Intimate partner violence (IPV) is a major public health issue in both developed and developing countries. IPV has been identified as a significant contributor to the burden of disease through its association with physical and mental ill-health, both in the short term, and in the long term through chronic health conditions. In developed countries, such as Australia, much of the research into IPV has been conducted in metropolitan settings. There is however a growing body of research, primarily from the USA, indicating that women living in non-metropolitan areas may experience differences in type, severity and prevalence of IPV compared to metropolitan women. To date there has been limited Australian research into aspects of IPV for women living outside major metropolitan centres. This thesis aimed to address this gap in the Australian IPV research by investigating differences in women's experiences of IPV across metropolitan, regional and more remote areas of Australia. This study used quantitative techniques to conduct a secondary analysis of data from the Australian Longitudinal Study on Women's Health (ALSWH), a national population-based health survey that provides longitudinal data for the sixteen year period from 1996 to 2012. This thesis specifically focuses on the ALSWH cohort of women born between 1973-78. This cohort of over 14,000 women was first surveyed in 1996 when their mean age was 21 years. Through the ALSWH, this cohort of women has been surveyed every three years and, to date, there have been six surveys, most recently in 2012, when the mean age of the cohort was 36 years. This thesis presents statistical analyses into geographic differences in five aspects of IPV, namely: lifetime prevalence of IPV, past 12 month prevalence and type of IPV, association of IPV and domestic relocation, IPV and self-reported health, and IPV and health service use.

Associations between intimate partner violence (IPV) and poor physical and mental health of women have been demonstrated in the international and national literature across numerous studies. This paper presents a review of the literature on this topic. The 75 papers included in this review cover both original research studies and those which undertook secondary analyses of primary data sources. The reviewed research papers published from 2006 to 2012 include quantitative and qualitative studies from Western and developing countries. The results show that while there is variation in prevalence of IPV across various cultural settings, IPV was associated with a range of mental health issues including depression, PTSD, anxiety, self-harm, and sleep disorders. In most studies, these effects were observed using validated measurement tools. IPV was also found to be associated with poor physical health including poor functional health, somatic disorders, chronic disorders and chronic pain, gynaecological problems, and increased risk of STIs. An increased risk of HIV was reported to be associated with a history of sexual abuse and violence. The implications of the study findings in relation to methodological issues, clinical significance, and future research direction are discussed.

Objective

To investigate differences in self-reported health among Australian women with a history of intimate partner violence (IPV) in relation to rurality of residence.

Methods

Data were drawn from six survey waves of the Australian Longitudinal Study on Women's Health 1973–78 birth cohort. Self-reported general and mental health scores derived from the SF-36 scale were compared for women with a history of IPV living in metropolitan, regional and rural areas. Multivariable generalised estimating equations were constructed adjusting for income hardship, number of children, education, social support, age and marital status.

Results

Women with a history of IPV living in regional and rural areas had no significant differences in self-reported general health scores compared to their metropolitan counterparts. Rural women affected by IPV had slightly better self-reported mental health than equivalent women living in metropolitan or regional areas. The socio-demographic factors with the strongest association with self-reported health were income, education, social support, and number of children.

Conclusions

Women in regional and rural areas were no more disadvantaged, in terms of self-reported general health or mental health, than IPV affected women living in major cities in Australia.