Intimate Partner Violence in the Relationships of Men With Disabilities in the United States

Abstract

Despite the growing literature on intimate partner violence (IPV) victimization against people with disabilities, few studies have examined IPV against men with disabilities. This study uses population-based data to examine the prevalence of past-year and lifetime IPV against men with disabilities in the United States in comparison with men without disabilities and women with and without disabilities, compare the demographic characteristics of men with disabilities who reported IPV to those of other men, and examine associations of IPV and disability status with mental and physical health and other health risks among men. Results indicate that, adjusting for demographic characteristics, men with disabilities were more likely to report lifetime IPV than men without disabilities and, among those reporting any lifetime IPV, men with disabilities were more likely to report past-year IPV than both nondisabled men and women. With few exceptions, comparisons of health indicators revealed that men with disabilities reporting lifetime IPV were more likely than other men to report poor health status and to report engaging in health risk behaviors. Directions for future research and programmatic and policy implications of these results are discussed.

Keywords

intimate partner violence men with disabilities disability abuse

Introduction

People with disabilities are at a higher risk for violence compared with those without disabilities (Barrett, O’Day, Roche, & Carlson, 2009; Casteel, Matin, Smith, Furka, & Kupper, 2008; Cohen, Forte, Du Mont, Hyman, & Romans, 2005; K. Hughes et al., 2012; R. L. Hughes, Gabrielli, Powers, & Curry, 2011; Martin et al., 2006; Mitra, Lu, & Manning, 2012; Mitra, Mouradian, & Diamond, 2011; Brownlie, et al., 2007; Oktay & Tompkins, 2004). Despite the growing literature on intimate partner violence (IPV) against adults with disabilities, few studies have examined IPV against men with disabilities. Like their female counterparts, men with disabilities are vulnerable to various forms of violence victimization (Mitra et al., 2011; Powers et al., 2008; Saxton et al., 2006) including IPV (Cohen, Forte, Du Mont, Hyman, & Romans 2006). Only one population-based study has examined IPV against men with disabilities. In that study, Cohen et al. (2006) found that men with activity limitations were at a greater risk than men without activity limitations for physical, emotional, and financial IPV during the five years preceding study participation, but found no difference in rates of sexual assault by an intimate partner.

Prior studies have found associations between IPV experience and poor mental, physical, and emotional health among women (Black et al., 2011; Coker et al., 2002; Coker, Smith, Bethea, King, & McKeown, 2000; Resnick, Acierno, & Kilpatrick, 1997) and men in the general population (Reid et al., 2008). Women and girls with disabilities who have experienced IPV have been found to be even more likely than their nondisabled peers to also experience these negative health outcomes (Barrett et al., 2009; Mitra, Mouradian, & McKenna, 2012). However, no prior studies have focused on the relationship between IPV victimization and the mental and physical health of men with disabilities.

In this study, we examine the prevalence of past-year and lifetime IPV against men with disabilities in the United States in comparison with men without disabilities and women with and without disabilities. We compare the demographic characteristics of men with disabilities who have experienced lifetime IPV with those of other men and examine associations of lifetime IPV with mental and physical health and select health risks among men with and without disabilities.

Based on the findings of prior research on disability and various forms of interpersonal violence, including studies of IPV and disability among women, we hypothesized that men with disabilities would be more likely than nondisabled men to have experienced IPV during their lifetimes. With regard to health status, we also expected patterns similar to those found by studies on IPV victimization history and disability status among women and IPV history among nondisabled men and women; namely, we expected men with disabilities who also have experienced IPV to be more likely than other men to also report poor health and engaging in behaviors that pose health risks.

Method

Study data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS; Centers for Disease Control and Prevention [CDC], 2005-2007). The BRFSS is a CDC-coordinated, state-based system of cross-sectional, random-digit-dialed telephone health surveys in the United States that collects information on health status and disease prevalence, health risk behaviors, preventive health practices, and health care access. BRFSS data are collected in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam.

For the purposes of this study, 2005-2007 BRFSS data were combined to obtain an effective sample size for persons with disabilities. Not every state and territory is represented in the sample, however, because the IPV module was a CDC-provided optional module that state and territorial health departments could choose to or not to administer as part of their own version of the survey. During the three years covered by the present study, states and territories that administered the IPV module during one or all of these years included: Arizona, Arkansas, Hawaii, Iowa, Louisiana, Missouri, Montana, Nevada, Ohio, Oklahoma, Puerto Rico, Rhode Island, Vermont, the U.S. Virgin Islands, Virginia, and West Virginia.¹

During the years utilized for these analyses, the BRFSS sampling frame was restricted to landline telephone numbers. For details about BRFSS sampling and weighting procedures, see the BRFSS Overview documents for the respective data years covered by this study available at http://www.cdc.gov/brfss/technical_infodata/surveydata/2005.htm and for information about validity and reliability, and the validity of combining BRFSS data across states, see the CDC web publication: BRFSS Data Quality, Validity, and Reliability, at http://www.cdc.gov/brfss/pubs/quality.htm.

Measures

Survey participants responding yes to any of the following questions were classified as having experienced any lifetime IPV: (a) whether they ever had been threatened with physical violence by an intimate partner (threatened); (b) whether an intimate partner had ever attempted physical violence against them (attempted); (c) whether an intimate partner had ever hit, slapped, pushed, kicked, or hurt them in any way (physical); (d) whether they had ever experienced any unwanted sex by a current or former intimate partner (sexual). Past-year IPV was defined as reports of experiencing any physical violence by or unwanted sex with an intimate partner in the past year. Respondents who answered no to all four of the “ever” questions were classified as not having experienced lifetime IPV. Respondents who either answered no to all four “ever” IPV questions or to both of the past-year IPV questions were classified as not having experienced IPV in the past year. Past-year IPV injury was indicated if respondents who experienced past-year IPV also indicated in answer to a follow-up question that they had had any physical injuries (including bruises, cuts, vaginal or anal tears or broken bones) as a result of physical violence or unwanted sex in the past year. Respondents who answered no to all four “ever” IPV questions or to both of the past-year IPV questions or to the past-year IPV injury question were classified as not having experienced injury due to IPV in the past year.

Respondents were asked whether they had limitations because of physical, mental, or emotional problems and whether they had a health problem that required use of special equipment. Those responding yes to either of the two questions were classified as having a disability. Survey participants who responded no to both disability screening questions were classified as not having a disability.

The health indicators included in this study consisted of a general health status question on whether respondents consider their general health to be excellent, very good, good, fair, or poor (of interest was the prevalence of reporting fair or poor health); health-related quality-of-life questions relating to respondents mental health status, including whether they had felt worried, tense, or anxious, that their mental health was not good, or whether they had slept poorly for two weeks or more within the 30 days preceding their interview. Furthermore, to indicate current smoking status and whether they had engaged in any binge drinking in the month preceding their interview, respondents were asked whether they had smoked within the last 30 days and about their level of alcohol consumption in the last month. For men, binge drinking was defined as having had five or more alcoholic beverages on a single occasion; for women, the threshold was four or more alcoholic beverages.

Analysis

Analyses were conducted on all cases for which there were valid answers to the gender, disability, and IPV module questions based on the operational definitions indicated above. In addition, cases missing information for one or more of the outcome or covariate measures in a given logistic regression analysis were also excluded in those analyses.

All data analyses were conducted in SAS 9.2 using proc surveymeans and proc surveylogistic with strata, cluster, and weighting variables provided by the CDC to account for the BRFSS’s complex multi-stage sampling design and to adjust estimates based on census-derived counts of each state’s gender, age, and race-ethnicity distribution. Within proc surveymeans, domain analyses were used to obtain prevalence estimates for population demographics and for various forms of IPV by gender and disability status. Multivariate logistic regression analyses were used to examine (a) the association of disability status and gender with IPV while controlling for age, race/ethnicity, education, marital status at time of interview, and employment status at time of interview, and (b) the association, among men, of disability status and experience with IPV with health indicators including mental health status and health risk behaviors controlling for the demographic characteristics indicated above. Relative standard errors (RSEs) were examined for all comparisons and were found to be below 0.30, unless otherwise noted in the text or tables.

Results

Men and women were about equally represented in this study (48.9% vs. 51.1%, respectively). Overall, 20.7% reported having a disability (19.5% of men; 21.8% of women). Men with disabilities were older, less likely to report being of Hispanic or Latino ethnicity, and more likely to report being White, non-Hispanic than men and women without disabilities. They were also less likely to have a college or university degree than those without disabilities but more likely than women with disabilities to have a college or university degree. Men with disabilities were also more likely to be married or part of an unmarried couple than women with and without disabilities and less likely to be employed compared with men and women without disabilities but more likely to be employed than women with disabilities (see Table 1).

Table 1.

Demographic Characteristics, by Gender and Disability Status (% [95% CI]).

	Men		Women
	With Disabilities (n = 9,574)	Without Disabilities (n = 30,651)	With Disabilities (n = 15,593)	Without Disabilities (n = 46,398)
Age
18-34	16.9 [15.0, 18.8]	37.2 [35.9, 38.4]	15.6 [14.1, 17.2]	35.5 [34.6, 36.4]
35-54	36.7 [34.8, 38.5]	39.8 [38.7, 40.9]	36.6 [35.2, 38.0]	39.5 [38.6, 40.3]
55+	46.4 [44.5, 48.3]	23.1 [22.3,23.8]	47.8 [46.3, 49.2]	25.0 [24.4, 25.7]
Race and ethnicity
White, non-Hispanic	76.1 [74.4, 77.8]	73.4 [72.4, 74.4]	76.7 [75.3, 78.0]	72.2 [71.4, 73.0]
Hispanic or Latino	7.9 [6.6, 9.2]	10.4 [9.6, 11.2]	8.0 [6.8, 9.2]	10.5 [9.9, 11.1]
Other, non-Hispanic	15.9 [14.6, 17.3]	16.2 [15.4, 17.0]	15.3 [14.4, 16.3]	17.3 [16.7, 18.0]
Education
High school or less	45.7 [43.8, 47.6]	38.1 [37.0, 39.2]	47.4 [45.9, 48.9]	38.0 [37.1, 38.9]
Some college/tech school	26.4 [24.8, 28.1]	25.1 [24.1, 26.1]	28.3 [27.0, 29.6]	27.3 [26.6, 28.1]
4-year college degree or more	27.8 [25.9, 29.7]	36.8 [35.7, 37.9]	24.3 [23.0, 25.6]	34.7 [33.8, 35.5]
Marital status
Married or part of an unmarried couple	68.9 [67.1, 70.6]	67.3 [66.1, 68.5]	54.6 [53.1, 56.1]	65.9 [65.1, 66.8]
Divorced, widowed, or separated	17.3 [16.1, 18.5]	10.4 [9.8, 11.0]	33.9 [32.6, 35.1]	17.2 [16.7, 17.8]
Never married and single	13.8 [12.3, 15.4]	22.3 [21.1, 23.5]	11.5 [10.1, 12.9]	16.9 [16.1, 17.7]
Employment status
Employed	44.6 [42.6, 46.5]	78.4 [77.5, 79.3]	34.4 [32.9, 35.8]	62.0 [61.2, 62.9]
Not employed	55.4 [53.4, 57.4]	21.6 [20.7, 22.5]	65.6 [64.2, 67.1]	38.0 [37.1, 38.9]

Note. n = 102,216. The “domain” specified in proc surveymeans was a combined gender and disability status variable. Therefore, within a demographic category, the subcategory prevalence estimates in the columns will sum to approximately 100%, but the row estimates will not. CI = confidence interval.

The overall prevalence of lifetime IPV was 19.8%, with 14.4% of men and 25% of women reporting lifetime IPV. Almost 30% of those with disabilities (27.9%) reported lifetime IPV compared with 17.7% of those without disabilities. Both these differences were statistically significant.

IPV by Disability Status and Gender

In bivariate analyses (Table 2), men with disabilities were more likely than men without disabilities to report lifetime IPV. They were also more likely than men without disabilities to report lifetime threatened, attempted, completed physical, and sexual IPV. Men with disabilities were as likely to report lifetime attempted IPV as nondisabled women. Women with disabilities were more likely than all other groups to report all forms of lifetime IPV.

Table 2.

Lifetime and Past-Year IPV Among Men and Women With and Without Disabilities (% [95% CI]).

	Men		Women
	With Disabilities	Without Disabilities	With Disabilities	Without Disabilities
Lifetime IPV	(n = 9,574)	(n = 30,651)	(n = 15,593)	(n = 46,398)
Any IPV	19.0 [17.4, 20.5]	13.3 [12.5, 14.1]	35.5 [34.1, 36.9]	22.1 [21.3, 22.8]
Any threatened IPV	11.8 [10.5, 13.1]	7.2 [6.5, 7.8]	26.6 [25.3, 27.9]	16.0 [15.4, 16.7]
Any attempted IPV	13.1 [11.7, 14.5]	9.0 [8.3, 9.7]	22.3 [21.0, 23.5]	13.1 [12.5, 13.7]
Any physical IPV	13.7 [12.3, 15.1]	9.2 [8.5, 9.8]	28.3 [27.0, 29.6]	16.6 [16.0, 17.3]
Any sexual IPV	2.6 [2.0, 3.3]	1.1 [0.9, 1.4]	17.0 [15.9, 18.0]	8.0 [7.5, 8.5]
Any IPV in past year (among those reporting any lifetime)	(n = 1,324)	(n = 2,799)	(n = 5,077)	(n = 9,084)
Past-year IPV	12.2 [6.7, 17.7]	8.0 [5.3, 10.6]	7.1 [5.6, 8.5]	7.8 [6.4, 9.1]
Any injuries in past year due to IPV (among those reporting past-year IPV)	(n = 103)	(n = 180)	(n = 303)	(n = 580)
Any injuries in past year due to IPV	43.7 [30.2, 57.2]	43.4 [24.9, 61.9]	56.6 [46.0, 67.2]	53.5 [46.1, 60.9]

Note. n = 102,216. CI = confidence interval; IPV = intimate partner violence.

Among those who reported any lifetime IPV, there were no statistically significant differences by disability and gender in the prevalence of past-year IPV. Similarly, among those who reported any past-year IPV, there were no statistically significant differences in the prevalence of injuries due to physical or sexual IPV in the past year by disability and gender group (Table 2).

In multivariate analyses controlling for demographics, men with disabilities were more likely to report any lifetime IPV compared with men without disabilities (Table 3). They were also more likely to report lifetime threatened, attempted, physical, and sexual IPV than men without disabilities (Table 3) and lifetime attempted IPV compared with women without disabilities (data not shown). Among those who reported any lifetime IPV, men with disabilities were more likely than women and men without disabilities to report past-year physical and/or sexual IPV. Caution should be exercised in interpreting the multivariate past-year IPV results, however, because the RSEs associated with the past-year estimates for males with disabilities were greater than .30 (Table 3).

Table 3.

Lifetime and Past-Year IPV Among Men and Women With and Without Disabilities (Adjusted Odds Ratio^a,b [95% CI]).

	Men		Women
	With Disabilities	Without Disabilities	With Disabilities	Without Disabilities
Lifetime IPV	(n = 9,364)	(n = 30,125)	(n = 15,269)	(n = 45,493)
Any IPV	1.9 [1.7, 2.2]	—	4.2 [3.8, 4.7]	1.9 [1.7, 2.0]
Any threatened IPV	2.2 [1.8, 2.6]	—	5.5 [4.9, 6.3]	2.5 [2.3, 2.8]
Any attempted IPV	1.9 [1.6, 2.2]^c	—	3.3 [2.9, 3.7]	1.5 [2.3, 2.8]
Any physical IPV	1.9 [1.7, 2.3]	—	4.5 [4.0, 5.0]	2.0 [1.8, 2.2]
Any sexual IPV	2.7 [1.9, 3.9]	—	19.5 [15.1, 25.2]	7.6 [5.9, 9.6]
Any IPV in past year (among those reporting any lifetime IPV)	(n = 1,299)	(n = 2,765)	(n = 4,984)	(n = 8,956)
Past-year IPV	2.0 [1.0, 4.1]^d	—	1.1 [0.7, 1.8]	1.1 [0.7, 1.6]
Any injuries in past year due to IPV (among those reporting past-year IPV)	(n = 101)	(n = 177)	(n = 299)	(n = 571)
Injuries in past year due to IPV	1.2 [0.5, 2.7]	—	1.6 [0.7, 3.5]	1.3 [0.7, 2.5]

Note. n = 100,251. CI = confidence interval; IPV = intimate partner violence.

Adjusting for race/ethnicity, age, education, and marital and employment status at time of interview.

Reference group is men without disabilities.

Men with disabilities more likely than women without disabilities to report any lifetime attempted IPV (statistics not shown in the table).

Men with disabilities also more likely than women without disabilities to report any past-year IPV, but relative standard error > .30 so interpret this comparison with caution (statistics not shown in the table).

Men with disabilities who reported lifetime IPV compared with men with disabilities who did not report any lifetime IPV were younger; more likely to be non-White, non-Hispanic; more likely to have some college education; less likely to be married or part of an unmarried couple; more likely to be separated, divorced, or widowed; and more likely to be employed. Compared with men without disabilities who did and did not report IPV, men with disabilities who reported any IPV were more likely to be middle aged (35-54) and less likely to be aged 18 to 34; more likely to be separated, divorced, or widowed; and less likely to be employed (see Table 4).

Table 4.

Demographic Characteristics Among Men With and Without Disabilities and IPV Victimization (% [95% CI]).

	Men With Disabilities		Men Without Disabilities
	IPV (n = 1,746)	No IPV (n = 7,828)	IPV (n = 3,851)	No IPV (n = 26,800)
Age
18-34	26.3 [21.8, 30.8]	14.7 [12.6, 16.8]	47.1 [43.8, 50.4]	35.6 [34.3, 37.0]
35-54	50.2 [45.5, 54.8]	33.5 [31.5, 35.5]	41.7 [38.7, 44.8]	39.5 [38.3, 40.7]
55+	23.5 [20.4, 26.7]	51.8 [49.6, 53.9]	11.1 [9.6, 12.7]	24.9 [24.0, 25.7]
Race and ethnicity
White, non-Hispanic	71.0 [67.1, 74.8]	77.4 [75.5, 79.3]	70.7 [67.9, 73.6]	73.8 [72.7, 75.0]
Hispanic or Latino	6.6 [4.5, 8.7]	8.2 [6.8, 9.7]	10.7 [8.5,12.8]	10.4 [9.6, 11.2]
Other, non-Hispanic	22.5 [19.0, 25.9]	14.4 [12.9, 15.8]	18.6 [16.3, 20.9]	15.8 [15.0, 16.7]
Education
High school or less	41.6 [37.1, 46.0]	46.7 [44.6, 48.8]	38.3 [35.1, 41.5]	38.1 [36.9, 39.3]
Some college/tech school	32.1 [27.9, 36.3]	25.1 [23.3, 26.9]	29.5 [26.5, 32.4]	24.4 [23.4, 25.5]
4-year college degree or more	26.3 [21.6, 30.9]	28.2 [26.1, 30.2]	32.2 [29.3, 35.2]	37.5 [36.3, 38.6]
Marital status
Married or part of an unmarried couple	55.8 [51.3, 60.3]	71.9 [70.0, 73.8]	53.2 [50.0, 56.5]	69.5 [68.3, 70.8]
Divorced, widowed, or separated	26.4 [22.9, 29.8]	15.2 [14.0, 16.4]	19.6 [17.3, 21.9]	8.9 [8.4, 9.5]
Never married and single	17.8 [14.2, 21.5]	12.9 [11.2, 14.6]	29.2 [23.8, 30.6]	21.5 [20.3, 22.8]
Employment status
Employed	56.2 [51.8, 60.7]	41.8 [39.7, 44.0]	82.0 [79.3, 84.8]	77.9 [76.9,78.8]
Not employed	43.8 [39.3, 48.2]	58.2 [56.0, 60.3]	18.0 [15.2, 20.7]	22.1 [21.2, 23.1]

Note. n = 40,225. IPV = intimate partner violence; CI = confidence interval. The “domain” specified in proc surveymeans was a combined disability status and IPV experience variable. Therefore, within a demographic category, the subcategory prevalence estimates in the columns will sum to approximately 100%, but the row estimates will not.

IPV, Disability Status, and Associated Health Risks

After controlling for demographic characteristics, with few exceptions, men with disabilities who experienced IPV were more likely than other men to report symptoms of stress and/or poor mental health, and behaviors that pose risks to health. In particular, men with disabilities who experienced IPV were more likely to report feeling worried, tense, or anxious for two or more weeks of the past month, poor mental health for two or more weeks of the past month, sleeping poorly for two or more weeks of the past month, and smoking cigarettes in the past 30 days compared with other men (Table 5).

Table 5.

Association Between IPV, Health Status, and Health Risks Among Men With Disabilities (Adjusted Odds Ratio [95% CI]).^a,b

	Men With disabilities and IPV Experience (n = 1,714) Compared With:
	Men With Disability, No IPV (n = 7,650)	Men Without Disability, IPV (n = 3,798)	Men Without Disability, No IPV (n = 26,327)
Fair or poor health	1.1 [0.9, 1.3]^c	4.7 [3.5, 6.3]	7.0 [5.7, 8.6]
Worried, tense, anxious 2 weeks+ in the past month^d	2.6 [1.3, 5.3]^c	5.4 [2.2, 13.2]	9.1 [4.5, 18.4]
Poor mental health 2 weeks + in past month	1.7 [1.3, 2.1]	3.0 [2.3, 4.0]	6.7 [5.3, 8.5]
Slept poorly for 2 weeks + in past month^d	3.8 [1.9, 7.4]	4.7 [2.2, 10.0]	9.0 [4.6, 17.4]
Smoked in past 30 days	1.7 [1.4, 2.1]	1.3 [1.0, 1.7]^c,e	2.5 [2.0, 3.0]
Binge drinking in the past month	1.4 [1.1, 1.8]^c	0.7 [0.5, 0.9]^c	1.2 [1.0, 1.5]^c,f

Note. n = 39,489. IPV = intimate partner violence; CI = confidence interval; RSE = relative standard errors.

Adjusting for race/ethnicity, age, education, and marital and employment status at time of interview.

Reference group for each column of results is indicated by the column’s title.

Interpret this comparison with caution because RSE > 0.30.

Comparison possible for Hawaiian sample only.

Due to rounding error, the confidence interval appears to include 1.0; however, the p value is < .05 for this comparison.

p = .0835.

Men with disabilities who reported having experienced IPV were also more likely than men who did not report IPV (regardless of disability status) to report binge drinking in the past month, but less likely to do so than men without disabilities who had experienced IPV. All of the binge drinking results should be interpreted with caution because the RSEs associated with the disability and IPV experience group were greater than .30 in each comparison (Table 5). Finally, men with disabilities who had experienced IPV were more likely than men without disabilities (regardless of IPV experience status) to report that their health was only fair or that it was poor.

Discussion

This study documents a greater prevalence of lifetime and past-year IPV victimization among men with disabilities relative to men without disabilities. Adjusting for demographics, men with disabilities were nearly twice as likely to have experienced lifetime IPV victimization compared with nondisabled men and were more likely to report lifetime attempted IPV and past-year physical and/or sexual IPV than men and women without disabilities. However, the past-year comparisons should be interpreted with caution as the RSEs associated with these estimates were greater than 0.30.

Men with disabilities who reported lifetime IPV were younger; more likely to be non-White; more likely to be separated, widowed, or divorced; and more likely to be employed than those with disabilities who did not report IPV. For most health indicators, men with disabilities who experienced IPV were more likely to report poor health and engaging in behaviors risky to health compared with other men. The findings from this study are consistent with earlier studies that have shown that people with disabilities are at higher risk for various forms of violence victimization (Barrett et al., 2009; Casteel et al., 2008; K. Hughes et al., 2012; R. L. Hughes et al., 2011; Martin et al., 2006; Mitra, Lu, et al., 2012; Mitra et al., 2011; Brownlie, et al., 2007; Oktay & Tompkins, 2004; Sullivan et al., 1987; Nannini, 2006), and that violence victimization is associated with negative health and health risk behaviors (Black et al., 2011; Coker et al., 2002; Coker et al., 2000; Mitra, Mouradian, et al., 2012; Resnick et al., 1997).

This study is a follow-up of an earlier study by Cohen et al. (2006). Cohen et al. (2006) documented the prevalence of IPV victimization over a 5-year period against Canadian men and women with activity limitations using population-based data. In this study, we advance the prior research by documenting both lifetime and past-year IPV victimization against men with disabilities. To our knowledge, this study is the first population-based study to examine the health associations of lifetime experience of IPV among men with and without disabilities. Both the results of this study and of prior studies on women and children with disabilities indicate that professionals who work with persons with disabilities need to be aware that women and men with disabilities who have a history of experiencing IPV may be especially in need of services for depression and anxiety (as found in prior research) or symptoms consistent with these mental health issues, and for substance use. IPV intervention providers who work with victims and perpetrators need to be aware of the prevalence of IPV experience among men (and women) with disabilities and ensure that their services are accessible to persons with disabilities. Similarly, service providers who work with persons with disabilities should receive appropriate education about IPV dynamics and use evidence-based/evidence-informed, private, face-to-face screening procedures for identifying client needs in this area. Such procedures need to include a plan for the sensitive, personal expression of concern and provision of up-to-date referrals for IPV intervention services when IPV dynamics are detected in the lives of clients, including male clients. Practitioners from both fields could better serve men and women with disabilities via cross-training and the development of collaborative professional relationships.

Additional research in this area is sorely needed. Basic surveillance could be improved by consistent, systematic inclusion in large, population-based surveys of questions screening for disability status, type, and timing of onset and/or duration. Future research should address the context of IPV among those with disabilities, including determining what proportion of violence against men with disabilities is occurring due to a partner’s acts of self-defense or otherwise in response to the man’s own use of violence and intimidation; whether the relationships between men and women with disabilities and people who perpetrate IPV against them differ in nature or kind from those in which people without disabilities are victimized; whether the nature, frequency, or severity of violence are influenced by disability status and gender; and whether the environments in which IPV occurs differ by disability status of victims and perpetrators. Research is also needed on whether type of disability influences the probability of victimization, the impact of IPV on the victim, system responses to victimization, and short- and long-term impacts on physical and mental health.

In this study, we address physical and sexual IPV against men with disabilities. However, earlier studies have found that men with activity limitations are more likely to experience emotional and financial IPV (Cohen et al., 2006). Women with disabilities also have been found to be at risk for disability-related violence, including medication manipulation, denial or destruction of assistive technology, and/or denial of personal care. Future studies need to compare the prevalence of disability-related abuse and the prevalence of emotional, psychological, and financial IPV and stalking by disability status and gender.

Longitudinal studies are needed to better understand the sequencing of disability and IPV. In what proportion of cases are people who already have a disability being victimized and in what proportion of cases has IPV led to disability? Longitudinal studies are also needed to better understand whether the long-term impacts of IPV differ by disability status and how policies and programming meant to reduce the prevalence of IPV or provide relief or redress impact people with disabilities.

Limitations

This study has several limitations. First, BRFSS methodology precludes participation of those living in institutions or needing assistance with completing the interview due to cognitive or intellectual disabilities. People who are deaf or hard of hearing may also be excluded from this telephone survey. In addition, for the data years analyzed, BRFSS methodology excluded people who did not have landline telephones. The BRFSS disability-specific questions do not allow for determination of type of disability, duration and severity of disability, or disability onset, all of which may have an effect on the association between gender and violence, and the associations between gender, disability status, violence, and health indicators. Earlier studies have found that people with psychiatric and developmental disabilities may be at a greater risk for violence as compared with those with other disabilities (K. Hughes et al., 2012). However, due to the limitations in the survey questions we could not determine the type of disability and the relative prevalence of IPV among men with specific disabilities. The IPV measures included in this study do not include questions on financial and psychological/emotional abuse and stalking, which consequently may underestimate the prevalence of IPV overall, and in this population specifically. In addition, this study does not address disability-specific abuse, which may further put men (and women) with disabilities at risk for IPV. The BRFSS data are based on self-report and therefore subject to the biases of self-reported data. Finally, caution should be exercised in interpreting data on violence against men. BRFSS data do not provide contextual information that would allow us to ascertain what proportion of men experienced violence due to a partner’s acts of self-defense or otherwise in response to the man’s own use of violence and intimidation.

Conclusion

Despite the limitations identified above, the findings of this study are consistent with those of prior research on the association between disability status and the experience of violence, including with studies specific to IPV comparing women with and without disabilities. The findings are also consistent with what has been found in earlier studies regarding the relationship between experiencing interpersonal violence and negative health states and risk behaviors. Thus, the results of this study support the contention that disability status is an important consideration in both future research on violence and in designing and implementing violence intervention and prevention services.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Notes

Author Biographies

Monika Mitra is Assistant Professor of Family Medicine and Community Health and at the Center for Health Policy and Research at University of Massachusetts Medical School. For more than a decade, she has been researching the health and well-being of people with disabilities and the epidemiology of secondary conditions among persons with disabilities. She is particularly interested in the maternal and perinatal health of women with disabilities and in violence against men and women with disabilities. She is also principal investigator for a Eunice Kennedy Shriver National Institute of Child Health and Human Development grant on the health needs and barriers to perinatal care for women with mobility disabilities. Prior to joining University of Massachusetts, she worked for the Office on Health and Disability at the Massachusetts Department of Public Health.

Vera E. Mouradian’s research has focused on intimate partner violence, family violence, and sexual violence prevalence and dynamics. A social psychologist by training, she held a post-doctoral research fellowship at the Family Research Laboratory at the University of New Hampshire and was a research scientist at the Wellesley Centers for Women at Wellesley College prior to joining the Massachusetts Department of Public Health (MDPH). At MDPH, she has worked in the Massachusetts Behavioral Risk Factor Surveillance System team as a senior research analyst and now works as an epidemiologist in the Division of Violence and Injury Prevention.

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