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Intimate Partner Violence and Resultant Concussions in Indigenous Populations

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Concussions are a major public health concern in terms of their incidence. The causes of concussion traditionally have included athletics, motor vehicles, and warfare, however, the consequences of physical assault, specifically domestic violence directed to the head, may surpass the existing concussion incidence estimates.

Violent physical acts, such as strangulation, blows to the head, or being forcibly shaken, place an individual at high risk for brain injury. A survey of three metropolitan emergency departments found that 67 percent of the women seeking medical services related to domestic violence had symptoms associated with traumatic brain injury (TBI).

To this extent, one in four women will experience domestic or intimate partner violence in their lifetime, and upwards of 67-90 percent will have symptoms of concussion. This indicates that approximately 30 million women experiencing domestic violence, of which 20 million could demonstrate signs of TBI. Alone, this is 11-12 times greater than the published incidence of TBI. Moreover, in 70 percent of homes where women are assaulted, children also are abused.

As many as 15.5 million American children live in families in which domestic violence has occurred during the past year. Currently, these victims have few places to seek education, advocacy, services, and treatment. Women in rural locations generally experience similar or greater rates of IPV as urban women, they may be subjected to more chronic and severe abuse, and those in rural areas typically live much farther from available resources than those in urban areas.

Consequently, victims of IPV in rural areas may be less likely to receive counseling and health care, and possibly receive lower quality health care when it is available, than urban women. Also, law enforcement interventions may be less likely to occur in rural areas, thereby exacerbating IPV as a chronic issue. Additionally, Indigenous people throughout North America are at greater risk for TBI and poor TBI-related outcomes based on health disparities, connections to poverty, violence, and systemic racism.

As documented in our epidemiological analysis, Indigenous populations have a dramatically different incidence than anticipated by population demographics and comprised a much greater proportion of diagnoses compared with the representative state demographics. Dr. Handmaker will discuss the obstacles to determining the true incidence of the problem and potential solutions to reduce its frequency and improve the outcomes for the victims.

Date Created: January 9, 2023