Intimate Partner Violence And Abuse Experience And Perpetration In UK military Personnel Compared To A General Population Cohort: A Cross-sectional Study
Background: Research exploring prevalence of, and factors associated with, increased risk of experiencing or perpetrating Intimate Partner Violence and Abuse (IPVA) in military communities is limited. This study aimed to describe IPVA prevalence in a military sample, explore the role of military-specific risk factors, and draw comparisons with a general population cohort.
Methods: We utilised data from a sample of military personnel participating in a cohort studyof the health and wellbeing of UK military personnel who reported having an intimate relationship in the previous 12 months (n = 5557). To allow for comparison with civilian populations, participants from a general population cohort study in England (n = 6075) were matched on age and sex to the military cohort (n = 8093).
Findings: The 12-month prevalences of IPVA experience and perpetration in the military sample were 12.80% (95% CI 11.72–13.96%) and 9.40% (8.45–10.45%), respectively. Factors associated with both increased IPVA experience and perpetration included childhood adversity, relationship dissatisfaction, military trauma, and recent mental health and alcohol misuse problems. Compared to the civilian cohort, adjusted odds (95% CI) of IPVA experience and perpetration were higher in the military: 2.94 (2.15–4.01) and 3.41 (1.79–6.50), respectively.
Interpretation: This study found higher prevalences of IPVA experience and perpetration in the military compared to the general population cohort and highlighted both non-military and military factors associated with increased risk of both. Relationship dissatisfaction, military trauma and mental health difficulties mark key areas for IPVA prevention and management efforts to target.
Abstract: The Department of Veterans Affairs (VA) is the largest integrated health care system in the US. However, most enrollees (80%) have other health insurance. Veterans’ selective use of VA health care creates an immense challenge for VA leadership, the scale of which is relatively unknown. The VA allocates substantial resources to improve equitable access, prevent suicides, and provide transparency on hospital quality by analyzing VA-provided and VA-purchased care. These analyses will be inaccurate if patient health and reliance on the VA are linked, especially as the VA expands its role as a payer of care and the recently passed PACT Act brings in younger veterans, who are more likely to have private health insurance. This study investigated whether VA reliance was associated with self-reported health, a predictor of health outcomes, and whether this association varied for individuals with different types of outside insurance using a nationally representative survey.