Examining the impact of state laws on intimate partner violence

ABSTRACT: Intimate partner violence (IPV) is common with over 7% of U.S. women reporting physical or sexual violence, and/or stalking in the past year. Moreover, nearly 10% of pregnant women report experiencing either physical or sexual violence during their pregnancy and the prevalence increases to 20% when psychological violence is included. IPV has widespread consequences, including physical injury, increased rates of chronic conditions, poorer mental health, and death. Pregnancy is a particularly risky time for women in violent relationships: Homicide is a leading cause of death for pregnant women in the U.S. and over half of pregnancy-associated suicides involve intimate partner conflict. Over half of women experiencing IPV are victimized multiple times over multiple years, therefore meeting the definition of a chronic condition. Reproductive coercion (RC), a hallmark of IPV, involves controlling contraception use, contraception sabotage, pressure to become pregnant, and pregnancy decision-making. This timely proposal will examine relationships between state law and rates of IPV, IPV-related morbidity and mortality among reproductive age women between 2015-2026. We propose to leverage the natural experiment created through enactment of state laws. We will use data from Medicaid, the Pregnancy Risk Assessment Monitoring System (PRAMS), the National Crime Victimization Survey (NCVS), and the National Violent Death Reporting System (NVDRS), along with strong quasi experimental methods, such as comparative interrupted time series (ITS) or differences-in-differences (DD), to characterize the relationships between state law and rates of IPV (Aim 1), IPV-related physical and mental health outcomes (Aim 2), health service use (Aim 2) and IPV-related mortality (Aim 3). Our comparisons will include 1) across state comparisons by state law; and 2) within state comparisons before and after law enactment. We will conduct subgroup analyses to examine for law effect heterogeneity by sociodemographic factors or community. This work will yield the best available evidence on the impact of state law on IPV and health outcomes.