Prevalence and Risk Factors of Intimate Partner Violence in Eighteen U.S. States/Territories, 2005 Matthew J. Breiding, PhD, Michele C. Black, PhD, George W. Ryan, PhD Background: Intimate partner violence (IPV) has been shown to have serious health consequences for both women and men, including poor general health, depressive symptoms, substance use, and elevated rates of chronic disease. Aside from crime surveys, there have been no large-scale IPV prevalence studies since the 1996 National Violence Against Women Survey. The lack of regular, ongoing surveillance, using uniform definitions and survey methods across states has hindered efforts to track IPV. In addition, the lack of state-specific data has hampered efforts at designing and evaluating localized IPV prevention programs. Methods: In 2005, over 70,000 respondents were administered the first-ever IPV module within the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a Centers for Disease Control and Prevention–sponsored annual random-digit-dialed telephone survey, provid- ing surveillance of health behaviors and health risks among the non-institutionalized adult population of the United States and several U.S. territories. Results: Approximately 1 in 4 women and 1 in 7 men reported some form of lifetime IPV victimization. Women evidenced significantly higher lifetime and 12-month IPV preva- lence, and were more likely to report IPV-related injury than men. IPV prevalence also varied by state of residence, race/ethnicity, age, income, and education. Conclusions: State-level data can assist state health officials and policy planners to better understand how many people have experienced IPV in their state. Such information provides a foundation on which to build prevention efforts directed toward this pervasive public health problem. (Am J Prev Med 2008;34(2):112–118) © 2008 American Journal of Preventive Medicine Introduction I ntimate partner violence (IPV) is a significant public health problem with an estimated annual cost of $5.8 billion in the United States alone (including medical and mental health costs and lost productivity). 1 The Centers for Disease Control and Prevention (CDC) defines IPV as threatened, at- tempted, or completed physical or sexual violence, and emotional abuse in the context of physical or sexual violence. IPV can be inflicted by a spouse, ex-spouse, current or former boyfriend or girlfriend, dating part- ner, or date. 2 IPV victimization occurs among women and men, in both heterosexual and same-sex couples. IPV victimization has been associated with short- and long-term negative health behaviors/outcomes, rang- ing from depression and heavy alcohol use to increased risk of chronic disease. 3–5 For women alone, IPV in the U.S. results in approximately 2 million injuries and 1300 deaths annually. 1 More recent data from thirteen states participating in the National Violent Death Re- porting System found that 77.2% of intimate partner homicide victims in 2003 were women (D. Karch, personal communication, October 2005). Although it is widely acknowledged that IPV is a significant public health concern, the magnitude of the IPV problem is less well understood. The most recent comprehensive IPV prevalence study was the 1996 National Violence Against Women Survey (NVAWS). 6 More recent data exist, but these do not examine violence among the full range of intimate partners. 7,8 In addition to health surveys, IPV data also have been collected in crime victimization surveys, but these stud- ies are believed to underestimate IPV prevalence. 9 –11 One analysis of the National Crime Victimization Sur- vey found comparable levels of intimate partner physi- cal assault as the NVAWS, but lower rates of intimate partner rape. 11 The lack of regular, ongoing surveil- lance, using uniform definitions and survey methods across states has hindered efforts to track IPV. Without such ongoing IPV surveillance, it is difficult for state From the Epidemic Intelligence Service, Office of Workforce and Career Development (Breiding); Division of Violence Prevention, National Center for Injury Prevention and Control (Breiding, Black); Office of Statistics and Programming (Ryan), National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia Address correspondence and reprint requests to: Matthew J. Bre- iding, PhD, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K-60, Atlanta GA 30341. E-mail: mbreiding@cdc.gov. 112 Am J Prev Med 2008;34(2) 0749-3797/08/$–see front matter © 2008 American Journal of Preventive Medicine • Published by Elsevier Inc. doi:10.1016/j.amepre.2007.10.001