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Megan, a 25 year-old single woman, visited her doctor five times in a six-month period. She was experiencing chronic, debilitating migraines that had caused her to miss a great deal of work as a manager of a hotel. Alarmingly, she had not experienced these before. A barrage of x-rays, MRIs, and other neurological tests were done. Despite thousands of dollars in healthcare services, nothing was found to explain her migraines.
Norma, a divorced mother of two young children, was seen at a local healthcare center nine times in less than one year. Her chief complaint was frequent gastrointestinal problems with nausea, diarrhea, and general fatigue. After many months of tests, medication regimens, and appointments with specialists, she was diagnosed with irritable bowel syndrome. But she still suffers from these symptoms on a regular basis.
May has been married for almost 40 years and has three grown children. She was seen five times in six months for frequent bouts of debilitating joint pain, coupled with sleeplessness and fatigue. She was depressed and had stopped the things she used to love to do, like social events and volunteering at church. Her doctors tried all kinds of different treatments and medications in an attempt to diagnose her condition. But nothing has seemed to work.
What do all of these women have in common? They are experiencing abuse by their partners but have been too ashamed and afraid to reach out for help. Meanwhile, the stress of living through violence and abuse manifested through physical symptoms.
An international study by the WHO in 2013 found that over 35 percent of women worldwide have experienced physical or sexual partner violence or non-partner sexual violence. This amounts to about 818 million women–almost the entire population of sub-Saharan Africa. The most common form of violence that women experience is intimate partner violence (IPV).
There are four main types of IPV:
- Physical violence: the intentional use of physical force such as scratching; pushing; shoving; choking; shaking; aggressive hair pulling; slapping; punching; and use of restraints or one’s body, size, or strength against another person.
- Sexual violence: can include rape, unwanted sexual contact, sexual harassment, and unwanted filming.
- Stalking: a pattern of repeated, unwanted, attention and contact that causes fear or concern for one’s own safety or the safety of a family member or friend. Some examples include repeated, unwanted phone calls, emails, or texts; spying; showing up in places unannounced; sneaking into the victim’s home or car; and damaging the victim’s personal property.
- Psychological Aggression: the use of verbal and nonverbal communication with the intent to harm another person mentally or emotionally, and/or to exert control over another person. Psychological aggression can include name-calling, humiliating; coercive control; threats of physical or sexual violence.
IPV has profound consequences on the health and well-being of women, families, communities, and economies. The negative health consequences of IPV are numerous and include: depression, post-traumatic stress disorder, anxiety, substance abuse, HIV and other sexually-transmitted infections, unintended pregnancies, abortion, traumatic physical injuries, cardiovascular problems, gastrointestinal problems, endocrine and immune systems issues, headaches, irritable bowel syndrome, chronic pain disorders, joint disease, asthma, and fibromyalgia.
IPV also has tremendous economic costs to society. Research has shown that victims of IPV generally utilize health care services more frequently than women who are not experiencing violence. Victims of IPV are also more likely to rate their health problems as worse than those who have not been victims of abuse. Overall, the costs of IPV include direct costs to the healthcare system, including emergency room visits, primary care visits, mental health counseling and related services. And studies show that increased annual health care costs for victims of IPV can persist as much as 15 years after the cessation of abuse.
Additionally, IPV drains resources from social services, the justice system, and child and welfare support services. It is important to also consider the multitude of indirect economic costs associated with IPV to victims, employers, and society in general. These include lost wages, absenteeism, reduced productivity and potential, as well as the cost of hiring and training of workers to replace them. Not to mention the long-term impacts of childhood exposure across generations, which are hard to quantify, but are substantial.
Women experiencing IPV earn 35 percent less than those not abused, which means they are at much higher risk for poverty. The US Centers for Disease Control found that, in the U.S., victims of severe IPV lose nearly eight million days of paid work. This is equivalent of more than 32,000 full-time jobs-and almost 5.6 million days of household productivity each year. In India, women can lose an average of at least five paid work days for each incident of IPV. This means she receives about 25 percent less of her salary for each incident. And in Uganda, about 9 percent of violent incidents force women to lose time from paid work, amounting to approximately 11 days a year or about half of her month’s salary. In the U.S. alone, IPV costs (direct and indirect) exceeded $8.3 billion in 2003, which included $460 million for rape, $6.2 billion for physical assault, $461 million for stalking, and $1.2 billion in the value of lost lives. These costs are obviously much higher in 2018.
Worldwide, research by UN Women indicates that the cost of violence against women could amount to around 2 percent of the global gross domestic product (GDP) annually. This is equivalent to $1.5 trillion annually, or approximately the size of Canada’s economy. That means that IPV causes more deaths and entails much higher economic costs than homicides or civil wars.
The extraordinary long-term costs of intimate partner violence underscore the urgent need to take measures to comprehensively address the problem. Because while IPV has substantial social costs, it is also a significant cause of poverty among women and families. And it represents a major barrier to sustainable development. More work needs to be done in order to protect women from violence around the world. As Malala, the Nobel Prize laureate who took a stance against the Taliban in support of girls’ education said, “We cannot all succeed when half of us are held back.”
