Spouse or partner abuse, use of health services, and unmet need for medical care in U.S. women

The objective of this study was to examine the relationship of spouse or partner abuse to the use of health services and to unmet need for health care in a representative sample of U.S. women, using a 1993 cross-sectional, nationally representative telephone survey. A total of 1324 women who were between the ages of 18 and 64 and who were married or cohabiting with a man at the time of the survey participated in the study. The main outcome measures were use of health services in the past year; and unmet needs for medical care in the past year. Our results showed that 8.4% of the participants reported being physically abused by their spouse or partner in the past year. Women exposed to spouse abuse were more likely to be young (18 to 24 years), African-American, less educated, poor, and reside in the central city or very rural areas. Those who had a need for health care (as measured by their worse physical and mental health status) and who had less access to health care (as measured by a lower likelihood of having health insurance, a regular doctor, and an increased likelihood of using the emergency room as a primary source of care) were also more likely to report spouse abuse. While there was no difference in the number of visits to physicians in the past year, women exposed to spouse abuse were more likely to report needing and not receiving medical care in the past year. This effect held in a multiple logistic regression model that controlled for predisposing factors, enabling factors, and need for medical care. Spouse/partner abuse is a health care issue. Future research and policy initiatives need to address improving access to health services for abused women and improving problem recognition and care within the health care system.