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Domestic Violence Services Not Reaching Low-Income Women


Despite the services available to women in abusive relationships, many low-income women victimized by domestic violence do not seek help from social service agencies, according to researchers at the Johns Hopkins Bloomberg School of Public Health. The study, published in the April 2002 issue of Patient Education and Counseling, suggests that in order to reach this group of women, domestic violence assistance needs to be better promoted, more readily available, and comprehensive enough to include all aspects of help that low-income women may need once they leave an abusive relationship.

“Almost 2 million women in America are battered by their partners each year. Higher rates of abuse occur in impoverished communities. Women living in low-income areas face hardships created by social and economic constraints, in addition to the psychological ailments suffered by all abused women, ” explains Patricia O’Campo, PhD, an associate professor of population and family health sciences at the Johns Hopkins Bloomberg School of Public Health. “We sought to gain insight into the ways low-income women react to violence, what types of help they seek, and their knowledge of and experiences with services for abused-–all important information in developing ways to better assist abused women.”

Dr. O’Campo and her colleagues recruited 611 women, all of whom were living in low-income, urban neighborhoods in Baltimore. Because HIV/AIDS is a particular problem for this population, they enrolled an equal number of HIV-negative and HIV-positive women. Of the sample, 390 women had experienced physical or sexual abuse from an intimate partner sometime after age 18, and were included in the study. Of these 390 women, the majority were African-American and almost half were infected with HIV.

Private interviews with the women revealed that about two-thirds could predict an episode of violence, relying on a variety of signs and situations. A partner’s drug or alcohol use was cited as the most common warning sign among all women, and more frequently among HIV-positive women.

In response to impending violence, more than half of the women said they fought back, yet almost one-fifth said they did nothing to prevent the abuse. When asked about whether the women considered getting help for these episodes of violence, 70 percent did not actively seek assistance. Of those women who did seek help, family and friends were the most common resource, followed by the police. Relatively few women accessed hotlines, shelters, social services, or health care services. Almost one-third of the sample said they knew of no such services for abused women.

“Our study shows that despite increases in the mass media messages regarding violence, many women are not being reached,” says Dr. O’Campo. “In addition, some women who did try to obtain help from services reported being turned away because of a lack of available space. This could indicate that the social services out there are operating beyond their capacities.”

HIV-positive and HIV-negative women reported similar experiences in help-seeking, knowledge of services, and needs. When asked what types of services or forms of assistance the women felt would be needed to leave an abusive relationship, the most common answers were jobs, education, housing, and money.

“Our findings suggest there is a greater need for identification and provision of appropriate services for women in abusive relationships. In addition, supplemental services, such as education or job training programs, are important in ensuring that women who are able to escape abuse can gain economic independence and remain free from the violence,” concludes Dr. O’Campo.

“Surviving physical and sexual abuse: what helps low-income women?” was written by Patricia O’Campo, Karen McDonnell, Andrea Gielen, Jessica Burke, and Yi-hua Chen and appears in the April 2002 issue of Patient Education and Counseling.

This study was funded by the National Institute of Mental Health.

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