Are money problems and violence related?

"What we don't know yet is whether financial stress makes a violent couple more violent, or is financial stress enough of a disruption in a relationship that violence begins?" says Corinne Peek-Asa, a corresponding author and director of the Injury Prevention Research Center at the UI College of Health. "Both are plausible."

What researchers did discover is more women than men report experiencing financial stressors; more women than men also report lashing out verbally and physically at their partners. But that doesn't necessarily mean women are more likely than men to respond to financial stressors with violence.

Like relationships themselves, teasing out cause and effect is complicated.

Though researchers aren't ready to identify specific interventions for couples that are struggling with finances and domestic abuse, they are beginning to see that stressors beyond health, such as financial strain or unstable housing, may be at the root of some health-related problems.

The study, "Association of financial stressors and physical intimate partner violence perpetration," was published March 1 online in Injury Epidemiology.

Using data from the National Longitudinal Study of Adolescent to Adult Health -- a study of a nationally representative sample of adolescents that began in 1994, when participants were in grades 7 through 12 -- researchers examined the association between financial stressors and three levels of violence, as reported by 11,499 participants. The researches gathered data for the UI study in 2008, when participants in the initial longitudinal study were between the ages of 24 and 32. The three levels of violence were "making threats/minor physical abuse," "severe physical abuse," and "physical abuse causing injury."

Participants recounted how often they committed each form of violence on a scale ranging from "never" to "more than 20 times in the last year." They also reported if they had experienced six types of financial stressors at least once in the past 12 months: nonpayment of utilities, nonpayment of housing, fears of food unavailability, utilities turned off, and eviction.

Researchers found that more women (27.7 percent) than men (22.9 percent) experienced at least one financial stressor. A higher percentage of women than men reported experiencing three of the six types of financial stressors. Plus, a higher percent of women than men were unable to pay their utilities (17.6 percent vs. 12.7 percent), reported food insecurity (14 percent vs. 9.9 percent), and experienced disconnected phone service (10.4 percent vs. 7.8 percent).

According to the data, men and women experienced housing nonpayment, having utilities turned off, and eviction in about the same proportions.

Also, a higher number of women than men reported perpetrating threats/minor physical abuse (11.4 percent vs. 6.7 percent) and severe physical abuse (8.8 percent vs. 3.4 percent). But more men who perpetrated violence reported causing injury to their partner (32 percent vs. 21 percent). Overall, 92.9 percent of men and 86.7 percent of women reported they had committed no form of violence to their partner in the prior year.

Laura Schwab-Reese, lead author and Ph.D. graduate in the Department of Community & Behavioral Health at the UI College of Public Health, says the data is helpful, but it isn't conclusive enough to develop interventions.

"So, we know violence happened in the last year, and we know that financial stressors happened in the last year," she says. "But what we haven't been able to tease apart with this data is whether the financial stressor happened immediately before a violent episode, or did it exacerbate an already violent relationship? That is a really important point in terms of developing interventions."

Peek-Asa says pinpointing the root issue is key to providing meaningful help.

"When we are developing interventions, do we need to focus on reducing the event, such as reducing the financial stressor, or do we need to help people manage the stress that happens as a result of the financial stressor?" she says.

Peek-Asa says the study comes at an important time, when more people than ever have access to health care because of the Affordable Care Act, which requires all hospitals to conduct a community needs assessment and increase efforts to refer patients to community resources.

That could mean expanding the scope of what doctors typically consider health-related stress, from things such as being overweight, smoking, and drinking, to include such stressors as food insecurity, unpaid bills, and eviction.

"Although hospitals aren't quite there yet, some of the most important health needs of patients are things like housing, employment services, and financial consulting -- things that could reduce financial stress and potentially reduce intimate partner violence," says Peek-Asa.