seek any help?”), sociodemographics (sex, age, education, city) and health factors (self-assessed health, public or private healthcare sector use), in victims, perpetrators and both was estimated using adjusted logistic regression odds ratios (AOR, 95% confidence intervals).

Results: Forgone healthcare ranged from 12.6% (Budapest) to 22.4% (Stuttgart) and was associated with bidirectional involvement in IPV (AOR, 95%CI= 1.37, 1.05-1.78). A lower educational level was associated with forgone care in multivariate models fitted for victims of and for bidirectional involvement in IPV. A fair/poor self-assessed health (contrasting to a good/very good/excellent health) was significantly associated with forgone care in victims (AOR, 95%CI=2.61, 1.96-3.47), in bidirectional IPV (AOR, 95%CI=2.94, 2.27-3.82) and for perpetrators (AOR, 95%CI=2.58, 1.96-3.40).

Conclusion: Beside the known barriers identified for inequalities and access to healthcare, the role of IPV in forgone healthcare should be considered.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify different patterns of involvement in intimate partner violence and describe how they associate with delaying, postponing or forgoing care.

Keyword(s): Health Care Access, Violence & Injury Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student in Public Health who has been involved in all stepts of the development of the project DOVE (www.doveproject.eu), an European multi-centre study designed to assess intimate partner violence, determinants and health consequences in men and women. My PhD thesis is based on data gathered in the scope of this project.
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.