Global epidemiology of intimate partner strangulation: A systematic review of prevalence among representative samples of community-residing adults

Background. Although intimate partner violence (IPV) is associated with a variety of injuries, few, aside from strangulation, are as difficult to detect or are associated with as wide of a range of health problems. This presentation reviews the epidemiology of IPV strangulation (also, albeit incorrectly, called choking) in the general population. Methods. The electronic databases of PubMed, ISI Citation Index, PsychInfo, and others were searched for peer-reviewed publications through December 2012. About a dozen representative sample or cohort studies of community-residing adults – in Canada, England, Jordan, Korea, Mexico, New Zealand, Norway, the U.S., and Vietnam – included questions about strangulation; Studies of fatal strangulation were identified from Canada, Denmark, England, Finland, Ghana, the Netherlands, Norway, Pakistan, Scotland, South Africa, the U.S., Wales, and Zambia. Results. Most studies of fatal strangulation were published in the past decade and focused on the deaths of women. Newspaper articles were the primary data source in low-income countries. Research on non-fatal strangulation documented past-year rates typically in the 2-3% range although there were a few outliers. Conclusions. Strangulation by an intimate partner is not unique to any geographic region. Women are more commonly the victims than are men. Some on-going surveys use less-than-optimal questions. For example, the USAID-funded Demographic Health Surveys, conducted in over 90 low-income countries, typically use a double-barreled question (choked or burned), which addresses potentially severe harm but precludes calculating prevalence of strangulation. A separate question is merited in future epidemiological research on IPV given the multiple negative sequelae of strangulation.