 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
M. Patricia West, MSSW, Public Health Consultant, 2134 Spring St., Philadelphia, PA 19103, 215-568-7811, westvernon@cs.com, Ellen Hutchins, ScD, MSW, Chief, Perinatal and Women's Health Branch, Maternal and Child Health Bureau, Parklawn Bldg Rm 10C-16, 5600 Fishers Lane, Rockville, MD 20857, and Ira J. Chasnoff, MD, President, Children's Research Triangle, 180 North Michigan Avenue, Suite 700, Chicago, IL 60601.
Substance abuse by women and their partners correlates with both family violence and in some cases untimely deaths for women and their children. Work in Philadelphia since 1998 using data from Women's Health Death Review Teams (WDRT), indicate service gaps that if addressed could prevent some of these deaths.
Of 235 women who died in 1999 reviewed by the WDRT, manners of death were: homicide (35), suicide (16), natural (92),or accident(51). The team found that 62% (143) of the 235 deaths were drug/alcohol related deaths. Among 79 of the143 women: 86% had a history of substance abuse, 44% had a diagnosis of mental illness, 16% had history of prostitution.
For example, a 44 yr. old grandmother, left in charge of 3 grandchildren, had been drinking. She apparently went to bed leaving the 3 children unsupervised. The oldest child, a 5 yr old boy, playing with matches started the fire in the couch. Grandmother and child died in the fire. Toxicology showed her BAC was .34. Another report revealed an 18 year old woman, with drug abuse and prostitution history, was thrown out of her parents home in another state when they learned she was pregnant. She came to Philadelphia to live with her boyfriend and his parents. She delivered her child at a local hospital, with no return for follow-up obstetrical care. Four months later the boyfriend filed a missing person report. Her body was found in a local park. She had been beaten, toxicology positive for cocaine and pcp.
Use of a new screening instrument, the 4P's Plus, has been successful in identifying pregnant women at risk of substance abuse and associated domestic violence. Across 3 communities, it was found that 17% of pregnant women needed further evaluation for substance abuse and related risk for violence.
Successful screening programs integrate substance abuse and violence risk and provide valuable information to be used to prevent future mortalities. In addition, such information can be used to tailor drug treatment programs and policy more specifically to the needs of substance using women.
Learning Objectives:
Keywords: Substance Abuse, Family Violence
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.