Unreported cases of domestic violence against women: towards an epidemiology of social silence, tolerance, and inhibition

The “iceberg” of domestic violence Data from different surveys indicate a high prevalence of domestic violence against women in all societies.1 In western countries it is estimated that about 25% of women experience intimate partner violence over their lifetimes.2,3 However, prevalence data show only one side of the problem: the seriousness of the problem in terms of how widespread it is in our societies. Another side of the problem, one that has received less attention, is that most of the cases of domestic violence are unreported. That is, reported cases of domestic violence against women represent only a very small part of the problem when compared with prevalence data. This part of the problem is also known as the “iceberg” of domestic violence. An image where reported cases of domestic violence against women (usually the most severe end of violence) and homicide of women by their intimate partners represents only the tip of the iceberg. According to this metaphor, most of the cases are submerged, allegedly invisible to society. Domestic violence against women has been considered a very serious public health problem.4 But probably few public health problems share this feature of domestic violence against women: a condition affecting about 25% of the population but only a few of those affected, between 2.5% and 15%,5 report that they are suffering from that condition. Again, the image of the iceberg tells us that although we can estimate how many women are victims of domestic violence, we are not reaching them because most cases are unreported. This suggests that we are not dealing very well with this problem. Of course, it is important to further understand why female victims of domestic …