It where it hurts: Healthcare access and intimate partner violence

Abstract

This paper investigates the causal link between healthcare access and intimate partner violence (IPV) victims’ help-seeking behavior. Access to healthcare serves as a critical avenue for screening or detecting IPV. Doctors are legally mandated to report suspected criminal injuries to the authorities and can guide victims towards IPV support services. We exploit the 2012 reform in Spain that removed access to the public healthcare system for undocumented immigrants. We use court reports and protection order requests from the Judicial Branch of the Spanish government to perform a difference-in-differences approach, comparing the helpseeking behavior of foreign and Spanish women before and after the reform. We find that restricting healthcare access led to an immediate 12% decrease in IPV reporting and protection order applications among foreign women, particularly in regions with strict enforcement. Importantly, we show suggestive evidence that the reform did not change the underlying incidence of IPV but the results are driven by a reduction in injury reports from medical centers. Our findings are important given the increase in migration flows globally as well as for corrent debates on granting/limiting access to healthcare for marginalized groups.