Socioeconomic determinants and mental health correlates of intimate partner violence-related emergency department visits among women in California.

BACKGROUND

Intimate partner violence (IPV) is a major public health concern affecting one in three US women. Many survivors rely on emergency departments (EDs), particularly when socioeconomic disadvantage and mental health vulnerabilities heighten risk.

OBJECTIVE

This study identifies demographic, socioeconomic, and clinical factors associated with IPV-related ED visits among women aged 15-64 years in California.

METHODS

We performed a cross-sectional analysis of the California State Emergency Department Database (SEDD-HCUP) records from 2018 to 2020. IPV was defined using validated ICD-10-CM codes capturing confirmed and suspected abuse. Covariates included age, race/ethnicity, insurance type, neighborhood socioeconomic status (Distressed Communities Index), and mental health and chronic conditions. Multivariable logistic regression was used to evaluate predictors of IPV-related ED visits.

RESULTS

Among 1 387 772 ED visits, 5729 (0.41%) involved IPV. Women living in the most distressed communities had significantly greater odds of an IPV-related visit than those in prosperous areas (adjusted odds ratio [aOR] 1.74; 95% CI 1.52-2.00). Young women demonstrated the highest risk, with those aged 15-24 years having fourfold greater odds compared with women aged 55-64 years (aOR 4.07; 95% CI 3.56-4.65). Uninsured/self-pay women also had more than twice the odds of IPV-related visits relative to privately insured women (aOR 2.59; 95% CI 2.23-3.00). Several mental health conditions, including bipolar disorder, PTSD, and alcohol abuse, were independently associated with elevated IPV risk.

CONCLUSION

IPV-related ED visits disproportionately affect young, uninsured women living in poor communities and those with mental health comorbidities. Enhancing ED-based screening, strengthening mental health integration, and expanding community-level prevention efforts are critical to reducing IPV burden.