Family violence as a public health problem: Effects and costs in Finnish health care

Abstract

The aim of this study was to provide more information on the long-term health effects of family violence on victims and the costs to health services of treating victims. This is the first longitudinal study conducted on the topic in Finland. It is also the first study to directly compare the health effects and costs of treating different types of interpersonal violence. The study also provides new information on Finnish health care professionals’ experiences of family violence. The study data comprise two separate data sets gathered in collaboration with the Central Finland Health Care District. The first data set was collected from employees of the Central Finland Health Care District using a cross-sectional wellbeing questionnaire (N = 1 952). The second data set comprised emergency care patients who had been identified as having experienced family, sexual or other interpersonal violence (N = 345) and whose health care use and costs were analysed two years before and two years after their identification date. Data were analysed using chi-square test for independence (crosstabs), one-way analysis of variance, Kruskal-Wallis test, confirmatory factor analysis, multinomial logistic regression analysis, correlation analyses with the Kendall’s Tau correlation coefficient, and structural equation modeling. The results showed that the health care costs of family violence victims had already exceeded the level of the general population 1.5 years before their identification in emergency care and further increased towards the identification date. These results indicate that the earlier identification of family violence in health care settings could significantly reduce both the associated health problems and the financial burden it places on health care services. Family violence was found to be common among a sample of health care professionals, and was significantly associated with impaired mental health and well-being. Hence, occupational health care services catering to health care professionals should also be better aware of family violence and able to offer active support to victims. This study demonstrates that family violence is a significant public health problem in Finland that affects individuals, institutions, and society. Thus, more resources should be dedicated to addressing family violence in health care services. Keywords: Family violence, interpersonal violence, health care use, health care costs, quantitative research