Disability, race, and risk of perinatal intimate partner violence: Findings from a nationally representative U.S. sample.
Jeanne L Alhusen, Genevieve Lyons, Rosemary B Hughes and 3 others
Women with disabilities had significantly higher odds of physical IPV both before and during pregnancy across every racial and ethnic group studied.
The gap was largest for American Indian/Alaska Native and Black women with disabilities, and persisted after adjusting for age, education, and insurance.
Key findings
1In unadjusted models, women with disabilities across all four racial/ethnic groups had significantly higher odds of IPV before pregnancy compared with non-Hispanic White women without disabilities, with the strongest association among NH AI/AN women with disabilities (OR = 7.81; 95% CI 4.46–13.70). After adjusting for age, education, and insurance, the association attenuated but remained significant for all groups (aOR ranging from 2.75 to 3.35).
2NH AI/AN women with disabilities had the highest IPV prevalence in both periods: 14.3% in the 12 months before pregnancy and 9.8% during pregnancy, compared with 5.5%–5.9% for the other disability groups in each period.
3After adjusting for maternal age, education, and insurance status, significant associations between disability and IPV remained, indicating the disparity is not fully explained by these sociodemographic factors.
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What it does not show
Cross-sectional design: shows association, not that disability causes higher IPV risk. The IPV measure is a single yes/no item about physical aggression only; it does not capture psychological abuse, sexual coercion, controlling behaviors, frequency, or severity. PRAMS only includes women with a recent live birth, excluding those with fetal loss or stillbirth, which may disproportionately exclude women with disabilities and those exposed to severe violence. Women with severe intellectual or developmental disabilities, who face some of the highest violence risk, may not be fully represented in PRAMS. Sample size was insufficient to disaggregate by disability type or severity, so the finding applies to 'disability' as a single category. Self-report in a survey context may underestimate IPV due to stigma and fear of disclosure, particularly among disabled women of minoritized races. Four racial/ethnic categories were excluded (Mixed Race, Other, Asian) due to heterogeneity, limiting generalizability.
Declared interests
No funding source or conflict-of-interest declaration is stated in the supplied text. The data source (PRAMS) is a publicly available CDC/state surveillance system, and the analysis was conducted at the University of Virginia using deidentified data.
The easy way to misread this
Do not read the odds ratios as a causal claim that disability causes IPV. This is a cross-sectional survey showing association, not a controlled experiment. Also, the IPV measure only captures physical aggression (pushing, hitting, choking); it does not assess psychological abuse, sexual coercion, or controlling behaviors, so the true scope of harm experienced by these women is almost certainly larger than the numbers reported here.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →