An ecological analysis of gender inequality and intimate partner violence in the United States

The Polish Variant of Patriarchy? Explaining the Relationship Between Gender Inequality and Violence Against Women in Poland

The largest European victimization survey of violence against women (VAW), has revealed an interesting paradox: countries with the highest gender equality indices had the highest VAW indices, while countries with low gender equality, also had low VAW indices. The country with the lowest VAW rates was Poland. This article attempts to explain this paradox. First, the results of the FRA study regarding Poland and its methodological issues are described. As these explanations may prove insufficient, it is necessary to recourse to sociological theories of VAW, together with analyses of the sociocultural roles of women, and gender relations since the communist period (1945-1989). The key question is whether the Polish variant of the patriarchy is more respectful toward women than Western European gender equality.

Sexual harassment and implicit gender-career biases negatively impact women's life expectancy in the US: a state-level analysis, 2011-2019

BACKGROUND

Despite some gains, women continue to have less access to work and poorer experiences in the workplace, relative to men. The purpose of this study was to examine the relationships among women's life expectancy and two work-related factors, sexual harassment and gender-career biases.

METHOD

We examined the associations at the state level of analysis (and District of Columbia) in the US from 2011 to 2019 (n = 459) using archival data from various sources. Measures of the ratio of population to primary health providers, year, the percent of adults who are uninsured, the percent of residents aged 65 or older, and percent of residents who are Non-Hispanic White all served as controls.

RESULTS

Results of linear regression models showed that, after accounting for the controls, sexual harassment and gender-career biases among people in the state held significant, negative associations with women's life expectancy.

CONCLUSION

The study contributes to the small but growing literature showing that negative workplace experiences and bias against women in the workplace negatively impact women's health.

Partner Violent Men's Perspectives on the Factors That They Believe Contributed to Their Abusive Behaviors

While research on perpetration of intimate partner violence (IPV) is growing, few studies have sought to explore perpetrators' perspectives on their abusive behaviors. Thus, much remains unknown regarding how perpetrators view their abuse. We conducted 34 semistructured, open-ended interviews with men convicted of an IPV crime in which we broadly explored their perspectives on contributors to abuse. A history of exposure to violence as children, experiences with other traumatic events, and other causes (e.g., drug abuse) were the most cited. Our findings highlight areas where intervention efforts need to be tailored to address the unmet needs of men who perpetrate.

Gender inequality and burden of orofacial clefts in the Eastern Mediterranean region: findings from global burden of disease study 1990-2019

BACKGROUND

Gender inequality may be associated with the burden of orofacial clefts (OFCs), particularly in low-and middle-income countries (LMICs). To investigate the OFCs' burden and its association with gender inequality in the Eastern Mediterranean region (EMR).

METHODS

Country-specific data on the OFCs' prevalence and Disability-Adjusted Life Years (DALYs) from 1990 to 2019 were gathered from the Global Burden of Disease database by age and gender. Estimated annual percentage change (EAPCs) was used to investigate the OFCs' trends. The association of the Gender Inequality Index (GII) with prevalence and DALY rates was determined using multiple linear regression. Human Development Index (HDI), Socio-Demographic Index (SDI), and Gross Domestic Product (GDP) were also considered as potential confounders.

RESULTS

In 2019, the overall regional OFCs' prevalence and DALYs (per 100,000 person-years) were 93.84 and 9.68, respectively. During the 1990-2019 period, there was a decrease in prevalence (EAPC = -0.05%), demonstrating a consistent trend across genders. Moreover, within the same timeframe, DALYs also declined (EAPC = -2.10%), with a more pronounced reduction observed among females. Gender differences were observed in age-specific prevalence rates (p-value = 0.015). GII was associated with DALYs (βmale= -0.42, p-value = 0.1; βfemale = 0.48, p-value = 0.036) and prevalence (βmale= -1.86, p-value < 0.001, βfemale= -2.07, p-value < 0.001).

CONCLUSIONS

Despite a declining prevalence, the burden of OFCs remained notably significant in the EMR. Gender inequality is associated with the burden of OFCs in the Eastern Mediterranean region. Countries in the region should establish comprehensive public policies to mitigate gender inequalities in healthcare services available for OFCs.

Drivers of men's use of intimate partner violence in conflict-affected settings: learnings from the Democratic Republic of Congo

BACKGROUND

Intimate partner violence against women (IPVAW) is prevalent in conflict-affected settings. Yet, there is limited knowledge about the risk factors that influence men's use of IPVAW in conflict-affected settings. This paper adopts a transdisciplinary perspective to understand how experiences hypothesized to increase men's use of IPVAW relate to each other and to men's use of IPVAW. The findings may help researchers and interventionists to better select and target interventions for IPVAW in conflict-affected settings.

METHODS

We used baseline data from the Tushinde Ujeuri project in the Democratic Republic of Congo. Men with at least partial data for the variables of interest were included in the analysis (n = 2080). We estimated a structural equation model that explored how five constructs - interpersonal violence, mental health, socioeconomic adversity, gender inequitable attitudes, and conflict violence - influenced men's self-reported past-year use of physical and/or sexual IPVAW.

RESULTS

The model had acceptable fit (χ2 = 1576.574, p = 0.000; RMSEA = 0.041; CLI = 0.882; SRMR = 0.055). There was a statistically significant path from interpersonal violence to IPVAW (β = 0.875; OR = 2.40). Interpersonal violence also was linked to gender inequitable attitudes (β = 0.364), which were linked to increased use of IPVAW (β = 0.180; OR = 1.20). Moreover, interpersonal violence was linked to trauma symptoms (β = 0.331), which were linked to increased use of IPVAW (β = 0.238; OR = 1.27). Use of IPVAW decreased as conflict exposures increased (β=-0.036; OR = 0.96), and there was no path from socioeconomic adversity to IPVAW.

CONCLUSIONS

Our findings suggest interpersonal violence exposures, trauma symptoms, and gender inequitable attitudes are all risk factors for the use of IPVAW in a conflict-affected setting. While continuing to focus on gender inequitable attitudes and norms, interventionists should also consider addressing men's experiences of victimization and mental wellbeing. Doing so can help to improve trauma symptoms and may hold promise to reduce IPVAW in conflict-affected settings.

Prevalence and changes of intimate partner violence against women aged 15 to 49 years in 53 low-income and middle-income countries from 2000 to 2021: a secondary analysis of population-based surveys

BACKGROUND

In low-income and middle-income countries (LMICs), intimate partner violence poses a substantial barrier to accomplishing target 5.2 of the Sustainable Development Goals: to eliminate all forms of violence against women and girls. Our study aimed to assess the prevalence and changes of intimate partner violence against women in LMICs. We also explored the association between women's empowerment and intimate partner violence.

METHODS

In this secondary analysis of population-based surveys, we obtained data from the nationally representative Demographic and Health Surveys conducted in LMICs between 2000 and 2021. We selected countries with available data on the domestic violence module, and women aged 15 to 49 years who currently or formerly had a husband or partner, and who had provided information about intimate partner violence, were included in the analysis. We first estimated the weighted prevalence of intimate partner violence in LMICs with available data, and then we assessed the average annual rate of change using Poisson regression with robust error variance in a subset of countries with at least two surveys. We used multilevel analysis to investigate the association between intimate partner violence and women's empowerment measured at both the country and individual levels. Country-level empowerment was measured by gender inequality index, while individual-level empowerment considered social independence, decision making, and attitude to violence.

FINDINGS

A total of 359 479 women aged 15 to 49 years were included from 53 LMICs. 336 811 women from 21 countries with two surveys provided data for assessing the trends of intimate partner violence. The weighted prevalence of any type of intimate partner violence was 37·2% (95% CI 36·6 to 37·8). A significant overall decline in the prevalence of any type of intimate partner violence was observed with an average annual rate of change of -0·2% (95% CI -0·4 to -0·03); however six countries showed significant increasing trends, with average annual rates of change ranging from 1·2% (95% CI 0·7 to 1·7) in Nigeria to 6·6% (5·3 to 7·8) in Sierra Leone. Notably, the prevalence of psychological intimate partner violence has risen (average annual rate of change, 2·3% [95% CI 2·1 to 2·6]), reflected in increased rates across eight countries. Higher levels of country-level women's empowerment were associated with a lower risk of intimate partner violence: women from countries with the highest tertile of gender inequality index had an increased odds of any type of intimate partner violence (odds ratio 1·58 [95% CI 1·12 to 2·23]). Similarly, better individual-level women's empowerment also showed significant associations with a lower risk of intimate partner violence.

INTERPRETATION

The prevalence of intimate partner violence remains high, and some countries have shown an increasing trend. The strong relationship between both country-level and individual-level women's empowerment and the prevalence of intimate partner violence suggests that accelerating women's empowerment could be one strategy to further reduce intimate partner violence against women.

FUNDING

National Natural Science Foundation; Vanke School of Public Health, Tsinghua University; and Sanming Project of Medicine in Shenzhen.

Prevalence of preconception health indicators among Brazilian women of reproductive age

This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age. We conducted a descriptive epidemiological study using data from 21,645 and 25,228 women, respectively, who responded the 2013 and 2019 national health surveys, and data for the period 2010 to 2020 derived from the national health system's Department of Informatics (DATASUS). We calculated the prevalence of indicators according to sociodemographic characteristics and statistical significance of differences was measured using Pearson's chi-squared test. Syphilis and HIV incidence rates were also calculated. There was an increase in the prevalence of access to health service indicators (medical and dental consultations and recent Pap smear). However, there was an increase in the prevalence of hypertension, alcohol use, and obesity. The prevalence of use of contraceptive methods and fertility treatment remained stable. Syphilis incidence increased sevenfold between 2010 and 2020. Black/brown women with a low level of education, higher parity, and living in the North or Northeast performed worse for preconception health indicators. Despite the increase in access to health services, performance on preconception health indicators declined and health inequities continued.

The Role of Sexting on the Perception of Image-Based Sexual Abuse

Gender-based violence is a widespread phenomenon that significantly impacts many women around the world. Among the different forms that it might take, image-based sexual abuse represents one of the most common forms nowadays. According to the literature, sexting-the sharing of sexually explicit messages or images-is one of the most important risk factors for image-based sexual abuse because sexts can be forwarded or published without the authorization of the originator. Nevertheless, sexting can play a role in sexual and relational development and serve as a first step in experimenting with sexual contact in real life. In this study (N = 603 from the general population), we examined the relations between people's beliefs about sexting, attitudes toward it, and sexting behavior on the one hand, and reactions to a situation of nonconsensual dissemination of sexts on the other hand. Results showed that social pressure exerted by peers and partners to sext was associated with both positive attitudes toward sexting and sexting behaviors. Attitudes toward sexting, then, have a spillover effect on the reactions toward a victim of nonconsensual dissemination of sexts, in terms of empathy, victim blaming, and affective reactions. Implications for both research and policymaking regarding this form of gender-based violence are discussed.

Sex/gender differences in the associations between adverse childhood experiences and intimate partner violence with mental disorders

Sex and gender differences exist in mental and substance use disorders (MSUDs). Studies examining the moderating effects of sex/gender on MSUDs may help understand these differences. This national study explored whether sex/gender moderated (1) the associations between adverse childhood experience (ACEs; i.e., child abuse, child neglect, and child household dysfunction) and intimate partner violence (IPV) with MSUDs and (2) more associations with past year than lifetime MSUDs or mental (i.e., mood disorder, anxiety disorder, and posttraumatic stress disorder) than substance use disorders (i.e., alcohol use disorder and nicotine dependence). Data was used from participants in the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression tested the main effects of ACEs, IPV, and sex/gender on five, past-year and lifetime MSUDs along with the ACE-sex/gender and IPV-sex/gender interactions. Sex/gender moderated 60% of the ACEs-MSUD and IPV-MSUD associations and more associations with lifetime (54%) than past year MSUDs (46%) and substance use (94%) than mental disorders (38%). For nearly half of the moderated associations, ACEs and IPV were associated with greater odds of MSUDs for males. Males who experienced IPV had greater odds of lifetime mood, anxiety, and alcohol use disorders than females. This study advances sex and gender informed research.

A health impact assessment of gender inequities associated with psychological distress during COVID19 in Australia's most locked down state-Victoria

BACKGROUND

Since March 2020, when the COVID19 pandemic hit Australia, Victoria has been in lockdown six times for 264 days, making it the world's longest cumulative locked-down city. This Health Impact Assessment evaluated gender disparities, especially women's mental health, represented by increased levels of psychological distress during the lockdowns.

METHODS

A desk-based, retrospective Health Impact Assessment was undertaken to explore the health impacts of the lockdown public health directive with an equity focus, on the Victorian population, through reviewing available qualitative and quantitative published studies and grey literature.

RESULTS

Findings from the assessment suggest the lockdown policies generated and perpetuated avoidable inequities harming mental health demonstrated through increased psychological distress, particularly for women, through psychosocial determinants.

CONCLUSION

Ongoing research is needed to elucidate these inequities further. Governments implementing policies to suppress and mitigate COVID19 need to consider how to reduce harmful consequences of these strategies to avoid further generating inequities towards vulnerable groups within the population and increasing inequalities in the broader society.

Exploration of barriers to screening for domestic violence in the perinatal period using an ecological framework

AIMS

To explore Australian healthcare providers' perspectives on factors that influence disclosure and domestic violence screening through the lens of Heise's (1998) integrated ecological framework.

DESIGN

This paper reports the findings that were part of a sequential mixed methods study with survey data informing interview questions. Participants for interviews were recruited after expressing an interest after completing surveys, as well as via snowball sampling.

METHODS

Semi-structured interviews were undertaken in 2017 with 12 practicing healthcare providers delivering care to women in the perinatal period in Greater Western Sydney, NSW, Australia. Data were analysed using Braun and Clarke's (2006) six-step thematic approach.

FINDINGS

The findings were framed within Heise's integrated ecological framework under four main themes. The main themes were 'Ontogenic: Factors preventing women from disclosing'; 'Microsystem: Factors preventing healthcare providers from asking'; 'Exosystem: Organizational structures not conducive to screening'; and 'Macrosystem: Cultural attitudes and socioeconomic influences affecting screening'.

CONCLUSION

Organizational policies are needed for better systems of reminding healthcare providers to enquire for domestic and family violence and mandating this within their practices. Mandatory domestic and family violence education and training that is suitable for the time constraints and learning needs of the healthcare provider is recommended for all healthcare providers caring for perinatal women. Further research is needed in addressing culturally specific barriers for healthcare providers to enquire about domestic and family violence in a culturally appropriate way.

PUBLIC AND PATIENT ENGAGEMENT AND INVOLVEMENT IN RESEARCH (PPEI)

No Patient or Public Contribution was embedded into the research reported in this paper as this research was specifically exploring healthcare providers' perspectives on domestic violence screening within their own practice experience.

Differential Experiences of Sexual, Physical, and Emotional Intimate Partner Violence Among Transgender and Gender Diverse Adults

Various forms of intimate partner violence (IPV) are unfortunately common amongst adults in the United States, and these rates are devastatingly higher for transgender and gender diverse (TGD) individuals than for the general population. However, the TGD population is not monolithic, and is diverse regarding gender, sexual orientation, age, race/ethnicity, urbanicity, and other sociodemographic categories. This study uses data from the 2018 Michigan Trans Health Survey to explore these within group differences regarding sexual, physical, and emotional forms of IPV using chi-square tests of independence and logistic regressions. Chi square tests of independence found homelessness had significant associations across all outcome variables: "ever experienced physical violence from a partner," "ever experienced forced sex from a partner," "ever been threatened to be outed by a partner," and "ever had gender belittled by a partner." Gender identity and sexual orientation had significant associations with "ever experienced forced sex from a partner," "ever been threatened to be outed by a partner," and "ever had gender belittled by a partner." Urbanicity showed a significant association with "ever being threatened to be outed by a partner." In the logistic regressions, age indicated significantly higher likelihood of IPV physical IPV with each year of age; experiences of homelessness were significantly related to likelihood for all outcomes variables. Gender and sexual orientation were also significant across the models, with differing levels of likeliness depending on identities. Findings demonstrate a need for TGD inclusive programming, and specifically programs that target TGD persons who are older, report additional genders (meaning, multiple identities and/or identities besides transfeminine, transmasculine, or nonbinary), queer sexual orientations, and who are/have experienced homelessness. Programs are needed both in the realms of intimate partner violence prevention work and social services that support survivors of violence, such as mental health clinics, rape crisis centers, and shelters.

Relational Mobility and Other Contributors to Decline in Intimate Partner Violence

This study explored whether changes in risk and protective factors of intimate partner violence (IPV) can account for the noted reduction in 12-month IPV prevalence in New Zealand between 2003 and 2019. Changes in relational mobility over time were also explored. Data from two population-based surveys of 18-64 year-old ever-partnered women in New Zealand that were conducted according to identical procedures in 2003 (n=2764) and 2019 (n=944) were used. Changes in a variety of potential risk and protective factors over time and their possible contribution to IPV reduction were assessed. The findings indicated that there was no change in the prevalence of the strongest risk and protective factors of IPV victimisation and perpetration over time (e.g. partner concurrent relationship, previous exposure to violence for both respondent and partner, and partner's problematic alcohol/drug use). However, a combination of factors including decline in women's problematic alcohol or drug use, decline in the number of children within families, and increases in the proportion of women and partners with a qualification higher than secondary education are likely to be associated with the reduction in IPV prevalence. A greater degree of relational mobility, demonstrated through a greater proportion of women who left their abusive partner permanently and increased numbers of relationships that women had, was also observed between two study years. Overall, these results indicate that changes in 12-month IPV prevalence over time are likely to be linked with changes that increase women's autonomy and ability to move out of violent relationships. To achieve sustained reductions in IPV, more comprehensive and planned efforts are needed to address other underlying and exacerbating causes, including problematic alcohol/drug use and previous exposure to violence during childhood and adulthood.

Understanding the Determinants of Gambling-Related Intimate Partner Violence: Perspectives From Women Who Gamble

Rates of intimate partner violence (IPV) victimization are higher among women with a gambling problem. However, women's experiences of this violence, from a gendered perspective, have not been examined. Based on interviews with 24 women, this study explored how problem gambling contributes to IPV against women across three levels of influence. Findings reveal that problem gambling did not directly cause IPV, but interacts where gendered drivers and reinforcers are present to exacerbate this violence. Reducing violence against women with a gambling problem requires a coordinated, integrated multidisciplinary approach targeting different levels of influence.

Dating Violence, Protection Orders, and Gender Inequality: A Cross-state Analysis of Policy Formulation and Implementation

Teen dating violence (TDV) is a public health crisis that organizations and individuals in several fields are working to prevent and address. State lawmakers are a group with substantial power to address TDV and intimate partner violence (IPV) through policies including Civil Protection Order (CPO) statutes. Understanding the factors that influence how state legislators craft TDV and IPV policies and how those policies are implemented can lead to policy processes that better serve survivors. Past research suggests the level of gender inequality in a state may be an important influence on TDV policies. This study used a case study approach to compare the processes of adding individuals in dating relationships to CPO statutes in a subset of states (n = 3) with high, middle, and low levels of gender inequality. Results did not suggest that gender inequality was related to variation between states but rather that it was a larger factor that creates the need for TDV policies at all. Relationships between the state IPV coalitions and lawmakers and the historical moment that laws were considered emerged as important factors in interstate variation. Future research can build on these results by further exploring the role of gender inequality in policy processes with additional states or policies and by examining the factors identified here in greater depth. Implications for practice are also discussed.

Gender Inequality in Low- and Middle-Income Countries: Associations with Parental Physical Abuse and Moderation by Child Gender

Gender inequality perpetuates women's economic insecurity and a culture of violence. Parental distress caused by economic pressure may increase violence against children. High levels of gender inequality and interpersonal violence may contribute to higher levels of physical abuse. Using an ecological perspective, this study examines the association of country-level gender inequality and household-level parental physical abuse, and the moderating role of child gender in this association in low- and middle-income countries. We used data on over 420,000 households from the UNICEF Multiple Indicator Cluster Surveys and country-level indicators from the United Nations Development Program Human Development data. We employed multilevel logistic regression to examine the association between gender inequality with the log-odds of physical abuse after accounting for country- and individual-level covariates. In order to more fully explore our results, we calculated predicted probabilities of abuse for several scenarios. The results indicated that higher levels of gender inequality were associated with higher probabilities of physical abuse. This association was stronger for female children than for male children. The probabilities of abuse by child gender were indistinguishable, although rates of physical abuse converged as gender inequality increased, at a statistically marginal level. These findings indicate that macro-level interventions that reduce gender inequality are necessary to prevent and reduce child physical abuse.

Factors associated with violence against women by an intimate partner in Northeast Brazil

This study examined the prevalence, and associated factors, of violence against women by an intimate partner amongst 369 women who attended nursing consultations at primary care centres in Northeast Brazil. Socio-demographic variables, substance use, mental health and the forms of violence were analysed. IPV was a reality for 65.4% of the women of reproductive age seen in the centres. IPV, including psychological violence, is associated with age, education and religion, particularly amongst female cannabis users whose partners were also substance users. Primary care providers are in a position to detect, screen, counsel and treat women who experience IPV.

Trauma Exposure and Intimate Partner Violence Among Young Pregnant Women in Liberia

Intimate partner violence (IPV) is a global threat to women's health and may be elevated among those exposed to traumatic events in post-conflict settings, such as Liberia. The purpose of this study was to examine potential mediators between lifetime exposure to traumatic events (i.e., war-related trauma, community violence) with recent experiences of IPV among 183 young, pregnant women in Monrovia, Liberia. Hypothesized mediators included mental health (depression, posttraumatic stress symptoms), insecure attachment style (anxious and avoidant attachment), and attitudes indicative of norms of violence (attitudes justifying wife beating). We tested a parallel multiple mediation model using the PROCESS method with bias-corrected and accelerated bootstrapping to test confidence intervals (CI). Results show that 45% of the sample had experienced any physical, sexual, or emotional IPV in their lifetime, and 32% in the 2 months prior to the interview. Exposure to traumatic events was positively associated with recent IPV severity (β = .40, p < .01). Taken together, depression, anxious attachment style, and justification of wife beating significantly mediated the relationship between exposure to traumatic events and experience of IPV (β = .15, 95% CI = [0.03, 0.31]). Only anxious attachment style (β = .07, 95% CI = [0.03, 0.16]) and justification of wife beating (β = .05, 95% CI = [0.01, 0.16]) were identified as individual mediators. This study reinforces pregnancy as an important window for both violence and mental health screening and intervention for young Liberian women. Furthermore, it adds to our theoretical understanding of mechanisms in which long-term exposure to traumatic events may lead to elevated rates of IPV in Liberia, and points to the need for trauma-informed counseling and multilevel gender transformative public health approaches to address violence against women.

"There's no place like home": Examining the associations between state eviction defense protections and indicators of biopsychosocial stress among survivors of intimate partner violence

Housing instability is prevalent among intimate partner violence (IPV) survivors and a source of biopsychosocial stress among this population. Eviction policies play an important role in determining housing instability of IPV survivors. However, few studies have investigated whether state-level policies that prevent evictions lessen vulnerability to biopsychosocial stress among IPV survivors. This study examined the relationship between state eviction defense policy and indicators of biopsychosocial stress among 6577 IPV survivors. State-level data on IPV-related housing policies were from a compendium on homelessness and violence. Individual-level data were collected from the National Intimate Partner and Sexual Violence Survey (NISVS), a nationally representative study of noninstitutionalized U.S. women and men from Wave 1 (2010). Multilevel regression models were conducted to investigate associations between the presence of an eviction defense policy and indicators of biopsychosocial stress (i.e., headaches, sleeping, safety concerns and PTSD symptoms). Stratified multilevel modeling was conducted to examine differences in the policy-stress associations across racial and ethnic groups and gender. Nearly 26% of states had an eviction defense policy for IPV survivors. Overall, residing in a state with an eviction defense policy (vs. none) was associated with no reports of frequent headaches (B [95% CI] = -0.21 [-0.41, -0.01], p < .05). For non-Hispanic Black survivors, residing in a state with an eviction defense policy (vs. none) was associated with reduced likelihood of reporting safety concerns (B [95% CI] = -1.36 [-2.16, -0.56], p < .001) and PTSD symptoms (B [SE] = -1.91 [-2.82, -1.01], p < .000). Among men survivors, residing in a state with an eviction defense policy was associated with reduced likelihood of reporting safety concerns (B [95% CI] = -0.63 [-1.26, -0.01], p < .05). State housing policies are important protective policies for IPV survivors. For IPV survivors, the eviction defense policy may interrupt the psychological sequeale of IPV and housing instability.

Undoing the 'Nordic Paradox': Factors affecting rates of disclosed violence against women across the EU

Measuring violence against women raises methodological questions, as well as the wider question of how to understand violence and locate it in relation to a societal context. This is all the more relevant given that measurement of violence against women in the EU has made an interesting phenomenon apparent, the so-called ‘Nordic Paradox’, whereby prevalence is higher in more gender equal countries. This article examines this phenomenon by exploring a range of factors—methodological, demographic and societal—to contextualise disclosed levels of violence. The analysis makes use of a multilevel analytic approach to take into account how macro and micro levels contribute to the prevalence of violence. The intercepts are then used to illustrate how taking these into account might provide an alternative ranking of levels of violence against women in EU countries. The results show that the ‘Nordic Paradox’ disappears—and can be undone—when factors at individual and country levels are considered. We conclude that the ‘Nordic Paradox’ cannot be understood independently from a wider pattern of violence in society, and should be seen as connected and co-constituted in specific formations, domains or regimes of violence. Our results show that the use of multi-level models can provide new insights into the factors that may be related to disclosed prevalence of violence against women. This can generate a better understanding of how violence against women functions as a system, and in turn inform better policy responses.

Age and Sexual Orientation Moderated the Effects of a Bystander-Focused Interpersonal Violence Prevention Program for High School Students

The objective of the current paper was to identify moderating factors of a bystander-focused violence prevention program for adolescents, Bringing in the Bystander-High School Curriculum. Participants were 2,403 high school students from 25 schools in northern New England (M age = 15.8 years; 50.9% female; 85.1% White, 84.5% heterosexual) who participated in a cluster-randomized controlled trial. We examined impact among different social groups (i.e., by race, gender, age, poverty, sexual orientation) using moderation analyses. The intervention effects for the past 12-month sexual harassment and stalking perpetration were stronger for younger participants and heterosexual participants; poverty, race, and gender did not moderate any program effects. Findings indicate that future prevention research should consider additional targets for older adolescents that may improve intervention program efficacy. An urgent need exists for interventions that are effective for sexual minority adolescents.

Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

Background

Gender inequality varies across countries and is associated with poor outcomes including violence against women and depression. Little is known about the relationship of source county gender inequality and poor health outcomes in female immigrants.

Methods

We used administrative databases to conduct a cohort study of 299,228 female immigrants ages 6–29 years becoming permanent residence in Ontario, Canada between 2003 and 2017 and followed up to March 31, 2020 for severe presentations of suffering assault, and selected mental health disorders (mood or anxiety, self-harm) as measured by hospital visits or death. Poisson regression examined the influence of source-country Gender Inequality Index (GII) quartile (Q) accounting for individual and country level characteristics.

Results

Immigrants from countries with the highest gender inequality (GII Q4) accounted for 40% of the sample, of whom 83% were from South Asia (SA) or Sub-Saharan Africa (SSA). The overall rate of assault was 10.9/10,000 person years (PY) while the rate of the poor mental health outcome was 77.5/10,000 PY. Both GII Q2 (Incident Rate Ratio (IRR): 1.48, 95% Confidence Interval (CI): 1.08, 2.01) and GII Q4 (IRR: 1.58, 95%CI: 1.08, 2.31) were significantly associated with experiencing assault but not with poor mental health. For females from countries with the highest gender inequality, there were significant regional differences in rates of assault, with SSA migrants experiencing high rates compared with those from SA. Relative to economic immigrants, refugees were at increased risk of sustaining assaults (IRR: 2.96, 95%CI: 2.32, 3.76) and poor mental health (IRR: 1.73, 95%CI: 1.50, 2.01). Higher educational attainment (bachelor’s degree or higher) at immigration was protective (assaults IRR: 0.64, 95%CI: 0.51, 0.80; poor mental health IRR: 0.69, 95% CI: 0.60, 0.80).

Conclusion

Source country gender inequality is not consistently associated with post-migration violence against women or severe depression, anxiety and self-harm in Ontario, Canada. Community-based research and intervention to address the documented socio-demographic disparities in outcomes of female immigrants is needed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10720-0.

Intimate Partner Violence and Resilience: The Experience of Women in Mother-Child Assisted Living Centers

Research has largely documented the damaging consequences of intimate partner violence. However, the literature presents an important gap in the identification of factors that may strengthen resilience in the victims, especially in the case of mothers and pregnant women. The present study aimed at investigating the experience of abused mothers engaged in an educative path in a Mother–Child Assisted Living Center. A qualitative descriptive methodology was used. Face-to-face in-depth interviews were conducted with a purposive sample of eight women. Four main themes emerged from the interviews: (1) improvement in the mother–child relationship; (2) a process of personal change during the educative path; (3) the rebuilding of trust relationships; and (4) attitudes and hopes toward the future. Taken together, these findings highlight the process of resilience, conceived from a socioecological perspective as the ability to use resources rooted in interconnected systems. The implications of these findings are discussed.

Myths about Intimate Partner Violence and Moral Disengagement: An Analysis of Sociocultural Dimensions Sustaining Violence against Women

Intimate partner violence (IPV) is a public health issue worldwide and a serious violation of human rights. Recognizing IPV as a form of violence is essential for both victims who need help and offenders who can join treatment programs. Furthermore, only a society able to identify violence can effectively deal with IPV. The present study is aimed at investigating the role of sociocultural dimensions (i.e., ambivalent sexism toward women, ambivalence toward men, and lay theories about gender differences) in sustaining myths about IPV and moral disengagement. The participants were 359 university students (76.5% female). The results show that hostile sexism toward women plays a key role in sustaining both myths and moral disengagement. Moreover, benevolence toward men and biological lay gender theories (i.e., “naïve” theories assuming that sex differences are a product of biology and genetics) significantly affected the endorsement of IPV myths. The implications are discussed.

Multilevel factors associated with perpetration of five types of intimate partner violence among men who have sex with men in China: an ecological model-informed study

In China, intimate partner violence (IPV) among men who have sex with men remains poorly investigated. Informed by the ecological model, this study explored multilevel factors associated with perpetration of IPV among men who have sex with men. The participants were recruited from 15 cities in mainland China. Univariate and multivariate regression analyses showed that the prevalence of committing physical, sexual, monitoring, controlling and emotional IPV was 8.6%, 7.1%, 15.2%, 7.6% and 17.1%, respectively. Committing physical IPV showed a positive association with perceived public discrimination and self-stigma towards homosexuality. Committing sexual IPV showed a positive association with involvement with a homosexual support agency and more sex partners. Monitoring IPV was positively associated with higher education and perceived stress, but negatively associated with instrumental and emotional support. Committing controlling IPV showed a positive association with drug use during sex and self-stigma but a negative association with self-esteem, self-efficacy and older age at first homosexual sex. Committing emotional IPV showed a positive association with commercial sex behaviour and perceived stress, but a negative association with resilience. Committing IPV was prevalent in this population. It is necessary to distinguish the various types of IPV in future studies, given their differences in associated factors.

Keeping it together for the kids: New mothers' descriptions of the impact of intimate partner violence on parenting

BACKGROUND

Intimate partner violence (IPV) affects 1 in 3 US women with the effects of IPV detectable for several generations. While IPV is known to have significant impacts on maternal-child outcomes, little is known about the mother's perspectives of the interplay between perinatal IPV exposure, parenting styles, and safety strategies.

METHODS

This secondary analysis of semi-structured, longitudinal qualitative interview data explored with pregnant women their histories of IPV, their parenting practices, and safety strategies. Data were derived from a randomized controlled trial, DOVE, with 22 interviews from 11 women collected during pregnancy and 12 or 24 months postpartum.

RESULTS

Data were analyzed using constant comparative analysis resulting in three themes: "broken spirit," "I want better for my kids and me," and "safety planning as an element of parenting." Women described at baseline having a "broken spirit" due to their experiences with household and family chaos and childhood abuse. However, when mothers ended the abusive relationship, they described a better life and several strategies to protect themselves and their children. During their final interviews, mothers discussed how their lives improved after ending the relationship as well as safety planning strategies they employed like looking for "red flags" in potential partners, struggles with finding trustworthy childcare, and stockpiling money should they choose to end the relationship.

CONCLUSION

These rich data add new information about how mothers of very young children navigate difficult parenting and safety decisions in the context of lifetime traumatic events and provide insights relevant for practice and research with this highly-vulnerable group of IPV survivors.

The Association Between Gender Inequality and Sexual Violence in the U.S

INTRODUCTION

Few societal-level factors are established as risk or protective factors for sexual violence. Traditional gender norms and gender inequality are linked to sexual violence, but much of this research was conducted internationally or is becoming outdated and may not reflect current norms in the U.S. This study expands on previously published research by examining gender inequality's association with state-level sexual violence.

METHODS

Using state-level prevalence estimates published in the National Intimate Partner and Sexual Violence Survey 2010-2012 State Report and the Gender Inequality Index, Pearson correlations were examined to investigate the relationship between state-level gender inequality and lifetime victimization for various types of sexual violence among U.S. female and male adults. The analysis was conducted in 2019.

RESULTS

Findings indicate that states with a high degree of gender inequality also report higher prevalence estimates among women for rape using physical force. Gender inequality was also negatively correlated with noncontact unwanted sexual experiences among women and men. In addition, an exploratory analysis of the relationship between individual indicators of gender inequality and violence outcomes suggest that the adolescent birth rate, female government representation, and labor force participation demonstrate an association with certain state-level violence outcomes, although the patterns were inconsistent.

CONCLUSIONS

Although this study relied on cross-sectional data, collectively, these findings suggest that gender inequality may represent an important societal-level factor associated with sexual violence among women and men. However, this relationship appears complex and requires further research. These findings have potential to inform population-level violence prevention approaches.