Health Care Seeking for Intimate Partner Violence in the Tokyo Metropolitan Area.

Abstract

Intimate partner violence (IPV) has a high prevalence in many nations and is a serious public health problem. IPV is associated with health problems as well as high medical expenditures. Both IPV and health care seeking are recurrent for victims throughout the life course. However, most previous studies that examine the impact of IPV on health care seeking are cross-sectional. Using life course data collected from Japanese women living in the Tokyo Metropolitan area, this study examines the factors influencing the first IPV specific health care seeking and IPV specific health care seeking over the life course and the trajectory of IPV specific health care seeking over the life course. The data were collected from 101 women from 2005 to 2006 through semi-structured interviews that utilized the Life History Calendar method. The data set included a total of 3,403 person years. The discrete-time models and hierarchical linear models were used for the data analysis. Anderson’s Behavioral Model of Health Service Utilization and cumulative risk theory provided the theoretical foundation of this study. Injury and formal help seeking increased the odds of the first IPV specific health care seeking. The current experience of injury, formal and informal help seeking, welfare status, smoking, and poor self-rated health status increased the likelihood of IPV specific health care seeking over the life course. The cumulative experience of sexual IPV and injury significantly increased the likelihood of IPV specific health care seeking over the life course. While the trajectory of injury was similar to that of IPV specific health care seeking, the trajectory of any form of IPV was different from that of IPV specific health care seeking. The occurrence of IPV was much more frequent than that of IPV specific health care seeking over the life course. These results highlight important policy implications for improving health care services for victims of IPV. Such policy implications, for example, include developing policies and programs to increase awareness of IPV as a health problem among victims of IPV, health care professionals and communities.Ph.D.Health Services Organization & PolicyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/75916/1/kamimura_1.pd