Domestic abuse survivors have high ongoing mortality risk
Author: Ingrid Torjesen
Women who have experienced domestic abuse appear to be 44% more likely to die from any cause compared to the general population, a study* published in Journal of the American Heart Association has found.
Using medical records from UK GP surgeries between 1995 and 2017, the researchers were able to identify 18,547 women with a recorded code relating to exposure to domestic abuse. These were matched to 72,231 similar women who did not have such an experience recorded.
The researchers then followed both groups and calculated the risk of developing cardiometabolic illness and all-cause mortality. They found that the risk of developing cardiovascular disease was increased by 31% and type 2 diabetes by 51% in the exposed group. There was no association found with hypertension. They also found that all-cause mortality among women exposed to domestic abuse was 44% higher. The absolute risk of death was six per 1,000 women per year in the exposed cohort (recorded exposure to domestic abuse) compared to 3.1 per 1,000 women per year in those without such a record in their medical notes.
Although the team were not able to confirm the reason for the increased mortality, it may be partly explained by the increased cardiovascular risk.
Only a small number of patients died during the study period (948 out of a total cohort of 91,778) probably due to the age at cohort entry being young (37-years-old).
The researchers pointed out that abuse reported in GP records (0.5%) was much lower than the level estimated prevalence suggested by survey data national survey data (one in four women at some stage during their life). This means that many of those not coded as exposed to domestic abuse may have actually experienced some abuse, which would suggest that the findings would underestimate the increased risk of death and cardiometabolic disease in women who have experienced abuse.
Dr Joht Singh Chandan, from Warwick Medical School and the University of Birmingham's Institute of Applied Health Research, said: "As further in-depth detail of the traumatic experiences is not available in these records it was not possible to assess whether the severity of domestic abuse was associated with a different risk impact. It is important to note that not all cases of domestic abuse go onto develop adverse health outcomes, but from this study we can see that within this dataset, the cohort of women recorded to have experienced domestic abuse are at a greater risk than those without such records present.
"Considering the prevalence of domestic abuse, there is a public health burden of cardiometabolic disease likely due to domestic abuse. Although our study was not able to answer exactly why this relationship exists, we believe that it is likely due to the effects of acute and chronic stress. Additionally, we know that exposure to domestic abuse may be associated with other lifestyle factors (such as poor diet, alcohol and smoking as seen in our study). Although we made attempts to account for the impact of this on our results, these lifestyle factors still contribute risk for the development of cardiometabolic disease, therefore need public health approaches to manage this in women who have experienced domestic abuse.”
The study findings add to the growing research exploring the physical and psychological effects of domestic abuse. In 2019, the same researchers found that women who have experienced domestic abuse are almost twice as likely to develop fibromyalgia and chronic fatigue syndrome, while a previous study published in June 2019 showed that UK survivors of domestic abuse are three times more likely to develop severe mental illnesses.
*Chandan JS, Thomas T, Bradbury‐Jones C, et al. Risk of Cardiometabolic Disease and All‐Cause Mortality in Female Survivors of Domestic Abuse. Journal of the American Heart Association. 2020;9:e014580