Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Direct and indirect costs of intimate partner violence in an outpatient sample of women

PURPOSE: Intimate partner violence interferes with women's economic autonomy and the development of their human capital over the life course. Violent partners often prevent women from working or continuing their education through threats and stalking. Loss of work opportunity is classified as an indirect cost, estimated as lost productivity. In addition, partner violence imposes direct costs on social institutions through injuries requiring medical care; through the increased demand for social services among abused women; and through arrests and adjudication in criminal justice. It is important to further develop our knowledge base about the costs – both direct and indirect – of intimate partner violence. Hundreds of articles have been published on the costs of different illnesses and on cost-effective interventions, yet only a handful of researchers have investigated the costs of intimate partner violence in women's lives.

METHOD: Our results are based on a cross-sectional study of 311 women outpatients in Boston, Massachusetts who were recruited from a large randomly-distributed survey of more than 2,400 women outpatients in waiting rooms in more than 8 hospitals. Women were interviewed in depth about their exposure to intimate partner violence, about the timing of abuse in their lives, and about their receipt of services and health care (direct costs) and employment histories and income (indirect costs). Types of services coded included: (1) domestic violence advocacy; (2) arrests; (3) filing restraining orders; (4) psychological counseling/mental health services. Average hourly costs in Boston for these services were computed and multiplied by the number of hours or incidents (e.g., arrests) per woman informant. Women were also asked about their occupation, education, receipt of TANF, and earned income through employment.

RESULTS: Direct social service costs were substantial per incident of abuse, costing on average over $1,500 per incident. When women followed all of the recommended steps of self-protection the total cost exceeded $2,200 per incident. Findings revealed that women with health problems and women with children incurred the largest costs from domestic violence services: women with children were more likely to use all societal remedies for intimate partner violence than unmarried women without children. In addition, women exposed to intimate partner violence during the past 12 months worked fewer hours, were less likely to be employed, reported more frequent job changes, and reported significantly less monthly income than women without an abusive partner during the past 12 months. Women with partners who were psychologically controlling as measured through the WEB earned the lowest reported incomes. Cost-benefit calculations indicate that there is a return on services in the income generated by the women, especially when projected over future years and potential earnings.

IMPLICATIONS: Findings indicate that intimate partner violence is expensive for society, but even more expensive for individual women. Violence against women is an economic barrier for women in the United States, and discourse about American poverty needs to be expanded to include abuse as a serious hindrance to women's economic equality.