The effects of violence on a victim’s health are severe. In addition to the immediate injuries from the assault, battered women may suffer from chronic pain, gastrointestinal disorders, psychosomatic symptoms, and eating problems. Although psychological abuse is often considered less severe than physical violence, health care providers and advocates around the world are increasingly recognizing devastating mental health effects of domestic violence, including anxiety, post-traumatic stress disorder, and depression. Women who are abused suffer an increased risk of unplanned or early pregnancies and sexually transmitted diseases, including HIV/AIDS. As trauma victims, they are also at an increased risk of substance abuse. Women are particularly vulnerable to attacks when pregnant, and thus may more often experience medical difficulties in their pregnancies.
Battering imposes significant costs on the community. According to the National Center for Injury Prevention and Control in the United States, the estimated annual direct medical cost of caring for battered women in the United States is $1.8 billion dollars. Another study, reported by UNICEF, estimates the direct cost in the United States to be between five and ten billion dollars annually. From UNICEF, Domestic Violence Against Women and Girls, 6 Innocenti Digest 1, 12 (2000).
As the World Health Organization notes, domestic violence also has significant indirect costs for society. A survey on violence against women in Canada revealed that 30% of battered women had to cease regular activities because of the violence, and 50% had to take sick leave from work because of injuries. A Nicaraguan study found that even after controlling for other factors that could affect earnings, women who were abused earned 46% less than women who were not abused. UNICEF reports that a study in Santiago, Chile, estimates that women who suffer physical violence earn, on average, less than half of the income of women who do not face violence at home.
Domestic violence can be fatal; women are both intentionally murdered by their partners and lose their life as a result of injuries inflicted by them. In particular, recent studies in the United States have focused on choking or strangulation, a tactic often used by batterers. Because choking or strangulation rarely leaves vivid external physical marks, police may not recognize the victim’s need for medical assistance or the seriousness of the violence. Injuries resulting from choking or strangulation can often be lethal; such injuries “may appear mild initially but they can kill the victim within 36 hours.” From When Abusers Choke Their Victims, Violence Against Women 22-5 (Joan Zorza ed., 2002).
In addition to the danger of death from injury or intentional homicides, research also indicates that women who are abused may be more likely to commit suicide. The Family Violence Prevention Fund, reporting on a 1995 study, stated that 29% of all women in the United States who attempted suicide were battered. UNICEF reports that a “close correlation between domestic violence and suicide has been established based on studies in the United States, Fiji, Papua New Guinea, Peru, India, Bangladesh and Sri Lanka. Suicide is 12 times as likely to have been attempted by a woman who has been abused than by one who has not.” From UNICEF, Domestic Violence Against Women and Girls, 6 Innocenti Digest 1, 4 (2000).
The secondary effects of domestic violence involve the victim’s ability to function in daily life. Victims of domestic violence often take more absences from work to visit the doctor. Battering may lead to feelings of shame, embarrassment and humiliation, particularly when beatings leave marks, which in turn may lead to further isolation from friends and family and to absences from work. Because of increased absences and substance abuse, battered women may find it difficult to maintain steady employment. Escaping the violence may require a complete abandonment of job, home and belongings. From Barbara Johnson, Reducing Intimate Partner Abuse: A Look at National, State, and Local Strategies for the Prevention of Domestic Violence (2002).
Other effects include the impact of domestic violence on children, family, friends, co-workers, and the community. Family and friends may themselves be targeted by the abuser in retaliation for helping a woman leave a violent relationship or find assistance.
Children in homes where domestic violence occurs may be witnesses to abuse, may themselves be abused, and may suffer harm “incidental” to the domestic abuse. Understanding the effect of domestic violence on children, and particularly the correlation between spouse and child abuse, is a critical part of an effective community response to violence. Without this basis, programs designed to help children may have unintended and negative effects on battered women, and may not be effective in helping children deal with and recover from witnessing and experiencing abuse.
Domestic violence also contributes to women’s vulnerability to other forms of violence against women. Research conducted by Minnesota Advocates for Human Rights in Moldova and Ukraine revealed that domestic violence may increase women’s vulnerability to trafficking; women who experienced violence at home were more willing to look for and accept an uncertain and potentially risky job abroad.
The World Health Organization’s Factsheet and Violence Against Women: Health Consequences detail the health consequences of violence against women around the world. The National Center for Injury Prevention and Control and the Family Violence Prevention Fund provides an excellent overview of the health effects of domestic violence on women and children.