Davidov, Danielle M., Stephen M. Davis, Motao Zhu et al., “Intimate Partner Violence-Related Hospitalizations in Appalachia and the Non-Appalachian United States,” PLOS One 12, no.9 (September 2017), doi:10.1371/journal.pone.0184222

URL: journals.plos.org/plosone/article?id=10.1371/journal.pone.0184222

Abstract

The highly rural region of Appalachia faces considerable socioeconomic disadvantage and health disparities that are recognized risk factors for intimate partner violence (IPV). The objective of this study was to estimate the rate of IPV-related hospitalizations in Appalachia and the non-Appalachian United States for 2007–2011 and compare hospitalizations in each region by clinical and sociodemographic factors. Data on IPV-related hospitalizations were extracted from the State Inpatient Databases, which are part of the Healthcare Cost and Utilization Project. Hospitalization day, year, in-hospital mortality, length of stay, average and total hospital charges, sex, age, payer, urban-rural location, income, diagnoses and procedures were compared between Appalachian and non-Appalachian counties. Poisson regression models were constructed to test differences in the rate of IPV-related hospitalizations between both regions. From 2007–2011, there were 7,385 hospitalizations related to IPV, with one-third (2,645) occurring in Appalachia. After adjusting for age and rurality, Appalachian counties had a 22% higher hospitalization rate than non-Appalachian counties (ARR = 1.22, 95% CI: 1.14–1.31). Appalachian residents may be at increased risk for IPV and associated conditions. Exploring disparities in healthcare utilization and costs associated with IPV in Appalachia is critical for the development of programs to effectively target the needs of this population.

This study notes that while there are similar population rates of intimate partner violence (IPV) between rural and non-rural locales, rural IPV occurs at a higher frequency and with greater severity. The higher IPV-related hospitalization rate for women in rural Appalachia is impacted by a number of factors, including poverty, lower education, shortages of preventative and intervention services, and older women experiencing a greater need for hospitalization. Recognizing that not all women who experience IPV require hospitalization demonstrates the urgency to provide greater preventative and intervention services for women in rural Appalachia.