title: Rural disparity in domestic violence prevalence and access to resources.
abstract: OBJECTIVE
  Intimate partner violence (IPV) against women is a significant health issue in the United States and worldwide. The majority of studies on IPV have been conducted in urban populations. The objectives of this study are to determine if prevalence, frequency, and severity of IPV differ by rurality and to identify variance in geographic access to IPV resources.
  
  
  METHODS
  A cross-sectional clinic-based survey of 1478 women was conducted to measure the 1-year prevalence of physical, sexual, and psychologic IPV. IPV intervention programs in the state were inventoried and mapped, and the distance to the closest program was estimated for each participant based on an innovative algorithm developed for use when only ZIP code location is available.
  
  
  RESULTS
  Women in small rural and isolated areas reported the highest prevalence of IPV (22.5% and 17.9%, respectively) compared to 15.5% for urban women. Rural women reported significantly higher severity of physical abuse than their urban counterparts. The mean distance to the nearest IPV resource was three times greater for rural women than for urban women, and rural IPV programs served more counties and had fewer on-site shelter services. Over 25% of women in small rural and isolated areas lived >40 miles from the closest program, compared with <1% of women living in urban areas.
  
  
  CONCLUSIONS
  Rural women experience higher rates of IPV and greater frequency and severity of physical abuse yet live much farther away from available resources. More IPV resources and interventions targeting rural women are needed.
authors.affiliation: Department of Occupational and Environmental Health, University of Iowa College of Public Health, 100 Oakdale Boulevard, Iowa City, IA 52242, USA. corinne-peek-asa@uiowa.edu
authors.forename: Corinne
authors.initials: C
authors.lastname: Peek-Asa
authors.forename: Anne
authors.initials: A
authors.lastname: Wallis
authors.forename: Karisa
authors.initials: K
authors.lastname: Harland
authors.forename: Kirsten
authors.initials: K
authors.lastname: Beyer
authors.forename: Penny
authors.initials: P
authors.lastname: Dickey
authors.forename: Audrey
authors.initials: A
authors.lastname: Saftlas
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D017579:Domestic Violence; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012934:Social Isolation / Q000523:psychology; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult