Non-medical drivers of health and imaging patterns in intimate partner violence

Non-medical drivers of health (NMDH) impact the risks and outcomes of intimate partner violence (IPV). Here, we investigate the relationship between NMDH and radiological manifestations of IPV.

This study analyzed female cases (N = 151) reporting IPV between 2013 and 2018 and controls (N = 146) who did not report IPV, each with at least one radiologic study and social work note. NMDH variables were collected, including age, race, language, primary care provider, social support, social services, housing stability, and area deprivation index. Radiology reports were reviewed to determine injuries and severity. Each patient received a cumulative NMDH index ranging from 0 (no NMDH risk factors) to 5 (maximal risk factors). Poisson and logistic regression were used to calculate adjusted incidence rate ratios (aIRR) and odds ratios (aOR) for imaging utilization and injuries with respect to NMDH risk factors.

NMDH variables associated with IPV included lack of a primary care provider (p = 0.0034), lack of social support ( p < 0.0001), use of social services (p < 0.001), housing instability (p < 0.0001), and a higher NMDH index (p = 0.0002). Imaging utilization rates were not significantly different between patients with a higher versus lower NMDH index for cases (aIRR: 0.84, p = 0.24) or controls (aIRR: 0.72, p = 0.19). Among cases, a higher NMDH index was associated with increased odds of injury detection on radiologic studies (aOR: 1.78, p = 0.008).

Multiple NMDH risk factors are associated with higher odds of IPV-related injuries visible on imaging. Integrating NMDH variables into clinical risk stratification tools may facilitate earlier identification and intervention for patients who experience IPV.