When Closeness Goes Wrong

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A CUP OF HEALTH WITH CDC
When Closeness Goes Wrong
Adverse Health Conditions and Health Risk Behaviors Associated with Intimate
Partner Violence — United States, 2005
February 14, 2008

[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC — safer,
healthier people.

[Dr. Shaw] Welcome to A Cup of Health with CDC, a weekly broadcast of the MMWR,
the Morbidity and Mortality Weekly Report. I’m Dr. Frederic Shaw, Editor of MMWR and
your host for this week.

For decades, scientific studies have shown that closeness and intimacy with another
person is good for your health. But violence between intimate partners can have the
opposite effect. Researchers at CDC recently found that people who experience
violence from an intimate partner can have more chronic diseases. Dr. Michele Black is
a researcher in CDC’s National Center for Injury Prevention and Control, and she
coauthored the research on intimate partner violence. She joins us today to discuss the
issue. Welcome to the show, Michele.

[Dr. Black] Thank you. It’s a pleasure to be here with you.

[Dr. Shaw] Michele, I’m sure intimate partner violence is not a new problem, but is it
becoming better understood these days?

[Dr. Black] Yes. That is correct. Intimate partner violence has been a social issue
throughout history, but over the past several decades, it’s also been recognized as
something that seriously harms the person who experiences it and the children who see
it happen. The bad impact isn’t just what happens at the time of the abuse. For
example, injuries, bruises, the fear that it causes, the loss of self esteem — the impact
can last for months and even years.

[Dr. Shaw] Is intimate partner violence mostly a one-time event or is it an ongoing
occurrence?

[Dr. Black] It certainly can be a one-time event, but that is not what happens most often.
Intimate partner violence can include a lot of different actions, not just physical abuse,
like punches and kicks that leave bruises and other injuries. It also includes emotional
abuse, sometimes forced sex, threats, things that cause fear and intimidation. And for a
few women who are victims, the abuse can be relatively minor — it happens a few times
and then its over. For most victims, however, the abuse is more severe, and it can go
on for years or even decades.

[Dr. Shaw] Now you said that it affects both sexes. Does it affect men and women
equally?

[Dr. Black] It is not just a problem for women, but it doesn’t affect women and men
equally. It’s a problem for women and men and the children who observed it, and it can
occur in opposite sex and same sex relationships. But, overall, women are much more
likely to be the victim of all forms of intimate partner violence. And the violence that
happens to women is more likely to be severe and more likely to cause major
consequences because of the difference in size and physical strength between men
and women. But it’s important not to focus only on physical violence and the resulting
bruises and other injuries that you can see. We know that the long-term mental and
physical health consequences of emotional abuse can be even more damaging. The
victim in the abusive relationship often feels a loss of control in their lives, and this loss
of control and the feelings of entrapment are one of the root causes of the ongoing
stress of intimate partner violence.

[Dr. Shaw] You said that this is an emotional issue, not just a physical one. Do you find
that victims of intimate partner violence are willing to talk openly about the issue?

[Dr. Black] Yes. Often they are willing to talk openly about the issue. CDC’s done
several studies that show people who experience partner violence and sexual violence
are willing to answer questions about abuse, even in surveys like the one in our most
recent report. The majority of people, more than 90 percent, whether or not they were
victims of abuse, think such questions should be asked and they’re not upset or afraid
to answer such questions. Having said that, there are safety considerations that must
be taken into account. The information must be kept confidential and private, individuals
need to feel safe and feel like they aren’t being judged, and that they will not be
overheard by someone who could harm them.

[Dr. Shaw] If a person has experienced intimate partner violence, what kinds of illnesses
are they more likely to have?

[Dr. Black] Our study showed that those who experienced intimate partner violence —
and an intimate partner can be a current or a former spouse, boyfriend, girlfriend,
someone you’re dating — those who experience intimate partner violence also reported
a range of adverse outcomes and health risk behaviors. And these included things like
asthma, arthritis, stroke, and also increased heavy or binge drinking, smoking, and risk
factors that put them at risk for such things as HIV or sexually transmitted diseases.

[Dr. Shaw] So, did your research find that intimate partner violence causes these
chronic diseases?

[Dr. Black] We can’t say that on the basis of the information we get from the survey.
Survey data don’t show whether intimate partner violence causes these health problems
or health risk behaviors. Our study was able to demonstrate a link between intimate
partner violence and these health outcomes and behaviors but not why or how they may
be linked. There could be several things contributing. The perpetrator of violence may
control the money and may limit the victim’s access to health care or their ability to
purchase medications, but research outside of CDC also suggests that one of the
underlying mechanisms that might link intimate partner violence and health problems is
the body’s response to long-term and ongoing stress, and stress is also linked to
several health problems like heart disease, asthma, and heavy drinking.

[Dr. Shaw] So what are the key messages you want our listeners to take away from
this?

[Dr. Black] Well, first of all, it’s important for our listeners to know that intimate partner
violence is preventable. CDC’s ultimate goal is to prevent intimate partner violence
before it even begins in the first place. One of CDC’s prevention programs is the
Choose Respect Initiative, which is launched in 2006, and it’s a multimedia program
designed to teach 12 to 14-year-olds how to have healthy, respectful relationships and
how to recognize unhealthy and harmful relationships. And the goal is teach these
things early, before dating even begins.

[Dr. Shaw] Is there anything else?

[Dr. Black] In addition to preventing abuse before it happens, preventing further harm
from those who’ve already experienced abuse or observed it, as children often do, is
also important. And if a doctor or nurse or a caring individual asks about intimate
partner violence in a way that the abuser is not going to overhear and retaliate and if the
victim can be referred to and get the access to the resources they need, then not only
can you prevent further abuse, the abuse can be stopped, but you’re also likely to have
a long-term impact on the overall health of the abused and the children who witness it.

[Dr. Shaw] Where can our listeners get more information about the issue of intimate
partner violence?

[Dr. Black] Listeners who are concerned about intimate partner violence either in their
own lives or for someone they care about can call the confidential National Domestic
Violence Hotline. The number is 1-800-799-SAFE. Listeners can also learn more about
intimate partner violence by going to CDC’s National Center for Injury Prevention and
Control’s website, which is www.cdc.gov/ncipc.

[Dr. Shaw] Michele thanks for sharing this information with us today.

[Dr. Black] Thank you. It was my pleasure.

[Dr. Shaw] That’s it for this week’s show. We hope you’ll join us next week. Until then,
be well. This is Dr. Frederic Shaw for A Cup of Health with CDC.

[Announcer] To access the most accurate and relevant health information that affects you, your family,
and your community, please visit www.cdc.gov.