Socioeconomic determinants and mental health correlates of intimate partner violence–related emergency department visits among women in California

BACKGROUND: Intimate partner violence (IPV) is a major public health concern affecting one in three US women. Many survivors rely on emergency departments (EDs), particularly when socioeconomic disadvantage and mental health vulnerabilities heighten risk. OBJECTIVE: This study identifies demographic, socioeconomic, and clinical factors associated with IPV-related ED visits among women aged 15-64 years in California. METHODS: We performed a cross-sectional analysis of the California State Emergency Department Database (SEDD-HCUP) records from 2018 to 2020. IPV was defined using validated ICD-10-CM codes capturing confirmed and suspected abuse. Covariates included age, race/ethnicity, insurance type, neighborhood socioeconomic status (Distressed Communities Index), and mental health and chronic conditions. Multivariable logistic regression was used to evaluate predictors of IPV-related ED visits. RESULTS: Among 1 387 772 ED visits, 5729 (0.41%) involved IPV. Women living in the most distressed communities had significantly greater odds of an IPV-related visit than those in prosperous areas (adjusted odds ratio [aOR] 1.74; 95% CI 1.52-2.00). Young women demonstrated the highest risk, with those aged 15-24 years having fourfold greater odds compared with women aged 55-64 years (aOR 4.07; 95% CI 3.56-4.65). Uninsured/self-pay women also had more than twice the odds of IPV-related visits relative to privately insured women (aOR 2.59; 95% CI 2.23-3.00). Several mental health conditions, including bipolar disorder, PTSD, and alcohol abuse, were independently associated with elevated IPV risk. CONCLUSION: IPV-related ED visits disproportionately affect young, uninsured women living in poor communities and those with mental health comorbidities. Enhancing ED-based screening, strengthening mental health integration, and expanding community-level prevention efforts are critical to reducing IPV burden.