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Health, Access to Health Care, and Health Care use Among Homeless Women with a History of Intimate Partner Violence

Journal of Community Health volume 37, pages 1032–1039 (2012)Cite this article

Abstract

Among a sample of sheltered homeless women, we examined health, access to health care, and health care use overall and among the subgroup of participants with and without intimate partner violence (IPV). We recruited homeless women from a random sampling of shelters in New York City, and queried them on health, access to health care and health care use. Using multivariable logistic regression, we determined whether IPV was associated with past-year use of emergency, primary care and outpatient mental health services. Of the 329 participants, 31.6% reported one or more cardiovascular risk factors, 32.2% one or more sexually transmitted infections, and 32.2% any psychiatric condition. Three-fourths (73.5%) had health insurance. Health care use varied: 55.4% used emergency, 48.9% primary care, and 75.9% outpatient mental health services in the past year. Across all participants, 44.7% reported IPV. Participants with IPV compared to those without were more likely to report medical and psychiatric conditions, and be insured. Participants with IPV reported using emergency (64.4%) more than primary care (55.5%) services. History of IPV was independently associated with use of emergency (Adjusted odds ratio (AOR) 1.7, 95% CI 1.0–2.7), but not primary care (AOR 1.5, 95% CI 0.9–2.6) or outpatient mental health services (AOR 1.9, 95% CI 0.9–4.1). Across the whole sample and among the subgroup with IPV, participants used emergency more than primary care services despite being relatively highly insured. Identifying and eliminating non-financial barriers to primary care may increase reliance on primary care among this high-risk group.

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Acknowledgments

We would like to thank the participants for their valuable contribution to our study. We would like to thank our research assistants including Ana Alicia De La Cruz, Gladyris Concepcion, and Jessica Eichler for conducting the patient interviews. We would like to thank Dr. Margot B. Kushel for her feedback on an earlier version of the manuscript. This study was funded by the National Institute on Drug Abuse ROI DA 091399. Dr. Vijayaraghavan is supported by a post-doctoral fellowship through the Moores Cancer Center at the University of California, San Diego.

Conflict of interest

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Author information

Affiliations

  1. Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, San Diego, CA, USA

    Maya Vijayaraghavan

  2. New York State Psychiatric Institute, Office of Mental Health, New York, NY, USA

    Ana Tochterman

  3. Department of Psychology, University of Southern California, Los Angeles, CA, USA

    Eustace Hsu

  4. Columbia Center for Homelessness Preventions Studies, Columbia University School of Social Work, New York, NY, USA

    Karen Johnson

  5. Division of Biostatistics, New York Psychiatric Institute, New York, NY, USA

    Sue Marcus

  6. Department of Psychiatry, Columbia College of Physicians and Surgeons, Columbia University, Manhattan, NY, USA

    Sue Marcus

  7. Department of Biostatistics, Mailman School of Public Health, New York, NY, USA

    Sue Marcus

  8. Department of Psychiatry and the Mailman School of Public Health, Columbia College of Physicians and Surgeons, Manhattan, NY, USA

    Carol L. M. Caton

  9. University of California, San Diego, 3855 Health Sciences Drive, #3063, MC 0901, La Jolla, CA, 92093-0901, USA

    Maya Vijayaraghavan

Authors
  1. Maya Vijayaraghavan
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  2. Ana Tochterman
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  3. Eustace Hsu
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  4. Karen Johnson
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  5. Sue Marcus
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  6. Carol L. M. Caton
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Correspondence to Maya Vijayaraghavan.

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Vijayaraghavan, M., Tochterman, A., Hsu, E. et al. Health, Access to Health Care, and Health Care use Among Homeless Women with a History of Intimate Partner Violence. J Community Health 37, 1032–1039 (2012). https://doi.org/10.1007/s10900-011-9527-7

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  • DOI: https://doi.org/10.1007/s10900-011-9527-7

Keywords

  • Homeless women
  • Intimate partner violence
  • Health
  • Health care use
  • Access to health care