This policy brief presents findings on the linkages between intimate partner violence (IPV), emotional health and substance use among adults ages 18-65 in California. Among the 3.5 million Californians who have ever been victimized by IPV as adults, over half a millionreport serious psychological distress (SPD) in the past year. Almost half of all adult IPV victims indicate that their partner was under the influence of alcohol or other drugs during the most recent incident. Two-fifths of adult IPV victims report past-year binge drinking and 7% report daily or weekly binge drinking. One in three IPV victims expressed a need for mental health, alcohol or other drug (AOD) services and almost one-fourth used mental health or AOD services during the past year. These disturbing findings can aid strategies to identify, intervene with and assist IPV victims who experience emotional and/or substance use problems.

This policy brief, based on data from the 2005 California Health Interview Survey (CHIS 2005), presents a comprehensive overview of mental health status and service use in California, and highlights differences by age, gender, race/ethnicity, income and insurance status. The authors find that nearly one in five adults in California, about 4.9 million persons, said they needed help for a mental or emotional health problem. Approximately one in 25, or over one million Californians, reported symptoms associated with serious psychological distress (SPD).1 Of those adults with either perceived need or SPD, only one in three reported visiting a mental health professional for treatment.

Mental health status was also closely linked to income and was pervasive regardless of race/ethnicity. Although mental health services can be effective, there were significant barriers to access to care, including fear of stigma as well as lack of insurance.

Despite living in the countryside where open space is plentiful and there is often significant agricultural production, rural older adults have higher rates of overweight/obesity, physical inactivity and food insecurity than older adults living in suburban areas. All three conditions are risk factors for heart disease, diabetes and repeated falls. This policy brief examines the health of rural elders and, by contrast, their urban counterparts, and finds that both groups lmost one in five California adults age 65 and over (18.2% or about 710,000 seniors) lived in a rural area in 2007. A rural area is defined as a nonmetropolitan area with fewer than 950 persons per square mile.1 The low population density of rural areas creates special challenges for addressing the health needs of rural seniors. Using data from the 2007 California Health Interview Survey (CHIS 2007), the social characteristics, health risks and health conditions of older adults living in rural areas are examined and contrasted with older adults in both urban and suburban areas.We then identify policies that more specifically address the health needs of rural older Californians. Older adults in rural California are less likely to be female (53.4%) and less likely to be of a racial/ethnic minority (20.8%) compared to older adults in other regions. Rural older adults are somewhat more likely to have low incomes (26.8%) than suburban older adults, but both groups have lower rates of poverty than urban elders. High education levels are more similar between rural and urban areas (28.7% and 25.9%, respectively), which are both lower than suburban rates. Rural and suburban older adults are also less likely than urban elders to live alone (Exhibit 1). Although the demographic characteristics between rural and urban elders often vary, they share common contextual factors that may impact their resulting health risks and health conditions. Both regions experience more problems than suburban areas with access to food outlets, parks, exercise facilities and health care sites. Limitations in the physical environment can lead to difficulties are more likely to be unhealthy than suburban older adults. Yet rural elders, because of their geographical isolation and lack of proximity to health care providers, experience unique environmental and other risk factors that require context-specific solutions to these health issues. In both policies and programs that impact health, policymakers need to take into account the distinctive environmental and social context of older adults living in California’s countryside.

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Nearly 1 in 6 adults in California, about 3.7 million persons, report experiencing physical intimate partner violence (IPV) as adults, according to the authors of this policy brief. Using data from the 2007 California Health Interview Survey, the authors found that over one million Californians were forced to have sex by an intimate partner during adulthood and17.2% of adults-—nearly four million Californians-—report being a victim of physical and/or sexual IPV as an adult. The brief also looks at patterns of reported IPV during adulthood by race ethnicity as well as gender and sexual orientation.