Skip to main content

Visions Journal

A reminder that this article from our magazine Visions was published more than 1 year ago. It is here for reference only. Some information in it may no longer be current. It also represents the point of the view of the author only. See the author box at the bottom of the article for more about the contributor.

Lucy McCullough, Natasha Jategaonkar, Lorraine Greaves, Cathy Chabot, and Nancy Poole

Reprinted from "Women's" issue of Visions Journal, 2004, 2 (4), p. 39-40

Tthe British Columbia Centre of Excellence for Women’s Health (BCCEWH) recently carried out a study of the interconnections between substance use, violence and stress among women staying at transition houses in rural and urban areas across British Columbia. The study was carried out in collaboration with 13 transition houses that are members of the BC/Yukon Society of Transition Houses.

In this article, the reports of women who were staying at transition houses in rural areas (i.e., population 30,000 or less) will be compared with those of women in urban areas (i.e., population greater than 30,000) with respect to their levels of substance use while moving through the transition house experience.

Women with significant levels of substance use were interviewed twice—at the time of entry into the transition house and again three months later. At the first interview, both rural and urban women reported drinking at levels that indicate alcoholism (84% and 86%, respectively). At the time of the second interview, women reported decreased use of alcohol and other substances, as well as less stress in many areas of their lives. We found that structural issues, such as housing, transportation and access to health care, were integrally related to women’s stress and substance use. Hence it is useful to examine how the experiences of rural women might differ from those living in urban centres.

Nineteen women from rural transition houses and 51 from urban transition houses were comparable on many demographic characteristics. The average age for each group was 35 years, the majority had children, and most were living on very low annual incomes of $10,000 or less. The majority (53%) of urban women were collecting social assistance, while only 32% of rural women reported receiving social assistance. At the same time, 21% of rural women were neither working nor collecting benefits, perhaps indicating greater financial dependence on their partners.

Physical abuse was common for both rural and urban women, with approximately half saying that their partners frequently scream and yell at them, and more than a third reporting that their partners frequently act like they want to kill them. Rural women were more likely than urban women to report frequent non-physical abuse, with a distressing 100% saying their partners frequently belittled them or became upset if dinner or housework was not completed punctually.

Rural and urban women differed in their patterns of binge drinking; that is, having three or more drinks on one occasion. The majority (85%) of rural women reported binge drinking during the few months prior to accessing help at the shelter. A smaller proportion (59%) of urban women engaged in binge drinking, but on a greater number of occasions.

A rural woman who worked in the sex trade talked about her reasons for drinking as being connected to the problems she faced in trying to access services: “My reasons [for drinking] are because it helps me when …I feel like my rights have been taken away with legal issues….I feel that I’ve been stripped of my feelings, opinions…like no one really cares about me in this world, a hopeless feeling. I feel like I’ve been raped by the system.”

Urban women were much more likely to report using stimulants (i.e., crack, cocaine and methamphetamine) than rural women (62% and 16%, respectively). Interestingly, urban women’s use decreased significantly to 30% by the time of the three-month follow-up interview, while there was no change among rural women. The large decrease among urban women may be a reflection of proactive discussions regarding drug and alcohol use among staff and residents and success in connecting women to needed services, which urban houses were more likely to report.

Fragmented social services were a common barrier to both groups of women trying to improve their lives. Many participants said they had difficulties navigating the social services system because individual programs are not coordinated to deal with multiple issues. A rural woman said: “I feel that I am forced to tell my story over and over again without anybody listening to me. This makes me give up on the system.”

Housing, legal and money issues emerged as factors causing women great stress, particularly at the first interview. However, three months later at the second interview, rural women were more likely than urban women to note that housing and legal issues were still causes of great stress. A number of women said that money stressors prevented them from leaving their violent relationships earlier. One rural woman stated: “…when I was on my own, I had to get my own place, child care, pay all my own bills, etc. So it was easier to just go back to the abusive partner who has the job, the house, the drugs, etc.”

The positive work of transition houses was validated by the results of this study, as significant improvements in stress and substance use were seen among the women following the shelter experience. However, rural women may face increased difficulty due to limited access to related health and social services.

Increased integration and awareness of the interconnections between substance use, mental health, experience of violence, and needs for income/social service supports are needed, among substance use treatment providers and mental health and social workers, particularly among those who work in rural settings.

About the Author

We are a team of researchers associated with the British Columbia Centre of Excellence for Women’s Health (BCCEWH) in Vancouver, one of four women’s health research centres in Canada, funded under the National Centres of Excellence in Women’s Health program. BCCEWH fosters collaboration on innovative, multidisciplinary research endeavours and action-oriented approaches to women’s health initiatives, women-centred programs and health policy



  1. Statistics Canada. (2003, June 23). Family violence. The Daily. Retrieved November 15, 2004, from English/030623/ d030623c.htm

Stay Connected

Sign up for our various e-newsletters featuring mental health and substance use resources.