The association of neighborhood characteristics and domestic violence in Santiago, Chile

Sex Differences in Profile and In-Hospital Death for Acute Stroke in Chile: Data From a Nationwide Hospital Registry

BACKGROUND

Knowledge of local contextual sex differences in the profile and outcome for stroke can improve service delivery. We aimed to determine sex differences in the profile of patients with acute stroke and their associations with in-hospital death in the national hospital database of Chile.

METHODS AND RESULTS

We present a retrospective cohort based on the analysis of the 2019 Chilean database of Diagnosis-Related Groups, which represents 70% of the operational expenditure of the public health system. Random-effects multiple logistic regression models were used to determine independent associations of acute stroke (defined by main diagnosis International Classification of Diseases, Tenth Revision [ICD-10] codes) and in-hospital death, and reported with odds ratios (ORs) and 95% CIs. Of 1 048 575 hospital discharges, 15 535 were for patients with acute stroke (7074 [45.5%] in women), and 2438 (15.6%) of them died during hospitalization. Differences by sex in sociodemographic and clinical characteristics were identified for stroke and main subtypes. After fully adjusted model, women with ischemic stroke had lower in-hospital death (OR, 0.79 [95% CI, 0.69-0.91]) compared with men; other independent predictors included age per year increase (OR, 1.03 [95% CI, 1.03-1.04]), chronic kidney disease (OR, 1.47 [95% CI, 1.20-1.80]), atrial fibrillation (OR, 1.50 [95% CI, 1.26-1.80]), and other risk factors. Conversely, for intracerebral hemorrhage, women had a higher in-hospital mortality rate than men (OR, 1.19 [95% CI, 1.02-1.40]); other independent predictors included age per year increase (OR, 1.009 [95% CI, 1.003-1.01]), chronic kidney disease (OR, 1.55 [95% CI, 1.23-1.97]), oral anticoagulant use (OR, 1.88 [95% CI, 1.37-2.58]), and other risk factors.

CONCLUSIONS

Sex differences in characteristics and in-hospital death of hospitalized patients exist for acute stroke in Chile. In-hospital death is higher for acute ischemic stroke in men and higher for intracerebral hemorrhage in women. Future research is needed to better identify contributing factors.

Sociological Theories to Explain Intimate Partner Violence: A Systematic Review and Narrative Synthesis

Intimate partner violence (IPV) is a highly prevalent public health challenge and human rights violation. Sociological theories address social structures to understand prevalence and dynamics of IPV against women. This systematic review aims (1) to identify, describe, categorize, and synthesize sociological theories that account for predictors of IPV against women, and (2) to compare and contrast sociological theories of predictors of IPV against women. Following a structured search of nine electronic databases, members of the review team screened title/abstract and full texts against inclusion and exclusion criteria, to identify studies that engaged with theory/ies of predictors of IPV. Review team members extracted data according to a data extraction template developed for the review. Results are presented using a narrative synthesis approach. Following review of 108 included articles, included articles were grouped into sub-theories. The sub-theories provide differing, yet overlapping, accounts of predictors of male perpetration of IPV and women's experience of IPV. Sociological theories primarily engage with exo- and macro-system levels of the social-ecological framework, yet some also address structural influences on individual behaviors. This systematic review fills a gap in theoretical syntheses of sociological theories of predictors of male-perpetrated IPV against women and also provides critical analysis of how these theories overlap and intersect. While sociological theories may not be able to fully explain all aspects of dynamics of male-perpetrated IPV against women, this overview indicates that there are several compelling components of sociological theory that hold explanatory power for comprehending how, where, and why IPV occurs.

Chronic high risk of intimate partner violence against women in disadvantaged neighborhoods: An eight-year space-time analysis

We conducted a small-area ecological longitudinal study to analyze neighborhood contextual influences on the spatio-temporal variations in intimate partner violence against women (IPVAW) risk in a southern European city over an eight-year period. We used geocoded data of IPVAW cases with associated protection orders (n = 5867) in the city of Valencia, Spain (2011-2018). The city's 552 census block groups were used as the neighborhood units. Neighborhood-level covariates were: income, education, immigrant concentration, residential instability, alcohol outlet density, and criminality. We used a Bayesian autoregressive approach to spatio-temporal disease mapping. Neighborhoods with low levels of income and education and high levels of residential mobility and criminality had higher relative risk of IPVAW. Spatial patterns of high risk of IPVAW persisted over time during the eight-year period analyzed. Areas of stable low risk and with increasing or decreasing risk were also identified. Our findings link neighborhood disadvantage to the existence and persistence over time of spatial inequalities in IPVAW risk, showing that high risk of IPVAW can become chronic in disadvantaged neighborhoods. Our analytic approach provides specific risk estimates at the small-area level that are informative for intervention purposes, and can be useful to assess the effectiveness of prevention efforts in reducing IPVAW.

The Relationship Between Family, Parent, and Child Characteristics and Intimate-Partner Violence (IPV) Among Ukrainian Mothers

OBJECTIVE

To assess the prevalence of intimate partner violence (IPV) in a sample of Ukrainian mothers of schoolchildren, and to examine the relationship between IPV and family, parent, and child characteristics utilizing multilevel models.

METHOD

Mothers of children aged 9-16 (n = 278, 93.5% Ukrainians) answered the Revised Conflict Tactics Scale (CTS2) assessing IPV. We also examined the relationship between IPV and maternal age, education, employment and marital status, family income, and rural or urban residence.

RESULTS

Eighty-one percent of women reported psychological violence and 58% reported physical assault. On average, women reported 66 instances of IPV during the last year. Multilevel modeling revealed that lower maternal education, unemployment, not living with the husband or partner, and urban residency were associated with higher IPV victimization. Younger age and family income were not significantly related to IPV.

CONCLUSIONS

IPV was a significant social problem in the present sample of Ukrainian mothers of school age children. Future policy and violence prevention programming should focus on supporting academic and employment opportunities for women, particularly for those living in urban areas.

Exposure to neighborhood green space and mental health: evidence from the survey of the health of Wisconsin

Green space is now widely viewed as a health-promoting characteristic of residential environments, and has been linked to mental health benefits such as recovery from mental fatigue and reduced stress, particularly through experimental work in environmental psychology. Few population level studies have examined the relationships between green space and mental health. Further, few studies have considered the role of green space in non-urban settings. This study contributes a population-level perspective from the United States to examine the relationship between environmental green space and mental health outcomes in a study area that includes a spectrum of urban to rural environments. Multivariate survey regression analyses examine the association between green space and mental health using the unique, population-based Survey of the Health of Wisconsin database. Analyses were adjusted for length of residence in the neighborhood to reduce the impact of neighborhood selection bias. Higher levels of neighborhood green space were associated with significantly lower levels of symptomology for depression, anxiety and stress, after controlling for a wide range of confounding factors. Results suggest that "greening" could be a potential population mental health improvement strategy in the United States.

Ecological factors and adolescent marijuana use: results of a prospective study in Santiago, Chile

Purpose: Despite the growing evidence that ecological factors contribute to substance use, the relationship of ecological factors and illicit drugs such as marijuana use is not well understood, particularly among adolescents in Latin America. Guided by social disorganization and social stress theories, we prospectively examined the association of disaggregated neighborhood characteristics with marijuana use among adolescents in Santiago, Chile, and tested if these relationships varied by sex. Methods: Data for this study are from 725 community-dwelling adolescents participating in the Santiago Longitudinal Study, a study of substance using behaviors among urban adolescents in Santiago, Chile. Adolescents completed a two-hour interviewer administered questionnaire with questions about drug use and factors related to drug using behaviors. Results: As the neighborhood levels of drug availability at baseline increased, but not crime or noxious environment, adolescents had higher odds of occasions of marijuana use at follow up, approximately 2 years later (odds ratio [OR] = 1.39; 95% CI = 1.16–1.66), even after controlling for the study’s covariates. No interactions by sex were significant. Discussion: The findings suggest that “poverty”, “crime”, and “drug problems” may not be synonyms and thus can be understood discretely. As Latin American countries re-examine their drug policies, especially those concerning decriminalizing marijuana use, the findings suggest that attempts to reduce adolescent marijuana use in disadvantaged neighborhoods may do best if efforts are concentrated on specific features of the “substance abuse environment”.

Gender Differences in Predictors of Self-Reported Physical Aggression: Exploring Theoretically Relevant Dimensions among Adolescents from Santiago, Chile

Research findings remain unclear on whether different factors predict aggression for adolescent men and women. Given that aggression research is rarely conducted with Latin American populations, the current study used multiple imputation and linear regression to assess gender differences in levels and predictors of self-reported physical aggression among a community sample of young (ages 11 through 17) men (n=504) and women (n = 471) from Santiago, Chile. Results revealed that adolescent women reported engaging in higher levels of physical aggression than men. The variables found to be significantly associated with higher levels of reported aggression-younger age, less family involvement, less parental control, less positive relationships with caregivers, having more friends who act out and use substances, having fewer friends committed to learning, presence of dating violence, and more exposure to neighborhood crime-were not moderated by gender, implying that similar factors are related to aggression in adolescent men and women from Chile. Implications for prevention and intervention efforts to address high-risk adolescents and reduce aggression among Chilean youth are discussed.