The main purpose of the review has been to identify which of them that have included questions on violence and then make limited analyses of these data and relate it to issues of physical and mental health.
Health surveys that included questions on violence
If we see the health surveys as a whole we find that little has mapped the occurrence of more serious potentially traumatizing events, such as violence and abuse, accidents and disasters and other life-threatening events. Only two of the surveys had included questions about physical violence; the health survey in Oslo (HUBRO) and the health survey in Hordaland (HUSK).
HUBRO was carried out in the years 2000-2001, and covered basically all inhabitants in Oslo, born in the years 1924-25, 1940-41, 1954-55, 1960 and 1969-70, a total of 58 178 people. Not all met, 22699, or 39%, participated. Only part of the selection was asked questions about violence, and only women should answer them, so that our analyses are based on a net selection of 8643 women.
HUSK was conducted in the municipalities of Hordaland in the years 1997-99. All persons born in the years 1953 to 1957 were invited to participate, in all 29 400 people and 16 170, or 55%, returned the form. Not all received questions about violence, or they returned blank forms, and only half of the men were to answer the questions about violence, so that our analysis file includes a selection of 11 059 people, 7724 women and 3335 men.
Analyses of data
Review of the surveys show that the incidence of violence and sexual assault among respondents is significant. Data from the health surveys support other different Norwegian and international research concerning the occurrence of such events in the population. In the HUBRO survey, a total of 36 % of the women reported that they had experienced violence, threats of violence or sexual assault. 17 % reported that they had experienced at least one type of abuse as a child and 26 % had been exposed in adult- hood. Unfortunately, the questions in HUSK are designed in such a way that it is not possible to give exact figures for the proportion of risk among respondents.
The surveys indicate that the exposure to violence and other negative life events are not evenly distributed in the population. The incidence is higher among people with low socio-economic status, including those who live alone, are divorced or separated, are lonely and have few friends, and among those who frequently get drunk. Those who have been the victim of abuse as a child are also at greater risk of being exposed as adults and those who have been subjected to a type of abuse is also more often exposed to other forms of abuse.
Mental and physical health
Both surveys have included measures of the respondents’ mental health, and in both surveys we find significant differences between those who have been exposed to violence and those who have not. The HUBRO survey suggests that the more kinds of abuses women had been exposed to, the greater the likelihood that they were also had mental problems.
In the HUBRO survey respondents were also asked if they had a variety of somatic diseases, and if so, when these had appeared for the first time. For a number of these diseases, there were a greater proportion of those who had been exposed to abuse than among those who had not been exposed, who reported that they had or had had these diseases. This was the case with asthma, hay fever, fibromyalgia, chronic bronchitis, angina pectoris, and for the most violence-prone also a heart attack. The violence-prone also had a larger consumption of a variety of medications and various health services.
Since we in the HUBRO survey ask questions about exposure to violence as a child, about health, both mental problems and somatic diseases as adults, we have the opportunity to look specifically at those who were subject to abuse as a child and their health as adults. We find then that both physical and mental health is significantly worse for those who were exposed as children than among those who were not. Although this does not provide sufficient basis to conclude that the abuse has led to later health problems, it weakens it in any case the probability that there are health issues that have led to their being subjected to violence.
Definitions and measuring instruments
In the review of the health surveys we also focus on how the issues of violence have been reviewed in the surveys. We have in the report dealt especially with questions about physical violence to investigate the validity and reliability. A problem both in national and international violence research is that questions about physical violence often are differently designed, and that they thus provide knowledge and information about different types of phenomena. We also see this in our review of health surveys. We therefore stress the need for drafting clearer definitions and more accurate measuring instruments in research on violence. In other words, work should be done to find good definitions and operationalizations of violence as a phenomenon and to coordinate this work in connection with the design of future health surveys.