The impact of the Great Recession on California domestic violence events, and related hospitalizations and emergency service visits

OBJECTIVE: Explore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California. METHODS: Hospital and ED data were drawn from California's Office of Statewide Health Planning and Development (OSHPD). DV-related hospitalizations and ED visits in California were analyzed between January 2000 and September 2015 (53,596), along with total medical costs. Time series were divided into pre-recession (Jan 2000-Nov 2007) and recession/post-recession (Dec 2007-Sept 2015) periods. RESULTS: The medical cost of DV-related hospitalizations alone was estimated as $1,136,165,861. A dramatic increase in DV episodes was found potentially associated with the Great Recession. The number of ED visits per month tripled from pre- to post-recession (104.9 vs. 290.6), along with an increased number of hospitalizations (77.1 vs. 95.6); African Americans and Native Americans were disproportionally impacted. In addition, psychiatric comorbidities, severe DV episodes, in-hospital mortality and charge per hospitalization escalated. The rise in DV hospitalizations and ED visits beginning in December 2007 was mainly attributable to physical abuse episodes in adults; minors had no change in DV trends. DISCUSSION: Recessions are frequent in modern economies and are repeated cyclically. Our study provides critical information on the effects of the 2007 financial crisis on DV-related healthcare service utilization in California. Given the current financial crisis associated with COVID-19, which expert predict could extend for years, the results from this study shine a spotlight on the importance of DV-related screening, prevention and response.