Prevalence of violence against women reported in a rural health region.

Introduction: Violence against women in Canada is an important public health problem. Published research that reports prevalence of violence against women by province or region is limited, and estimates of the rates of violence experienced by rural women are sparse.

Methods: This study reports the results of a secondary analysis of data to examine the prevalence of physical and sexual assault reported by women in a rural health region in Alberta, Canada. The report of assault was then examined to determine its relationship to self-reported health conditions, behaviours and health service use.

Results: In this study, 5% of women reported experiencing physical assault in the last 12 months and 23% reported experiencing sexual assault in their lifetime. Younger women reported more assault than older women. Women who reported sexual assault were more likely to report having used illicit drugs. Women who reported physical assault within the last 12 months were significantly more likely to also report having accessed mental health services and emergency services within the past year. Most women had seen a general practitioner or family doctor within the last 12 months.

Conclusion: We argue that an integrated community-based model of service that includes the health sector is necessary to address violence against women in rural areas.

Introduction : La violence envers les femmes au Canada constitue un important probleme de sante publique. Les recherches publiees sur la prevalence de la violence envers les femmes selon la province ou la region sont limitees et les estimations des taux de violence envers les femmes rurales sont rares.

Methodes : Cette etude presente les resultats d'une analyse secondaire de donnees portant sur la prevalence de la violence physique et sexuelle signalee par les femmes d'une region rurale de l'Alberta, au Canada. On a ensuite etudie le rapport de l'agression pour determiner son lien avec des problemes de sante, des comportements et l'utilisation des services de sante autodeclares.

Resultats : Dans le cadre de cette etude, 5 % des femmes ont declare avoir ete victimes d'une agression physique au cours des 12 derniers mois et 23 % ont declare avoir deja subi une agression sexuelle. Les jeunes femmes ont declare plus d'agressions que les femmes agees. Les femmes qui ont declare avoir subi une agression sexuelle etaient plus susceptibles de signaler avoir consomme des drogues illicites. Les femmes qui ont declare avoir ete victimes d'une agression physique au cours des 12 mois precedents etaient beaucoup plus susceptibles de signaler aussi qu'elles avaient eu recours a des services de sante mentale et a des services d'urgence au cours de l'annee ecoulee. La plupart des femmes avaient consulte un omnipraticien ou un medecin de famille au cours des 12 mois precedents.

Conclusion : Nous soutenons qu'il faut un modele communautaire integre de services qui comprenne le secteur de la sante pour lutter contre la violence envers les femmes en milieu rural.

Introduction

Violence against women is an important problem with substantial public health implications. Half of all women murdered around the world in a given year are killed by partners or by husbands. (1) Recent reports estimate 23% of Canadian women are abused each year (2) and that gender-based violence in Canada costs health and justice services in excess of $1.5 billion annually. (3) Multiple health conditions in women are associated with a history of having experienced violence, (3) yet published Canadian research that studies the relationship between violence and health is sparse. (2)

Estimates of the prevalence of violence against women vary, in part due to multiple definitions of violence and inconsistent data-collection time frames to describe when the violence took place. (4) The 1993 telephone Canadian Violence Against Women Survey (VAWS) selected 12 300 women by random digit dialling and interviewed them about their experiences with violence. (5) In this nationally representative sample, just over half (51%) of the women interviewed reported having experienced at least one incident of physical or sexual violence since the age of 16. (6) The 1999 General Social Survey (GSS), also a telephone survey, interviewed 9178 women about their experiences of violence over the previous 1-year period. (7) It estimated spousal violence against women at 8%, but that survey limited questions to spousal relationships, with less emphasis on women's other experiences of violence or sexual violence. (6) Published research that reports prevalence of violence against women by province or region is limited and also subject to complexities of multiple definitions and methods. For example, in the 1993 VAWS 58% of women in Alberta reported having experienced violence, with 30% reporting spousal assault. (6) However, a random digit dial survey conducted in Alberta (also in 1993) estimated rates of wife abuse as physical (10.6%) or psychological (13.1%). (8)

Estimates of the rates of violence experienced by rural women in Canada are few, (1) although one study showed reported rates of violence varied little between urban and rural women. (9) Although the rates of violence may be similar, availability of services, including health services, that address domestic violence is not. (1,10) Limited access to services restricts women's options for solutions that aid them in leaving abusive relationships, (9) thus heightening risk and disadvantaging rural women. (1) Studies in other countries also recognize that differences in availability of health services to support women experiencing violence in rural areas may have a detrimental impact on women's health care needs and/or trap women in an abusive relationship. (11-13)

The purpose of this paper is to present evidence that violence against women should be considered a serious public health issue in rural regions. This study reports the results of a secondary analysis of data representative of the population in a rural health region in Alberta, Canada. The purpose of the analysis was to examine the prevalence of physical and sexual assault reported by women living within this rural area, and to examine the relationship to self-reported health conditions, behaviours and health service use.

Methods

Original survey

The primary purpose of the original survey was to describe health status, behaviours and health services utilization by the population living within the health region. The original survey was conducted in 1999 as a random digit dial survey, using the Mitofsky-Waksberg method that was modified to increase the likelihood of obtaining a representative sample for epidemiological research, as described by Potthoff. (14) Eligible telephone prefixes for the health region were selected, with the remaining telephone digits randomly generated…