Thirty-five percent of women around the world have been raped or physically abused, according to statistics the World Health Organization released Thursday. About 80 percent of the time this violence occurs in the home, at the hands of a partner or spouse.

"For me personally, this is a shockingly high figure," says Karen Devries, an epidemologist from the London School of Hygiene and Tropical Medicine. "The levels of violence are very high everywhere."

Devries and a team at the WHO analyzed data from 141 studies in 81 countries. Their findings offer the first comprehensive look at domestic violence globally and give insights into how abuse hurts women's overall health.

"The main message is that this problem affects women everywhere," Devries says. Because of the stigma associated with rape and abuse, "some of our findings may underestimate the prevalence."

When women are murdered, a partner or spouse is the killer 38 percent of the time, the study finds. By comparison, men die at the hands of a wife or partner only 6 percent of the time.

Prevalence of rape and domestic violence in each region of the world.

Prevalence of rape and domestic violence in each region of the world.

Courtesy of the World Health Organization

Domestic violence not only kills some women; it also leaves others with long-standing mental and physical health problems.

Abused women are twice as likely to report being depressed and having their own problems with alcohol. They are also 1.5 times more likely than women who haven't been abused to have a sexually transmitted disease including, sometimes, an HIV infection.

The health impacts can even spill over into the next generation, says Claudia Garcia-Moreno, a physician from the WHO. A woman who has experienced violence has a greater chance of having a low-birth-weight baby. And children who were abused, or who witnessed abuse, are more likely to end up in violent relationships themselves, research shows. "Preventing child abuse is an important strategy for reducing these forms of violence," Garcia-Moreno says.

What else can be done to stop this global trend? Educate women and give them a chance economically, Garcia-Moreno says.

A few years ago, researchers in South Africa gave women small loans to start vegetable stands, tailoring services or other retail businesses. They also educated the women about domestic violence and gender equality. After two years, abuse among the women decreased by more than half.

But Garcia-Moreno thinks the onus is on health professionals worldwide to turn the tide of domestic violence. "We want to see this issue integrated into the curriculum in the basic training for doctors and nurses," she says.

"There is no magic bullet, no vaccine or pill" for rape and abuse, Garcia-Moreno says. "But what we hear from women is that oftentimes, just having an empathetic listener who can provide some practical support and help her get access to some other services — that in itself is an important intervention."

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Transcript

MELISSA BLOCK, HOST:

Today, the World Health Organization released the first global estimate of violence against women. The figures are high all over the world. And as NPR's Rhitu Chatterjee reports, the violence has serious implications for women's health in ways that aren't always apparent.

RHITU CHATTERJEE, BYLINE: According to the new report, about one in three women aged 15 and above has been physically abused or raped. And over 85 percent of those women were attacked by their own partners.

KAREN DEVRIES: I think this is a shockingly high figure.

CHATTERJEE: Karen Devries is at the London School of Hygiene and Tropical Medicine and contributed to the WHO report. She's also the author of a paper on domestic violence in the latest issue of the journal Science. She says not only does domestic violence physically injure women, it can also lead to death.

DEVRIES: Thirty-eight percent of all women who were murdered were actually murdered by their intimate partners.

CHATTERJEE: She says victims of domestic violence are also at a greater risk of developing a range of health problems: Depression, alcoholism and, in some places, even AIDS. And these health effects, Devries says, may carry over into the next generation.

DEVRIES: We see that women who've experienced partner violence have a greater chance of having a low birth-weight baby.

CHATTERJEE: The report is the first comprehensive look at levels of sexual and domestic abuse around the globe. Claudia Garcia-Moreno is a physician with the World Health Organization and one of the lead authors of the report.

DR. CLAUDIA GARCIA-MORENO: When we look at all this data together, what it flags is that this is a tremendous problem.

CHATTERJEE: She admits that some of the findings may even underestimate the prevalence of violence against women. But she says the report goes well beyond just presenting data.

GARCIA-MORENO: We are releasing guidelines for health care providers, doctors, nurses midwives.

CHATTERJEE: So they're better prepared to identify victims of domestic violence.

GARCIA-MORENO: When and how to ask about domestic violence, how to respond appropriately to disclosure of violence.

CHATTERJEE: There's a strong stigma attached to sexual violence, and most victims don't reveal that they were abused. But they do access regular health care facilities so, Garcia-Moreno says, doctors and nurses must be prepared to step in and help.

GARCIA-MORENO: We want to see these issues integrated into the curriculum on the basic training of doctors and nurses.

CHATTERJEE: The report is being well received by experts. Anita Raj directs the Center on Gender Equities and Global Public Health at the University of California, San Diego. She welcomes the report, especially the guidelines for health workers.

DR. ANITA RAJ: A lot of health providers don't have training on how to do assessments and screen to see if such violence has occurred.

CHATTERJEE: And she says they often feel helpless when they do confront cases of sexual or domestic violence.

RAJ: I think there's a lot of providers that worry, OK now what am I going to do?

CHATTERJEE: Raj says the new report is full of detailed advice and information about resources. Sohaila Abdulali is with the Ubuntu Education Fund, a non-profit that works on public health and sexual violence in South Africa. She agrees that the new report has the potential to make a big difference. But she says it could have gone further.

SOHAILA ABDULALI: There's only one vague mention of social support.

CHATTERJEE: And Abdulali knows just how important social support is. She was raped herself as a teenager. And for years, she worked with victims of sexual violence at a rape clinic in Boston.

RAJ: Medical intervention is great. But really, if somebody comes in to you for support, no matter what you give her, it can't make up for what she could get from her own community.

CHATTERJEE: She says most victims' families aren't supportive of them. In fact, they often blame the victim. Even one trustworthy person to talk to, Abdulali says, can take a victim a long way on the road to recovery. Rhitu Chatterjee, NPR News. Transcript provided by NPR, Copyright NPR.

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