Jeane Ann Grisso, M.D., Donald F. Schwarz, M.D., M.P.H., Nancy Hirschinger, M.A., Mary Sammel, Sc.D., Colleen Brensinger, M.S., Jill Santanna, M.S., Robert A. Lowe, M.D., M.P.H., Elijah Anderson, Ph.D., Leslie M. Shaw, Ph.D., Courtney A. Bethel, M.D., M.P.H., and Leslie Teeple, M.D.
Background Although the rate of death from injuries due to violentacts is much higher among black women than among white womenin the United States, little is known about the nature and correlatesof violent injuries among black women living in urban areas.
Methods In this case–control study conducted at threeemergency departments in one inner-city community (in west Philadelphia),we studied 405 adolescent girls and women who had been intentionallyinjured and 520 adolescent girls and women (control subjects)who had health problems not related to violent injury. Datawere collected by conducting standardized interviews with useof questionnaires and by screening urine for illicit drugs.Individual logistic-regression models were constructed to identifyfactors associated with violent injuries inflicted by partnersand those inflicted by persons other than the partners of thevictims.
Results The male partners of the injured women were much morelikely than the male partners of control subjects to use cocaine(odds ratio, 4.4; 95 percent confidence interval, 2.3 to 8.4)and to have been arrested in the past (odds ratio, 3.1; 95 percentconfidence interval, 1.8 to 5.2). Fifty-three percent of violentinjuries to the women had been perpetrated by persons otherthan their partners. Women's use of illicit drugs and alcoholabuse were factors associated with both violence on the partof partners and violence on the part of other persons. Neighborhoodcharacteristics, including low median income, a high rate ofchange of residence, and poor education, were independentlyassociated with the risk of violent injuries among women.
Conclusions Women in this urban, low-income community face violencefrom both partners and other persons. Substance abuse, particularlycocaine use, is a significant correlate of violent injuries.Standard Census data may help identify neighborhoods where womenare at high risk for such violence and that would benefit fromcommunity-level interventions.
Source Information
From the Department of Biostatistics and Epidemiology and the Center for Clinical Epidemiology and Biostatistics (J.A.G., N.H., M.S., C.B., J.S., R.A.L.), the Division of General Internal Medicine (J.A.G.), the Department of Pediatrics (D.F.S.), the Department of Emergency Medicine (R.A.L.), the Department of Social Sciences (E.A.), and the Department of Pathology and Laboratory Medicine (L.M.S.), University of Pennsylvania School of Medicine; Misericordia Hospital Division, Mercy Catholic Medical Center (C.A.B.); and Presbyterian Medical Center, University of Pennsylvania (L.T.) — all in Philadelphia.
Address reprint requests to Dr. Grisso at the Division of General Internal Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, 920 Blockley Hall, 423 Guardian Dr., Philadelphia, PA 19104-6021, or at jgrisso{at}cceb.med.upenn.edu.
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