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Introduction: Urban emergency departments (ED) provide care to populations with multiple health-related and overlapping risk factors, many of which are associated with intimate partner violence (IPV). We examine the 12-month rate of physical IPV and its association with multiple joint risk factors in an urban ED.Methods: Research assistants surveyed patients regarding IPV exposure, associated risk factors, and other sociodemographic features. The joint occurrence of seven risk factors was measured by a variable scored 0–7 with the following risk factors: depression; adverse childhood experiences; drug use; impulsivity; post-traumatic stress disorder; at-risk drinking; and partner’s score on the Alcohol Use Disorders Identification Test. The survey (N = 1037) achieved an 87.5% participation rate.Results: About 23% of the sample reported an IPV event in the prior 12 months. Logistic regression showed that IPV risk increased in a stepwise fashion with the number of present risk factors, as follows: one risk factor (adjusted odds ratio [AOR] [3.09]; 95% confidence interval [CI], 1.47-6.50; p

BackgroundUrban emergency department (ED) patients have elevated smoking and substance use compared with the general population. We analyzed gender differences in smoking among an urban ED sample and assessed the contribution of substance use, demographic, and couple factors.MethodsWe conducted a secondary analysis of data obtained from a cross-sectional, observational survey (N = 1037 participants) on drinking, drug use, and intimate partner violence (IPV). Gender-specific logistic regression models for current (past 30-day) smoking and multinomial regression models for smoking intensity (light: ⩽5 cigarettes per day [CPD]; moderate: 6 to 10 CPD; heavier: >10 CPD) were estimated.ResultsSmoking prevalence was higher among men than women (35.5% vs 18.9%; P < .001). Substance use (frequency of intoxication, marijuana, amphetamine, and cocaine use), demographic (food insufficiency, unemployment), and couple-related factors (having a spouse/partner who smoked, IPV involvement, being in a same-gender couple) were differentially associated with current smoking and level of intensity among men and women.ConclusionsEmergency department staff should consider the impact of polysubstance use, food insufficiency, unemployment, and whether both partners in the couple smoke when screening patients for smoking and formulating cessation treatment plans. Women in same-gender relationships and those who have experienced IPV involvement may require additional referral.

This paper examines whether U.S./Mexico border residence in California is related to the prevalence of DSM-5 alcohol use disorder (AUD) among Whites and Hispanics. Household survey data were obtained from 1,209 adults (59.7% female) 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample, with data collected on the phone or online. Results show that AUD rates were not different between border and non-border location and between Whites and Hispanics. AUD was negatively associated with higher income ($20,000 to $60,000: AOR=.38; 95%CI=.17–.86; p<.01—more than $60,000: AOR=.27; 95%CI:.09–.81; p<.01) and poor risk perception (AOR=.86; 95%CI=.78–.94; p<.01). AUD was positively associated with continued volume of drinking (AOR = 1.05; 95%CI = 1.01–1.09; p<.01), drinking in Mexico (AOR = 4.28; 95%CI = 1.61–11.36; p<.01), marijuana use (AOR = 4.11; 95%CI = 1.73–9.77; p<.01), and impulsivity (AOR = 1.55; 95%CI = 1.23–1.94). Efforts to prevent AUD in the population in California, and especially among those who live close to the border with Mexico, should take into consideration factors such as impulsivity, marijuana use, border crossing to drink in Mexico, all of which increased risk of AUD. [ABSTRACT FROM AUTHOR]

PurposeFew studies have compared acute use of alcohol in suicide decedents with that in a nonsuicide group. This study provides the first national analysis of acute use of alcohol before suicide compared with an estimate of acute use of alcohol in a living sample.MethodsPooled 2003-2011 National Violent Death Reporting System data were used to estimate the prevalence of postmortem blood alcohol content positivity (blood alcohol content >0.0 g/dL) and intoxication (blood alcohol content ≥0.08 g/dL). Population estimates of comparable use of alcohol (within the past 48 hours) were based on the National Epidemiologic Survey on Alcohol and Related Conditions.ResultsCompared with the living sample, male and female suicide decedents showed, respectively, a 1.83-fold (95% confidence interval [CI], 1.73-1.93) and 2.40-fold (95% CI, 2.24-2.57) increased risk of alcohol ingestion before their death after age, race/ethnicity, and chronic alcohol problems were controlled. Furthermore, male and female decedents exhibited, respectively, a 6.18-fold (95% CI, 5.57-6.86) and a 10.04-fold (95% CI, 8.67-11.64) increased risk of being intoxicated before their death after confounders were considered.ConclusionsThe findings underscore the crucial need to include among the essential components of suicide prevention policies programs that minimize the use of alcohol, particularly drinking to intoxication.

AbstractThis paper examines self-reported rates of drinking and cannabis use and co-use among White and Hispanic adults randomly selected in four counties in California: Imperial on the border; and Kern, Tulare, and Madera in California’s Central Valley. Co-use was significantly higher among the U.S. born than among those born abroad, and in the Central Valley than on the border. Co-users were heavier drinkers, had higher rates of alcohol use disorder, other alcohol problems, and a positive history of illicit drug use than drinkers only. [ABSTRACT FROM AUTHOR]

Introduction: Patients in emergency departments (EDs) constitute a diverse population with multiple health‐related risk factors, many of which are associated with intimate partner violence (IPV). This paper examines the interaction effect of depression, posttraumatic stress disorder (PTSD), impulsivity, drug use, adverse childhood experiences (ACEs), at‐risk drinking, and having a hazardous drinker partner with gender on mutual physical IPV in an urban ED sample. Methods: Research assistants surveyed 1037 married, cohabiting, or partnered patients in face‐to‐face interviews (87% response rate) regarding IPV exposure, alcohol and drug use, psychological distress, ACEs, and other sociodemographic features. IPV was measured with the Revised Conflict Tactics Scale. Interaction effects were examined in multinomial and logistic models. Results: Results showed a significant interaction of gender and PTSD (odds ratio [OR] 3.06, 95% CI 1.21–7.23, p < 0.05) for mutual IPV. Regarding main effects, there were also statistically significant positive associations between mutual physical IPV and at‐risk drinking (OR 1.73, 95% CI 1.07–2.77, p < 0.05), having a hazardous drinker partner (OR 2.19, 95% CI 1.35–3.55, p < 0.01), illicit drug use (OR 2.09, 95% CI 1.18–3.71, p < 0.01), ACEs (OR 1.23, 95% CI 1.06–1.42, p < 0.01), days of cannabis use past in the 12 months (OR 1.003, 95% CI 1.002–1.005, p < 0.001), and impulsivity (OR 2.04, 95% CI 1.29–3.22, p < 0.01). Conclusions: IPV risk assessment in EDs will be more effective if implemented with attention to patients' gender and the presence of various and diverse other risk factors, especially PTSD. [ABSTRACT FROM AUTHOR]

Rape is an underreported violent crime that frequently remains uncleared (open) in the legal system. Rape disproportionately affects women, with 91% of rape victim-survivors estimated to be female. However, law enforcement agencies, the entry point into the criminal justice system, are predominantly comprised of male officers. According to the theory of representative bureaucracy, groups with greater representation in a bureaucratic system are more likely to have their interests protected. This study aims to determine if California law enforcement agencies with a higher percentage of female officers are more likely to have higher rates of rape reporting, clearances, and arrests. No previous study has examined this relationship using statewide data. Crimes and Clearances, Monthly Arrest and Citation Register, and Uniform Crime Reporting data for California (2013–2016) were aggregated into 499 Law Enforcement Reporting Areas (LERA). Bayesian space-time Poisson regressions controlling for LERA demographics and crime produced scaled relative rates for three outcomes: (a) rape report rate: number of reports relative to population ages 18+; (b) rape clearance rate: number of clearances relative to reports; and (c) rape arrest rate: number of arrests for rape relative to reports. A 5% increase in the percentage of female officers within an agency was associated with a 6.2% increase in the rape report rate (ARR: 1.062, 95% credible interval (CI) [1.048, 1.077]), a 2.9% decrease in the clearance rate (ARR: 0.971 95% CI [0.950, 0.993]), and no change in the rape arrest rates (ARR: 1.010; 95% CI [0.981, 1.039]) across all LERA. Thus, increased female officer representation was associated with an increase in rape reporting rates but associated with a decrease in rape clearance rates. The theory of representative bureaucracy was only partially supported, and these relationships may not be causal. The quantity of rape reports received by an agency, employment and promotion practices of agencies, and victim-survivor's attitudes toward officer's gender should also be considered. [ABSTRACT FROM AUTHOR]

This paper compares drinking patterns of Whites and Hispanics who after crossing the U.S./Mexico border drink and do not drink in Mexico. Data came from a household survey of 1,209 adults 18 to 39 years of age in California. Residence near the US/Mexico border increases the likelihood of drinking in Mexico (AOR = 4.57; 95%CI = 2.45–8.52; p <.001). Hispanics (AOR = 1.91; 95%CI = 1.26–2.90; p <.01), those who drink more frequently (AOR = 1.05; 95%CI = 1.02–1.09; p <.01) and those who drink six or more drinks in day (AOR = 1.91; 95%CI = 1.26–2.29; p <.01) are more likely than Whites and lighter drinkers to report this behavior. Crossing the U.S./Mexico border to drink is influenced by living close to the border, Hispanic ethnicity, and drinking many drinks in a day. [ABSTRACT FROM AUTHOR]

To examine self-reported rates of driving under the influence (DUI) with and without arrest among border and non-border residents in California. Data were obtained from 1,209 adults 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample. Data were collected on the phone or online and analyzed with a heteroskedastic ordinal generalized linear model. Driving after drinking (11.1% vs. 6.5%; q = 0.04) and the lifetime DUI arrest rates were higher for men than women (10.7% vs. 4%; q = 0.001). In multivariable analysis driving after drinking and DUI arrests were not higher on the border, not higher among Hispanics than Whites, and among Hispanics, the rates were not higher among those located on the border. Income was positively associated with drinking and driving. Impulsivity was positively and significantly associated with both drinking and driving and lifetime DUI arrest. The null results suggest that DUI related risk behaviors may not be higher on the border than in other areas of California. There may be health related risk behaviors of higher prevalence in the border population than in other areas, but DUI related behavior may not be one of them. [ABSTRACT FROM AUTHOR]

The authors examined the relationship of alcohol outlet density (AOD) and neighborhood poverty with binge drinking and alcohol-related problems among drinkers in married and cohabitating relationships and assessed whether these associations differed across sex. A U.S. national population couples survey was linked to U.S. Census data on AOD and neighborhood poverty. The 1,784 current drinkers in the survey reported on their binge drinking, alcohol-related problems, and other covariates. AOD was defined as the number of alcohol outlets per 10,000 persons and was obtained at the zip code level. Neighborhood poverty was defined as having a low (less than 20%) or high ([greater than or equal] 20%) proportion of residents living in poverty at the census tract level. We used logistic regression for survey data to estimate odds ratios and 95% confidence intervals and tested for differences of associations by sex. Associations of neighborhood poverty with binge drinking were stronger for male than for female drinkers. The association of neighborhood poverty with alcohol-related problems was also stronger for men than for women. We observed no relationships between AOD and binge drinking or alcohol-related problems in this couples survey. Efforts to reduce binge drinking or alcohol-related problems among partners in committed relationships may have the greatest impact if targeted to male drinkers living in high-poverty neighborhoods. Binge drinking and alcohol-related problems, as well as residence in an impoverished neighborhood are risk factors for intimate partner violence (IPV) and other relationship conflicts. (Contains 2 tables and 1 figure.)

The objectives of this study were to examine racial and ethnic disparities in perpetrator and incident characteristics and discrepancies between police charges and reported perpetrator behaviors in police-reported intimate partner violence (IPV). This cross-sectional study used standardized police data and victim narratives of IPV incidents reported to the police in Dallas, Texas in 2004. The sample included non-Hispanic White, non-Hispanic Black, and Hispanic male perpetrators who were residents of Dallas (N = 4470). Offense charges were prioritized in descending order: sexual assault, aggravated assault, simple assault, kidnapping, robbery, and intimidation. Textual data from the victim narratives were coded, based on the revised Conflict Tactics Scales (CTS), and categorized in descending order of priority: sexual (severe, minor), physical (severe, minor), and psychological (severe, minor) assault. Perpetrators were more likely to be Black and Hispanic. Perpetrator and incident characteristics varied significantly by race/ethnicity, particularly age, age difference between partners, marital status, injury, and interracial relationships. Qualitative data revealed that greater proportions of Black and Hispanic men perpetrated severe physical, but not sexual violence, compared with White men. The greatest disparity between CTS categories and police charges occurred among those cases identified by the CTS as severe physical IPV; 84% were charged with simple assault. Significant differences by race/ethnicity were found only for simple assault charges, which were coded as severe physical as opposed to minor physical IPV more often among Black (69% and 31%) compared with White (62% and 38%) men. The disparities revealed in this study highlight the need to enhance primary and secondary prevention efforts within Black and Hispanic communities and to increase linkages between police, community, and public health organizations. (Contains 4 tables.)

Despite the growing number of interethnic marriages in the United States, few studies have examined intimate partner violence (IPV) in interethnic couples. This article examined past-year occurrences of IPV across interethnic and intraethnic couples and tested correlates of IPV specifically in interethnic couples. Data were from a national survey of couples 18 years of age and older from the 48 contiguous states. Interethnic couples (n = 116) included partners from different ethnic backgrounds, including Black-White, Hispanic-White, and Black-Hispanic couples. White (n = 555), Black (n = 358), and Hispanic (n = 527) intraethnic couples included partners with the same ethnicity. Data analyses were prevalence rates and logistic regressions. The analysis showed that interethnic couples were comparatively younger and had shorter relationships than intraethnic White, Black, and Hispanic couples. Male partners in interethnic couples had higher rates of binge drinking and alcohol problems compared with male partners in intraethnic couples. Past-year prevalence rates for any occurrence of IPV and acts of severe IPV were higher for interethnic couples relative to intraethnic couples. Most occurrences of IPV for interethnic couples were mutual. Factors predicting IPV among interethnic couples included marital status, couples' age, male alcohol problems, and female impulsivity. Mounting evidence points to interethnic couples as a high-risk group for IPV. Interethnic couples may be at greater risk for IPV because of their younger age, binge drinking, and alcohol problems. Future research could build on this study by examining cohort effects and regional differences in IPV for interethnic couples and the risk for IPV across interethnic couples of different ethnic compositions. (Contains 5 tables.)

The purpose of this study was to examine the association between acculturation, birthplace, and alcohol-related social problems across Hispanic national groups. A total of 5,224 Hispanic adults (18+ years) were interviewed using a multistage cluster sample design in Miami, New York, Philadelphia, Houston, and Los Angeles. Multivariate analysis shows no association between acculturation and problems among men or women. Birthplace is a risk factor for social problems among both genders. Among men, Mexican Americans, Puerto Ricans, and South/Central Americans are more likely to report social problems than Cuban Americans. Other risk factors for men are unemployment, a higher volume of drinking, and a higher frequency of binge drinking. Among women, Mexican American origin and binge drinking are also risk factors for reporting problems. U.S.-born Hispanics may experience stress and other detrimental effects to health because of their minority status, which may increase the likelihood of more drinking and the development of alcohol-related problems. (Contains 3 tables.)

This article examines the association between neighborhood characteristics at the census tract-level, couples' perceived neighborhood social cohesion and informal social control, and male-to-female (MFPV) and female-to-male (FMPV) partner violence in the United States. Data come from a second wave of interviews (2000) with a national sample of couples 18 years of age and older who were first interviewed in 1995. The path analysis shows that poverty is associated with perceived social cohesion and perceived social control as hypothesized. However, there is no significant mediation effect for social control or social cohesion on any type of violence. In the path analysis, Black ethnicity is associated with social cohesion, which is associated with MFPV. Intimate partner violence (IPV), as a form of domestic violence, may not be as concentrated in high-poverty neighborhoods as criminal violence. IPV may be more determined by personal and dyadic characteristics than criminal violence. (Contains 1 table and 1 figure.)

This paper examines the relationship between intimate partner violence and depression. A multicluster random household sample of U.S. couples was interviewed as part of a five-year national longitudinal study (response rate = 72%). Depression was assessed with the CES-D. The multivariate analyses for men showed that the odds of depression did not vary significantly by type of male-to-female (MF) or female-to-male (FM) aggression. Men who engaged in infrequent binge drinking, compared to those who never binged, were less likely to be depressed, as were men with greater collective efficacy. For women, the multivariate analysis, showed that FM aggression (psychological: minor and severe, and physical) was associated with a greater likelihood of depression. Exposure to parental violence was also associated with depression. Women may experience depression as the result of psychological and physical aggression even if they are the perpetrators of such aggression. (Contains 4 tables.)

Purpose: To estimate prevalence rates of intimate partner violence (IPV) among Brazilian couples and to assess the contribution of drinking and sociodemographic factors to the risk of IPV. Methods: A sample consisting of 1,445 married or cohabitating males and females in the Brazilian population was interviewed. The survey response rate was 66%. Results: The analyses indicate 10.7% and 14.6% prevalence, respectively for male-to-female and female-to-male IPV. Males were drinking in 38.1% of IPV events and females in 9.2%. The male's partner was drinking in 30.8% and the females' partner in 44.6% of IPV acts. Bivariate associations between violence and sociodemographics were found for age groups, household monthly income and educational level. Logistic regression analysis indicate that younger age for both male and female partners, men with no religious affiiliation and women who are homemakers are significant predictors of violence. Conclusion: This survey provides important information to further IPV research in Brazil. (Contains 4 tables.)

This article examines agreement on reports of male-to-female and female-to-male psychological, physical, and sexual violence among White, Black, and Hispanic couples in the United States. Using a probability sample, separate face-to-face interviews were conducted in respondents' homes with both members of 1,025 intact couples living in the 48 contiguous states. The overall survey response rate was 72%. Results indicate that agreement on each of the three types of violence is low, independent of perpetrator's gender and ethnicity. Kappa coefficients of agreement range from 0.07 to 0.48. Higher agreement is obtained for psychological violence, followed by physical and sexual violence. Depending on the type of violence, between 30% (psychological aggression) and 90% (sexual coercion) of events would not have been identified if identification required agreement between partners. Logistic analysis shows that the severity of violence is the only variable that increases the likelihood of agreement across the three types of violence. (Contains 4 tables.)