Womens Health Business Case Report

This is despite research suggesting that 87% of women who experience partner violence or sexual assault never contact police . Under-reporting of violence and hesitancy in seeking assistance is particularly pronounced amongst women from Aboriginal and Torres Strait Islander and CALD Backgrounds 20 . Women who have experienced sexual violence report worse physical and mental health including increased rates of chronic conditions and pain, sexually transmitted infections, gynaecological/urogenital issues, anxiety, depression and psychological distress 21 . Disease burden estimates in Australia indicate that domestic and family violence contributes to 19% of suicide & self- inflicted injuries burden, 15% of depressive disorders burden, 17% of early pregnancy loss burden, 11% of anxiety disorders burden and 4% of alcohol use burden in women 22 ; many of these conditions result in presentations to emergency departments and subsequent hospitalisations of women.

Physical

Sexual and Reproductive

• Acute or immediate physical injuries, such as bruises, abrasions, lacerations, punctures, burns and bites, as well as fractures and broken bones or teeth • More serious injuries to the head, eyes, ears, chest and abdomen • Gastrointestinal conditions, long-term health problems and poor health status, including chronic pain syndromes • Death, including femicide and AIDS-related death

• Unintended/unwanted pregnancy • Abortion/unsafe abortion • Sexually transmitted infections, including HIV • Pregnancy complications/miscarriage • Vaginal bleeding or infections

• Chronic pelvic infection • Urinary tract infections • Fistula (a tear between the vagina and bladder, rectum, or both) • Painful sexual intercourse • Sexual dysfunction

Mental

Behavioural

• Depression • Sleeping and eating disorders • Stress and anxiety disorders (eg. post-traumatic stress disorder) • Self-harm and suicide attempts • Poor self-esteem

• Harmful alcohol and substance use • Multiple sexual partners • Choosing abusive partners later in life • Lower rates of contraceptive and condom use

Fig 3: Common Health Consequences of Violence Against Women (WHO 2021) 23

The adverse physical and mental health impacts associated with domestic and family violence and sexual violence and trauma are serious, long-lasting and complex, and continue even after the violence has ceased 24 . Trauma also impacts on many other facets of women’s lives and social determinants of health including their family and social relationships, work capacity, financial security and health behaviours. Domestic, family and sexual violence costs NSW an estimated $7.4 billion each year, based on 2015-16 figures 25 . In the 2022-23 Budget, the NSW Government acknowledged the wide-ranging impacts of this violence on both women’s health and economic participation through increased absenteeism, and decreased work performance and productivity. Women who experience domestic and family violence are also more likely to have lower incomes, fragmented work history, and to be employed in part-time or casual work 26 . The prevalence and health impacts of domestic and family violence and sexual assault highlight the need for accessible, holistic, trauma-informed health services that address the multi-faceted impacts of this trauma on women. Tangible assistance with immediate and acute needs, coupled with mental health services, emotional support and social interaction, and physical activity have all been shown to improve overall health outcomes for women who have experienced sexual violence 27 .

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Women’s Health NSW – October 2022