Male Partner Violence: Relevance to Health Care Providers
Mary P. Koss
Maia Ingram University of Arizona
Sara L. Pepper Region 2 Consortium, Idaho
Since the 1970s, researchers and advocacy groups have documented the extent of partner violence, as health and medical consequences of violence lives. As a result, violence by male intimates is now recognized as one of the most prevalent and serious threats to the health of women. Despite gains in awareness and knowledge of the risk and outcomes of abuse, however, victims of partner violence have remained largely unrecognized in medical care settings. Yet, as efforts aimed at primary and secondary prevention of illness and injuries, as well as cost containment, become central to health care, partner violence is ever more clearly an issue of medical concern. To underscore the relevance of the problem to health care practitioners, this chapter reviews empirical evidence regarding both the prevalence and the impact of partner violence within the medical care system. The review covers three principal areas. First, the most frequent portals of entry, the consequences and medical presentations associated disproportionately high rate of medical care utilization by victims are reviewed. Second, the rate and consequences of failure to identify and appropriately treat and refer victims in the medical setting are described. Third, the potential role of health care providers in the detection and referral of victims, as well as personal and systematic barriers to these actions are presented. The chapter concludes with a critique of the existing methodologies in the field and suggests avenues of future study to address the many gaps in existing knowledge.
Although the term domestic violence is often used to describe abusive adult relationships, the present discussion adopts the expression male partner violence to denote violence against women by male intimates. This alternative term reflects a need to clearly define the predominant pattern in violent relationships, as well as those most likely to result in physical harm. Although large scale studies have reported that men and women are about equally likely to be physically aggressive toward an intimate partner at least once (Straus & Gelles, 1990; Straus, Gelles, & Steinmetz, 1980), further analysis reveals that both the frequency and severity of assaults by men against female intimates are much greater than assaults perpetrated by women against male partners (R. A. Berk, S. F. Berk, Loseke, & Rauma, 1983; Brush, 1990; Bureau of Justice Statistics, 1994; M. I? Koss, Goodman, et al., 1994; Makepeace, 1989). Women are much more likely to be injured in assaults by a male intimate than are men by a female partner (R. A. Berk et. al., 1983; Brush, 1990; Bureau of Justice Statistics, 1995; Makepeace,