Family adversity and health characteristics associated with intimate partner violence
A population-based birth cohort study in England evaluating IPV and family adversities during the first 1,000 days of a child's life.
Published in The Lancet Public Health
Read the full peer-reviewed study detailing clinical characteristics of families affected by IPV.
Intimate partner violence (IPV) is a significant public health issue that affects millions of women worldwide. One in three women experiences IPV, translating to over 800 million women globally. Affected individuals often face significant psychological and physical distress, including restrictions on their autonomy and concerns regarding the safety of their children.
The World Health Organization (WHO) defines IPV as any behaviour causing physical, psychological, or sexual harm within intimate relationships. IPV is often linked to other family adversities and is associated with various mental and physical health problems, increased health and social care needs, and premature death. Despite the increased healthcare needs of affected families, IPV is often unrecorded in general practice, representing a missed opportunity to support vulnerable families.
Key findings
Using a population-based birth cohort of mothers and children linked to electronic health records (EHRs), researchers evaluated IPV and family adversities during the first 1,000 days of a child's life. The study examined associations between different adversities and IPV, assessing the prevalence of parental physical and mental health problems among families with and without IPV.
- Prevalence of adversity: Two in five children and parents had recorded family adversities, while 2.1% had recorded IPV during the study period.
- Compounding factors: The probability of IPV increased with the number of different family adversities. The highest probability was observed in families experiencing three or more adversities.
- Associated health burdens: Families with IPV had significantly increased risks of parental physical and mental health problems compared to families without IPV.
Lead author Dr Shabeer Syed (UCL Great Ormond Street Institute of Child Health), said:
“Our findings highlight the co-occurrence of intimate partner violence with other adverse childhood experiences. It is essential that healthcare professionals are trained to safely ask about IPV and family adversities during clinical encounters to support the safety and well-being of affected families.”
Clinical implications
The study provides valuable insights into the prevalence and associations of IPV and family adversities, offering important implications for early identification and support of affected families through healthcare settings. It emphasizes the need for a comprehensive and integrated approach to address the complex issue of intimate partner violence.
- Healthcare professionals in primary and secondary care settings should systematically ask about IPV when families present with indicators of family adversity or associated health problems.
- A "think-family" approach is important, involving a comprehensive review of both parents' and children's electronic health records to effectively inform clinical responses to IPV.
- Healthcare providers should implement integrated think-family functions in electronic health record systems, allowing clinicians to securely search for adversity across household records.
- National policies should prioritise family-centered interventions to support families experiencing adversity, offering emotional support, risk assessment, safety planning, and appropriate referrals to specialists.
- Adequate training and resources for health and social care professionals are necessary to respond effectively to family adversities and IPV disclosures.
Study limitations
- The low prevalence of recorded IPV (2.1%) may underestimate the actual extent of the problem in the population.
- Some parents may not disclose IPV, leading to underreporting in electronic health records.
- Associations between adversities, health problems, and IPV might reflect surveillance bias rather than true differences in the underlying risk of IPV.
- The study excluded same-sex couples, limiting the generalizability of the findings to these families.
