Experience of Hurricane Katrina and reported intimate partner violence

Intersections of Intimate Partner Violence and Natural Disasters: A Systematic Review of the Quantitative Evidence

Natural disasters and extreme weather events are increasing in both intensity and frequency. Emerging evidence suggests that there is a relationship between intimate partner violence (IPV) and natural disasters. However, there is a scarcity of methodologically sound research in this area with no systematic review to date. To address the gap, this paper systematically assesses the quantitative evidence on the association between IPV with natural disasters between 1990 and March 2023. There were 27 articles that meet the inclusion criteria for the data extraction process. A quantitative critical appraisal tool was used to assess the quality of each study and a narrative synthesis approach to explore the findings. The review found an association between IPV and disasters, across disaster types and countries. However, more research is needed to explore the nuances and gaps within the existing knowledge base. It was unclear whether this relationship was causal or if natural disasters heightened existing risk factors. Further, it is inconclusive as to whether disasters create new cases of IPV or exacerbate existing violence. The majority of studies focused on hurricanes and earthquakes with a dearth of research on "slow onset disasters." These gaps represent the need for further research. Further research can provide a more thorough understanding of IPV and natural disasters, increasing stakeholders' ability to strengthen community capacity and reduce IPV when natural disasters occur.

Aftermath of COVID-19: Exploring the Perception of Violence Against Women in the Middle East and North Africa

This article explores the perception of violence against women (VAW) in the Middle East and North Africa in the aftermath of the COVID-19 pandemic using Arab Barometer VI parts 1 and 3 (N = 12,548). Results showed that men and social conservatism were less likely to perceive that the VAW in the community had increased. For religious people, the odds of perceiving violence in the community were higher. Individuals whose jobs were interrupted because of the COVID-19 outbreak were more likely to perceive VAW in the community has increased compared to individuals whose jobs were not interrupted. The strongest predictor of the perception of increased VAW in the community because of COVID-19 was the current economic situation of the country. Those who perceived the economic situation of the country as bad were 1.6 times more likely to believe that VAW has increased. Government handling of the crisis and overall government performance increased the odds of perceiving that VAW has increased. Investigating correlates of VAW as the consequence of the COVID-19 pandemic is crucial because it helps governments, emergency services, and community leaders develop strategies of prevention for future disasters and improve community and institutional reactions.

Associations between climate change-related factors and sexual health: A scoping review

There is growing attention to the ways in which climate change may affect sexual health, yet key knowledge gaps remain across global contexts and climate issues. In response, we conducted a scoping review to examine the literature on associations between climate change and sexual health. We searched five databases (May 2021, September 2022). We reviewed 3,183 non-duplicate records for inclusion; n = 83 articles met inclusion criteria. Of these articles, n = 30 focused on HIV and other STIs, n = 52 focused on sexual and gender-based violence (GBV), and n = 1 focused on comprehensive sexuality education. Thematic analysis revealed that hurricanes, drought, temperature variation, flooding, and storms may influence HIV outcomes among people with HIV by constraining access to antiretroviral treatment and worsening mental health. Climate change was associated with HIV/STI testing barriers and worsened economic conditions that elevated HIV exposure (e.g. transactional sex). Findings varied regarding associations between GBV with storms and drought, yet most studies examining flooding, extreme temperatures, and bushfires reported positive associations with GBV. Future climate change research can examine understudied sexual health domains and a range of climate-related issues (e.g. heat waves, deforestation) for their relevance to sexual health. Climate-resilient sexual health approaches can integrate extreme weather events into programming.

Risk and Protective Factors for Violence Against Women and Girls Living in Conflict and Natural Disaster-Affected Settings: A Systematic Review

This systematic review provides an overview of existing research on risk and protective factors associated with violence against women and girls (VAWG) in conflict and natural disaster settings. PubMed (Medline); PsycINFO; Scopus; and Cochrane Center trials registrar were searched as well as relevant internet repositories for VAWG research. The inclusion criteria covered studies that were published between January 1995 and December 2020, documented risk and/or protective factors for VAWG in conflict or natural disaster-affected settings and included primary or secondary data analysis. A total of 1,413 records were initially identified and 86 articles (covering 77 studies) were included in the final analysis. The findings show that many preexisting risk factors for VAWG are exacerbated in armed conflict and natural disaster-affected settings. Poverty and economic stress, men's substance abuse, exposure to violence, changing gender roles in contexts of inequitable gender norms, and a lack of social support are some of the risk factors associated with male perpetration or female experience of violence. In addition, risk factors specific to experiences during armed conflict or in a natural disaster (e.g., displacement, insecurity or congestion in and around displacement camps, militarization of society, killing of family, destruction of property, etc.) are associated with higher prevalence of VAWG in these contexts.

Effect of the COVID-19 Pandemic on the Epidemiology of Pediatric Traumatic Brain Injury in Brazil

Aim In response to the coronavirus 2019 disease (COVID-19) pandemic, governments worldwide implemented measures to prevent infection, resulting in restricted school activities, restricted children's freedom of movement, and increased risk of violence and injuries at home, including traumatic brain injury (TBI), among children. In Brazil, the consequences of the COVID-19 pandemic on the causes, severity, and mortality of pediatric TBI have not yet been investigated. Thus, our study aimed to determine whether the COVID-19 pandemic has affected the epidemiology of pediatric TBI among Brazilian children. Materials and methods We investigated the patients with TBI aged <18 years who visited a tertiary trauma center in Brazil in 2019 and 2020. TBI-related variables, such as classification, mechanism, clinical manifestations, need for intervention, morbidity, and mortality, were recorded. Furthermore, we used a nationwide databank to collect information on mortality from external causes of trauma and violence in the pediatric population in 2019 and 2020. The Mann-Whitney test was used to compare quantitative variables related to the mechanisms and severity of TBI in both periods in order to determine the impact of the COVID-19 pandemic. Results Of the patients with traumatic brain injury, 1371 visited the trauma center in 2019 and 1052 in 2020. No difference was noted in the incidence rate of abusive head trauma between these periods (p=0.142) or in mortality from violence in Brazil. Recreational causes of pediatric TBI increased during the first year of the COVID-19 pandemic in Brazil and falls from bicycles significantly increased during the pandemic (p<0.001). Conclusion A global reduction in pediatric admissions to emergency rooms as well as no impact on mortality and severity of pediatric TBI were observed during the COVID-19 pandemic in Brazil. Additionally, a public education program regarding child safety during recreational activities, particularly how to avoid falls from bicycles was recommended.

Risk Factors for Intimate Partner Violence in the Context of Disasters: A Systematic Review

Women are at increased risk for experiencing intimate partner violence (IPV) in the context of disasters. However, the factors that increase this risk are not well understood. The purpose of the current study was to systematically review the literature on IPV in the context of disasters. The first aim was to identify risk factors predicting women's exposure to IPV. The second aim was to identify disaster-specific risk factors for IPV. The third aim was to construct a social ecological framework of risk factors for IPV in disasters at the individual, relationship/household, community, and structural levels. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA; Moher et al., 2009). Articles were identified using keywords in seven ProQuest databases. Of the 67 articles identified for full-text review, 24 were eligible for inclusion. Studies were evaluated based on critical appraisal of methodology using an adapted version of the Mixed Methods Appraisals Tool (MMAT; Hong et al., 2018). Findings suggest that disasters give rise to unique risk factors across social ecologies which interact with pre-existing characteristics of social vulnerability to increase women's risk of IPV. Findings inform violence prevention strategies within the context of disaster response and therefore have implications for research, policy, and practice.

Intimate Partner Violence Survivorship, Posttraumatic Stress Disorder and Disaster: Implications for Future Disasters

This study investigated posttraumatic stress disorder (PTSD) prevalence among a sample of intimate partner violence (IPV) survivors (n  =  77) who filed for restraining orders in rural Louisiana during the COVID-19 pandemic. IPV survivors were individually interviewed to assess their self-reported levels of perceived stress, resilience, potential PTSD, COVID-19-related experiences, and sociodemographic characteristics. Data were analyzed to differentiate group membership between two groups; non-PTSD and probable PTSD. Results suggest the probable PTSD group had lower levels of resilience and higher levels of perceived stress compared to the non-PTSD group. Findings suggest the importance of providing services during disaster to reduce PTSD for IPV survivors.

The effect of the COVID-19 pandemic on community violence in Connecticut

INTRODUCTION

Natural disasters may lead to increases in community violence due to broad social disruption, economic hardship, and large-scale morbidity and mortality. The effect of the COVID-19 pandemic on community violence is unknown.

METHODS

Using trauma registry data on all violence-related patient presentations in Connecticut from 2018 to 2021, we compared the pattern of violence-related trauma from pre-COVID and COVID pandemic using an interrupted time series linear regression model.

RESULTS

There was a 55% increase in violence-related trauma in the COVID period compared with the pre-COVID period (IRR: 1.55; 95%CI: 1.34-1.80; p-value<0.001) driven largely by penetrating injuries. This increase disproportionately impacted Black/Latinx communities (IRR: 1.61; 95%CI: 1.36-1.90; p-value<0.001).

CONCLUSION

Violence-related trauma increased during the COVID-19 pandemic. Increased community violence is a significant and underappreciated negative health and social consequence of the COVID-19 pandemic, and one that excessively burdens communities already at increased risk from systemic health and social inequities.

Association of the COVID-19 Pandemic With Unstable and/or Unsafe Living Situations and Intimate Partner Violence Among Pregnant Individuals

IMPORTANCE

The social, behavioral, and economic consequences of the COVID-19 pandemic may be associated with unstable and/or unsafe living situations and intimate partner violence (IPV) among pregnant individuals.

OBJECTIVE

To investigate trends in unstable and/or unsafe living situations and IPV among pregnant individuals prior to and during the COVID-19 pandemic.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional population-based interrupted time-series analysis was conducted among Kaiser Permanente Northern California members who were pregnant and screened for unstable and/or unsafe living situation and IPV as part of standard prenatal care between January 1, 2019, and December 31, 2020.

EXPOSURES

COVID-19 pandemic (prepandemic period: January 1, 2019, to March 31, 2020; during pandemic period: April 1 to December 31, 2020).

MAIN OUTCOMES AND MEASURES

The 2 outcomes were unstable and/or unsafe living situations and IPV. Data were extracted from electronic health records. Interrupted time-series models were fit and adjusted for age and race and ethnicity.

RESULTS

The study sample included 77 310 pregnancies (74 663 individuals); 27.4% of the individuals were Asian or Pacific Islander, 6.5% were Black, 29.0% were Hispanic, 32.3% were non-Hispanic White, and 4.8% were other/unknown/multiracial, with a mean (SD) age of 30.9 (5.3) years. Across the 24-month study period there was an increasing trend in the standardized rate of unsafe and/or unstable living situations (2.2%; rate ratio [RR], 1.022; 95% CI, 1.016-1.029 per month) and IPV (4.9%; RR, 1.049; 95% CI, 1.021-1.078 per month). The ITS model indicated a 38% increase (RR, 1.38; 95% CI, 1.13-1.69) in the first month of the pandemic for unsafe and/or unstable living situation, with a return to the overall trend afterward for the study period. For IPV, the interrupted time-series model suggested an increase of 101% (RR, 2.01; 95% CI, 1.20-3.37) in the first 2 months of the pandemic.

CONCLUSIONS AND RELEVANCE

This cross-sectional study noted an overall increase in unstable and/or unsafe living situations and IPV over the 24-month period, with a temporary increase associated with the COVID-19 pandemic. It may be useful for emergency response plans to include IPV safeguards for future pandemics. These findings suggest the need for prenatal screening for unsafe and/or unstable living situations and IPV coupled with referral to appropriate support services and preventive interventions.

Unwanted sexual activity among United States women early in the COVID-19 pandemic

BACKGROUND

Female sexual activity and, accordingly, birth rates tend to decline in times of stress, such as a pandemic. In addition, when resources are scarce or exogenous conditions are threatening, some women may engage in sexual activity primarily to maintain socioeconomic security. Having unwanted sex may indicate sexual activity in exchange for economic security.

OBJECTIVE

This study aimed to describe patterns and correlates of unwanted sex, defined as having sex more frequently than desired, among US women early in the COVID-19 pandemic.

STUDY DESIGN

The National US Women's Health COVID-19 Study was conducted in April 2020, using a nested quota sample design to enroll 3200 English-speaking women (88% cooperation rate) aged 18 to 90 years recruited from a research panel. The quota strata ensured sufficient sample sizes in sociodemographic groups of interest, namely, racial and ethnic subgroups. Patterns of sexual activity, including unwanted sex early in the pandemic, were described. To further elucidate the experiences of women reporting unwanted sex, open-ended responses to an item querying "how the coronavirus pandemic is affecting your sex life" were assessed using conventional content analysis. Logistic regression analyses-adjusting for sociodemographic characteristics, self-reported health, and prepandemic health-related socioeconomic risk factors, including food insecurity, housing instability, utilities and transportation difficulties, and interpersonal violence-were used to model the odds of unwanted sex by a pandemic-related change in health-related socioeconomic risk factors.

RESULTS

The proportion of women who were sexually active early in the pandemic (51%) was about the same as in the 12 months before the pandemic (52%), although 7% of women became active, and 7% of women became inactive. Overall, 11% of sexually active women were having unwanted sex in the early pandemic. The rates of anxiety, depression, traumatic stress symptoms, and each of the 5 health-related socioeconomic risk factors assessed were about 2 times higher among women having unwanted sex than other women (P<.001). Women having unwanted sex were also 5 times more likely than other women to report an increased frequency of sex since the pandemic (65% vs 13%; P<.001) and 6 times more likely to be using emergency contraception (18% vs 3%; P<.001). Women reporting unwanted sex commonly described decreased libido or interest in sex related to mood changes since the pandemic, having "more sex," fear or worry about the transmission of the virus because of sex, and having sex to meet the partner's needs. Among sexually active women, the odds of unwanted sex (adjusting for demographic, reproductive, and health factors) were higher among women with 1 prepandemic health-related socioeconomic risk factor (adjusted odds ratio, 2.0; 95% confidence interval, 1.1-3.8) and 2 or more prepandemic health-related socioeconomic risk factors (adjusted odds ratio, 6.0; 95% confidence interval, 3.4-10.6). Among sexually active women with any prepandemic health-related socioeconomic risk factor, those with new or worsening transportation difficulties early in the pandemic were particularly vulnerable to unwanted sex (adjusted odds ratio, 2.7; 95% confidence interval, 1.7-4.3).

CONCLUSION

More than 1 in 10 sexually active US women was having unwanted sex early in the COVID-19 pandemic. Socioeconomically vulnerable women, especially those with new or worsening transportation problems because of the pandemic, were more likely than others to engage in unwanted sex. Pandemic response and recovery efforts should seek to mitigate unwanted sexual activity and related health and social risks among women.

Practitioner Experiences with Domestic and Family Violence in COVID-19

The advent of COVID-19 as a global public health crisis in 2020 was quickly followed by predictions regarding likely increases in occurrences of domestic and family violence (DFV). The aim of this study was to understand the impact of the pandemic on practitioner experiences of DFV in one service organisation in New South Wales, Australia. Qualitative focus group interviews were performed with senior practitioners at Relationships Australia (NSW), and a grounded theory approach was employed in formulation of a perspective which highlighted social isolation under public health management social distancing measures as that which distinguished practitioner experiences of DFV during COVID-19. Social isolation was conceived as the overarching factor across categorisations of practitioner responses, including: (a) situations of client domestic relations; (b) client general life circumstances; (c) emerging client self-awareness; (d) organisational and social systems changes; and (e) necessary work practice changes. Organisational and workplace recommendations address the relative difference of pandemic management measures from natural disaster occurrences, with respect to supporting people experiencing DFV.

The Impact of the COVID-19 Pandemic on the Needs and Lived Experiences of Intimate Partner Violence Survivors in the United States: Advocate Perspectives

We explored the challenges and lived experiences of intimate partner violence (IPV) survivors during the COVID-19 pandemic by interviewing 53 U.S.-based IPV advocates between June and November 2020. Advocates described how the COVID-19 pandemic limited survivors' abilities to meet their basic needs. The pandemic was also described as being used by abusive partners to perpetrate control and has created unique safety and harm reduction challenges. IPV survivors experienced compounding challenges due to structural inequities. IPV must be considered by local, state, and federal governments when developing disaster planning policies and practices, including in the context of pandemics.

Effects of hurricane harvey on trajectories of hostile conflict among newlywed couples

Natural disasters have been purported to increase, and decrease, hostile conflict in intimate relationships, but heavy reliance on retrospective designs prohibits strong tests of these contrasting perspectives. The present study aims to resolve this ambiguity using a sample of newlywed couples from Houston, Texas who reported their levels of hostile conflict three times before and three times after experiencing Hurricane Harvey. Latent growth curve piecewise regression models showed that robust declines in conflict prior to the hurricane were slowed after the hurricane hit, such that posthurricane conflict slopes flattened and became nonsignificant. Thus, by disrupting natural declines in conflict that occur in the early years of marriage, Hurricane Harvey appears to have been detrimental for couples. Factors examined in relation to hostile conflict (including personality traits, adverse childhood events, stress, and relationship satisfaction) were similar in their predictive power prior to and following the hurricane, suggesting that the hurricane did not markedly alter which couples were most prone to hostile interactions. Implications for understanding relationships in the context of natural disasters are outlined. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal Analysis of Short-term Changes in Relationship Conflict During COVID-19: A Risk and Resilience Perspective

This study uses a risk and resilience framework to examine short-term self-reported changes in relationship conflict early in the COVID-19 pandemic (March and April 2020). Longitudinal data from U.S. adults in a romantic relationship (N = 291) were collected via three waves of an online survey. Participants self-reported anxiety, depression, increased alcohol use, and dyadic coping since the pandemic. Relationship conflict variables included whether the participant reported that they and their partner "had disagreements related to the Coronavirus," "had more disagreements than usual," "had more verbal fights than usual," and "had more physical fights than usual" in the past two weeks. Analyses controlled for sociodemographic characteristics as well as days spent in lockdown and employment change due to COVID-19. Results indicated that couples' disagreement and verbal fighting scores increased from Time 1 to Time 2, but disagreements related to COVID-19 and physical fighting did not. Couples with higher levels of dyadic coping reported fewer fights and disagreements on average. However, dyadic coping did not buffer participants from increases in relationship conflict. Increased alcohol use since the pandemic was positively associated with disagreements related to COVID-19, disagreement scores, and verbal fighting scores. More days spent in lockdown was associated with increases in disagreements related to COVID-19. The conditions created by COVID-19 may contribute to worsening relationship conflict, even among couples who start with high levels of dyadic coping. Depression and alcohol use may contribute to poorer relationship quality during the pandemic. There is need for enhanced intervention and mental health supports to mitigate the potential effects of the pandemic on couples' relationship functioning.

The Danger in Danger - A study on the psychological impact of COVID-19 lockdown on people in the Indian context

The present study attempts to find the factors resulting in increased risk of anxiety and stress due to nation-wide lockdown imposed to reduce the transmission of coronavirus in the Indian context. Grounded theory approach is used to collect, analyze, and code the data elicited from 37 semi-structured interviews. Qualitative analysis of the data found that the lockdown during coronavirus outbreak led to boredom, financial loss, and intimate terrorism which resulted in an elevated risk of anxiety and stress. It was also revealed that risk of anxiety and stress further increased during the lockdown due to the moderating role of the media and doom scrolling. Significance of the study rests in developing a grounded theory framework for stress and anxiety in the Indian context that can help the government and the associated bodies as well as the healthcare departments to devise strategies and policies to reduce the risk of nation-wide lockdown on the mental health of the people. This study is one of the initial attempts that use the grounded theory to unearth and add to the existing literature the intervening and intriguing factors which directly or indirectly increases individuals' anxiousness and stress during COVID-19 lockdown in the Indian context.

The COVID-19 pandemic and associated increases in experiences of assault violence among black men with low socioeconomic status living in Louisiana

Background

The COVID-19 pandemic has had mental health, social, and economic implications among communities with high levels of social disadvantage; this may have impacted community violence rates. The objective of this study was to characterize overall trends in assault and social disadvantage of patients experiencing assault before and during the COVID-19 pandemic.

Methods

All trauma activations at a level one trauma center serving the entire southeast Louisiana region were included during March–August pre-COVID (2018–2019) and during COVID (2020). ICD-10 E-codes were used to identify trauma intent (assault vs. other). Assaults in this context are defined as physical injuries caused by an act of violence wherein the perpetrator was suspected or confirmed to have intended harm, injury, or death to the victim. Social disadvantage was assessed using the Area Deprivation Index (ADI). Change in the monthly rate of assault-trauma activations was assessed using negative binomial regression with adjustment for race, gender, and injury intent. The study was reviewed and approved by the Louisiana State University Health Sciences Institutional Review Board.

Results

A total of 4,233 trauma activations were included. The majority of activations occurred among men. Assaults increased from 27.5% of all activations pre-Covid to 35.6% during the pandemic. Penetrating trauma similarly increased from 29.5% to 35.7% of all activations. Negative binomial regression demonstrated that in addition to this increase in proportion of assaults relative to all activations, the monthly assault rate also increased by 20% during the pandemic. These increases were driven primarily by increased assaults among Black men. ADI rank did not change between study periods.

Conclusions

Health disparities in violence worsened during the pandemic: increased cases of assault occurred disproportionately among Black men, and assaults persisted in occurring primarily among low-ADI communities where burden had been high pre-pandemic. There is a critical need for resources and support to Black men, to mitigate violence and improve racial heath equity.

Extreme events and gender-based violence: a mixed-methods systematic review

The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme events and their effect on gender-based violence (GBV) experienced by women, girls, and sexual and gender minorities. We searched ten databases until February, 2022. Grey literature was searched using the websites of key organisations working on GBV and Google. Quantitative studies were described narratively, whereas qualitative studies underwent thematic analysis. We identified 26 381 manuscripts. 41 studies were included exploring several types of extreme events (ie, storms, floods, droughts, heatwaves, and wildfires) and GBV (eg, sexual violence and harassment, physical violence, witch killing, early or forced marriage, and emotional violence). Studies were predominantly cross-sectional. Although most qualitative studies were of reasonable quality, most quantitative studies were of poor quality. Only one study included sexual and gender minorities. Most studies showed an increase in one or several GBV forms during or after extreme events, often related to economic instability, food insecurity, mental stress, disrupted infrastructure, increased exposure to men, tradition, and exacerbated gender inequality. These findings could have important implications for sexual-transformative and gender-transformative interventions, policies, and implementation. High-quality evidence from large, ethnographically diverse cohorts is essential to explore the effects and driving factors of GBV during and after extreme events.

Social Vulnerability and COVID-19: Changes in Trauma Activations at a Safety-Net Hospital

Introduction

Following the declaration of the COVID-19 pandemic, there were reports of decreased trauma hospitalizations, although violent crime persisted. COVID-19 has had the greatest impact on minoritized and vulnerable communities. Decreases in traumatic events may not extend to these communities, given pandemic-related socioeconomic and psychological burdens that increase the risk of exposure to trauma and violence.

Materials and methods

This was a retrospective cohort study (n = 1634) of all trauma activations presenting to our institution January 1, 2020 to May 31, 2020, and same time periods in 2018 and 2019. Census tracts and associated Social Vulnerability Index quartiles were determined from patient addresses. Changes in trauma activations pre and post Massachusetts’ state-of-emergency declaration compared to a historical control were analyzed using a difference-in-differences methodology.

Results

Weekly all-cause trauma activations fell from 26.44 to 8.25 (rate ratio = 0.36 [0.26, 0.50]) postdeclaration, with significant difference-in-differences compared to a historical control (P < 0.0001). Nonviolent trauma activations significantly decreased from 21.11 to 5.17 after the declaration (rate ratio = 0.27 [0.37, 0.91]; P < 0.0001), whereas there was no significant decrease in violent injury (5.33 to 3.08 rate ratio = 0.69 [0.39, 1.22]; P = 0.20). Stratified by vulnerability, the most vulnerable quartile had an increased proportion of all-cause trauma postdeclaration and had no decrease in violent trauma activations following the declaration compared to the historical control (rate ratio = 0.84 [0.38-1.86]; P = 0.67).

Conclusions

The state-of-emergency declaration was associated with significant decreases in overall trauma, to a greater extent in nonviolent injuries. Among those living in the most socially vulnerable communities, there was no decrease in violent trauma. These findings highlight the need for violence and injury prevention programs in vulnerable communities, particularly in times of crisis.

The Impact of the COVID-19 Pandemic on Intimate Partner Violence Advocates and Agencies

Relatively few studies have considered the impact of the COVID-19 pandemic on intimate partner violence (IPV) advocates or the agencies where they work. In this study, based on United States IPV advocates' experiences working with survivors during the COVID-19 pandemic, we conducted interviews to explore: 1) personal challenges and resilience working as IPV advocates during the COVID-19 pandemic; 2) how agencies adapted to the pandemic to support IPV survivors and advocates; and 3) specific needs and challenges of culturally-specific agencies. We conducted semi-structured interviews with 53 IPV advocates from June to November 2020. Participants were included if they worked directly with survivors, identified as an IPV advocate, worked at a US-based agency, and spoke and understood English. We created a sampling matrix to ensure adequate representation from IPV advocates serving survivors from communities which have been marginalized. Interviews were conducted through a virtual platform by a trained member of the research team. We used an inductive thematic analysis approach, with weekly coding meetings to resolve discrepancies in coding. Five themes emerged from the data: 1) IPV advocates described how working as an IPV advocate during the COVID-19 pandemic impacted them personally; 2) agencies developed new methods of addressing IPV advocates' needs; 3) agencies developed new solutions to address pandemic-related client needs; 4) transitioning advocacy work to virtual formats created challenges but also opportunities and; 5) pandemic limitations and impacts compounded pre-pandemic challenges for culturally specific agencies. IPV advocates are frontline workers who have played essential roles in adjusting services to meet survivor needs during the COVID-19 pandemic while simultaneously coping with pandemic impacts on themselves and their agencies. Developing inter-agency collaborations and promoting advocates' safety and wellbeing during future public health crises will help support IPV survivors.

Parental Social Isolation and Child Maltreatment Risk during the COVID-19 Pandemic

On March 11, 2020, COVID-19 was declared a pandemic by the World Health Organization. The social isolation and economic stress resulting from pandemic have the potential to exacerbate child abuse and neglect. This study examines the association of parents' perceived social isolation and recent employment loss to risk for child maltreatment (neglect, verbal aggression, and physical punishment) in the early weeks of the pandemic. Participants (N = 283) were adults living in the U.S. who were parents of at least one child 0-12 years of age. Participants completed an online survey approximately 2 weeks after the World Health Organization declared that COVID-19 was a pandemic. The survey asked about recent changes (i.e., in the past 2 weeks) to employment status, parenting behaviors, use of discipline, use of spanking, and depressive symptoms. Nearly 20% of parents had hit or spanked their child in the past two weeks alone. Parents' perceived social isolation and recent employment loss were associated with self-report of physical and emotional neglect and verbal aggression against the child, even after controlling for parental depressive symptoms, income, and sociodemographic factors. Parents' perceived social isolation was associated with parental report of changes in discipline, specifically, using discipline and spanking more often in the past 2 weeks. Associations were robust to analyses that included two variables that assessed days spent social distancing and days spent in "lockdown." Study results point to the need for mental health supports to parents and children to ameliorate the strain created by COVID-19.

Exploring the Linkages between Substance Use, Natural Disasters, Pandemics, and Intimate Partner Violence against Women: A Rapid Review in the Context of COVID-19

Rates of intimate partner violence (IPV) and substance use have risen during the COVID-19 pandemic, with potentially enduring effects on women’s health. A rapid review was conducted on IPV and women’s substance use in the context of the COVID-19 pandemic. The rapid review explored two separate research questions with a view to integrate the literature related to: (1) containment, social isolation, pandemics, disasters, lockdowns, and IPV; and (2) the relationships between substance use and IPV. Two different searches for each question were conducted between May and October 2020 and n = 47 articles were included. Women experience multiple physical and mental health consequences related to IPV that can be exacerbated by public health crises such as pandemics and disasters. Perpetrators may use these events as a tactic to threaten, isolate, or use coercive control. Similar tactics are reported in the complex relationship between IPV and substance use, where substance use can accompany IPV and/or be used as a coping mechanism for survivors. The findings highlight long standing women’s health concerns made further visible during the COVID-19 pandemic. Additional research is needed to identify actions required to reduce gender inequities and harms associated with IPV and substance use, and to adequately tailor and prepare effective responses in the context of future public health crises.

Experiencing a Natural Disaster Temporarily Boosts Relationship Satisfaction in Newlywed Couples

How do natural disasters affect intimate relationships? Some research suggests that couples are brought closer together after a disaster, whereas other research suggests that relationships become more strained in the aftermath. Yet all of this work is limited by a lack of predisaster data that would allow for examination of how relationships actually change. The current study is the first to use longitudinal data collected before and after a natural disaster to examine its effect on relationship outcomes. Using a sample of 231 married couples in Harris County, Texas, who experienced Hurricane Harvey, we found that spouses experienced significant increases in satisfaction from before to after the hurricane, but the increase was temporary; couples decreased in satisfaction after the initial boost. Thus, couples appear to grow closer in the immediate aftermath of a natural disaster but then revert to their prehurricane levels of functioning as the recovery period continues.

What Is the Effect of COVID-19 Social Distancing on Oral and Maxillofacial Trauma Related to Domestic Violence?

PURPOSE

To understand the impact of social distancing policies on the incidence and severity of oral and maxillofacial trauma (OMT) secondary to interpersonal violence (IPV) and domestic violence (DV).

METHODS

The authors designed a retrospective cohort study enrolling subjects who presented to an urban Level 1 trauma center in Seattle, WA, for the evaluation and management of OMT between January 1 and December 31 in the years 2018 through 2020. The primary predictor variable was evaluation of OMT during periods with (2020: investigational group) or without (2018 or 2019: control group) social distancing policies in place. The primary outcome variables were the mechanism and severity of injury, defined as IPV, DV or neither, the abbreviated injury scale (AIS) and the injury severity score (ISS). Descriptive, univariate and bivariate analyses were performed with statistical significance at P < .05.

RESULTS

Eight hundred twenty-eight subjects; 737 (89%) IPV and 91(11%) IPV due to DV. The incidence of OMT secondary to IPV or DV was unchanged (P = .81, P = .57 respectively). There was a nonsignificant increase in ISS for IPV (P = .07) and no change for DV (P = .46). AIS scores were unchanged for IPV (P = .36). For DV, AIS scores were lower in 2020 when compared to 2019 (P = .04) but unchanged from 2018 (P = .58). At least half of the DV victims were male (50% in 2018, 59% in 2019, and 53% in 2020). Of these, 65% were under 18, and represented the pediatric majority (62%). A nonsignificant increase in non-white subjects presenting with DV in 2020 (P = .15) was seen.

CONCLUSIONS

The COVID-19 pandemic did not change the number or severity of OMT cases secondary to IPV or DV in this region of Washington. Pediatric males were more likely to be victims of DV.

Examining Violence Against Women at a Regional Level 1 Trauma Center During the COVID-19 Pandemic

Introduction

There is a growing concern that certain public health restrictions imposed to prevent the spread of coronavirus disease 2019 (COVID-19) could result in more violence against women (VAW). We sought to determine if the rates and types of VAW changed during the COVID-19 pandemic at our level 1 trauma center (L1TC).

Methods

We performed a retrospective review of female patients who presented to our L1TC because of violence from 2019 through 2020. Patients were grouped into a pre-COVID or COVID period. The primary aim of this study was to compare rates of VAW between groups. Secondary aims sought to evaluate for any difference in traumatic mechanism between periods and to determine if a temporal relationship existed between COVID-19 and VAW rates.

Results

There was no difference in rates of VAW between the pre-COVID and COVID period (3.1% vs 3.6%, P = .6); however, rates of penetrating trauma were greater during the COVID period (38.2% vs 10.3%, P = .01). After controlling for patient age and race, the odds of penetrating trauma increased during the pandemic (OR 5.8, 95% CI 1.6-28.5, P < .01). From February 2020 through October 2020, there was a direct relationship between rates of COVID-19 and VAW (r2 .78, P < .01).

Conclusion

Rates of VAW were unchanged between the pre-COVID and COVID periods, yet the odds of penetrating VAW were 5 times greater during the pandemic. Moving forward, trauma surgeons must remain vigilant for signs of violence and ensure that support services are available during future crises.

COVID-19 lockdowns, intimate partner violence and coercive control

2020 was a year like no other, with the COVID-19 virus upending life as we know it. When governments around the world imposed lockdown measures to curb the spread of COVID-19, advocates in the domestic and family violence (DFV) sector recognised that these measures were likely to result in increases in violence against women, particularly intimate partner violence (IPV). IPV can take many forms, including physical, emotional, psychological, financial, coercive controlling behaviours, surveillance and isolation tactics. Lockdown conditions provide fertile ground for the exercise of coercive control by encouraging people to stay at home, limiting social interactions to household members, reducing mobility and enabling perpetrators to closely monitor their partner's movements. However, media reports and awareness of IPV are generally dominated by a focus on physical violence and lethality, which are easily defined and measured. By contrast, coercive control as a concept is difficult to operationalise, measure and action in law, policy and frontline interventions. This paper discusses the challenges inherent in measuring coercive control and engages with current debates around the criminalisation of coercive control in NSW. Such reflection is timely as the conditions of COVID-19 lockdowns are likely to lead to an increase in coercive controlling behaviours.

The psychology of climate anxiety

This paper focuses on climate anxiety and its role in the psychology of climate change, compared with responses to the COVID-19 global pandemic. Four psychological hypotheses for why we do not act on climate change will be reviewed, and the role of anxiety for each, as well as potential solutions. Different types of climate anxiety both inside and outside the clinic will be explored, along with associated defence mechanisms and treatment.

Adapting Service Delivery during COVID-19: Experiences of Domestic Violence Practitioners

COVID-19 rapidly altered patterns of domestic and family violence, increasing the complexity of women's needs, and presenting new barriers to service use. This article examines service responses in Australia, exploring practitioners' accounts of adapting service delivery models in the early months of the pandemic. Data from a qualitatively enriched online survey of practitioners (n = 100) show the ways services rapidly shifted to engage with clients via remote, technology-mediated modes, as physical distancing requirements triggered rapid expansion in the use of phone, email, video calls and messaging, and many face-to-face interventions temporarily ceased. Many practitioners and service managers found that remote service delivery improved accessibility and efficiency. Others expressed concerns about their capacity to assess risk without face-to-face contact, and were unsure whether new service modalities would meet the needs of all client groups and reflect best practice. Findings attest to practitioners' mixed experiences during this period of rapid service innovation and change, and underline the importance of monitoring emerging approaches to establish which service adaptations are effective for different groups of people, and to determine good practice for combining remote and face-to-face service options in the longer term.

Rising incidence of interpersonal violence in Pennsylvania during COVID-19 stay-at home order

BACKGROUND

The coronavirus disease 2019 pandemic and associated policies have had important downstream consequences for individuals, communities, and the healthcare system, and they appear to have been accompanied by rising interpersonal violence. The objective of this study was to evaluate the incidence of injuries owing to interpersonal violence after implementation of a statewide stay-at-home order in Pennsylvania in March 2020.

METHODS

Using the Pennsylvania Trauma Outcome Study registry, we conducted a retrospective cohort study of patients with gunshot wounds, stab wounds, and blunt assault-related injuries attributable to interpersonal violence treated at Pennsylvania trauma centers from March 16 to July 31 of 2018, 2019, and 2020.

RESULTS

There were fewer total trauma admissions in 2020 (17,489) vs 2018 (19,290) and 2019 (19,561). Gunshot wounds increased in 2020 to 737 vs 647 for 2019 and 565 for 2018 (P = .028), whereas blunt assault injuries decreased (P = .03). In all time periods, interpersonal violence primarily impacted urban counties. African American men were predominantly affected by gunshot wounds and stab wounds, whereas Caucasian men were predominantly affected by blunt assault injuries. There were more patients with substance abuse disorders and positive drug screens during coronavirus disease than in comparison periods: (stab wound population 52.3% vs 33.9% vs 45.9%, coronavirus disease era vs 2018 vs 2019, respectively P = .0001), (blunt assault injury population 41.4% vs 33.1% vs 33.5%, coronavirus disease era vs 2018 vs 2019, respectively P < .0001). There was no correlation between the incidence of interpersonal violence and coronavirus disease 2019 rates at the county level.

CONCLUSION

The implementation of a stay-at-home order was accompanied by rising incidence of gunshot and stab wound injuries in Pennsylvania. Preparedness for future resurgences of coronavirus disease 2019 and other pandemics calls for plans to address injury prevention, recidivism, and access to mental health and substance abuse prevention services.

The Endemic Amid the Pandemic: Seeking Help for Violence Against Women in the Initial Phases of COVID-19

During the first months of the COVID-19 pandemic, governments instituted a series of measures to control the spread of the virus. The measures were widely believed to increase women's risk of violent victimization, most of which is by an intimate partner. We examined help-seeking during this period in a large U.S. city and used an interrupted time series analysis to assess the effects of three government interventions on domestic violence and sexual assault hotline calls and on "911" calls regarding domestic violence, assault, and rape. Declaration of an emergency appeared to reduce victim calls to the rape crisis hotline and the few "911" calls about rape. School closure was associated with a reduction in "911" calls about assault and rape and victim calls to the domestic violence hotline. Implementation of stay-at-home orders was associated with a gradual increase in domestic violence hotline calls. Although "911" calls regarding assault fell by nearly half, calls to police for domestic violence were unchanged. In sum, there was a decrease in help-seeking for sexual assault and assault in general but not for domestic violence during the initial phases of the COVID-19 outbreak. The analysis underscores the importance of distinguishing between the violence itself, calls to police, and calls to helplines when claims are made about changes over time in violence against women. The opportunities and constraints for each can differ widely under usual circumstances, circumstances that were altered by public health interventions related to the pandemic.

Change in Health-Related Socioeconomic Risk Factors and Mental Health During the Early Phase of the COVID-19 Pandemic: A National Survey of U.S. Women

Background: During a pandemic, women may be especially vulnerable to secondary health problems driven by its social and economic effects. We examined the relationship between changes in health-related socioeconomic risks (HRSRs) and mental health. Materials and Methods: A cross-sectional survey of 3,200 women aged 18-90 years was conducted in April 2020 using a quota-based sample from a national panel (88% cooperation rate). Patterns of change in HRSRs (food insecurity, housing instability, interpersonal violence, and difficulties with utilities and transportation) were described. Weighted, multivariate logistic regression was used to model the odds of depression, anxiety, and traumatic stress symptoms among those with and without incident or worsening HRSRs. Results: More than 40% of women had one or more prepandemic HRSRs. In the early pandemic phase, 49% of all women, including 29% with no prepandemic HRSRs, had experienced incident or worsening HRSRs. By April 2020, the rates of depression and anxiety were twice that of prepandemic benchmarks (29%); 17% of women had symptoms of traumatic stress. The odds of depression, anxiety, and posttraumatic stress symptoms were two to three times higher among women who reported at least one incident or worsening HRSR; this finding was similar for women with and without prepandemic HRSRs. Conclusions: Increased health-related socioeconomic vulnerability among U.S. women early in the coronavirus disease 2019 (COVID-19) pandemic was prevalent and associated with alarmingly high rates of mental health problems. Pandemic-related mental health needs are likely to be much greater than currently available resources, especially for vulnerable women.

Natural hazards, disasters and violence against women and girls: a global mixed-methods systematic review

INTRODUCTION

Disasters triggered by climate and other natural hazards are increasing in frequency, severity and duration worldwide. Disasters disproportionately impact women and girls, with some evidence suggesting that violence against women and girls (VAWG) increases in disaster settings. Suggested risk factors for postdisaster VAWG include increased life stressors, failure of law enforcement, exposure to high-risk environments, exacerbation of existing gender inequalities and unequal social norms. We aim to systematically appraise the global literature on the association between disasters from natural hazards and VAWG.

METHODS

We conducted a systematic review using the following databases: Embase, Global Health, Medline, PubMed and Social Policy and Practice and searched grey literature. We included quantitative, qualitative or mixed-methods studies published in English language that examined the association between disasters from natural hazards and VAWG. We summarised the findings using a narrative synthesis approach.

RESULTS

Of 555 non-duplicate records, we included a total of 37 quantitative, qualitative and mixed-methods studies. Among the quantitative studies, eight studies found a positive association between disaster exposure and increased VAWG, and four additional studies found positive associations with some violence types but not others. Qualitative findings offered insights into three hypothesised pathways: disaster exposure associated with (1) an increase of stressors that trigger VAWG; (2) an increase of enabling environments for VAWG and (3) an exacerbation of underlying drivers of VAWG.

CONCLUSION

As the first known global systematic review on the relationship between disasters from natural hazards and VAWG, this review contributes to the evidence base. We were limited by the quality of quantitative studies, specifically study designs, the measurement of variables and geographic scope. The severe health consequences of VAWG and increasing frequency of extreme events means that rigorously designed and better quality studies are needed to inform evidence-based policies and safeguard women and girls during and after disasters.

Perspectives on the Health Effects of Hurricanes: A Review and Challenges

Hurricanes are devastating natural disasters which dramatically modify the physical landscape and alter the socio-physical and biochemical characteristics of the environment, thus exposing the affected communities to new environmental stressors, which persist for weeks to months after the hurricane. This paper has three aims. First, it conceptualizes potential direct and indirect health effects of hurricanes and provides an overview of factors that exacerbate the health effects of hurricanes. Second, it summarizes the literature on the health impact of hurricanes. Finally, it examines the time lag between the hurricane (landfall) and the occurrence of diseases. Two major findings emerge from this paper. Hurricanes are shown to cause and exacerbate multiple diseases, and most adverse health impacts peak within six months following hurricanes. However, chronic diseases, including cardiovascular disease and mental disorders, continue to occur for years following the hurricane impact.

COVID-19 pandemic and violence: rising risks and decreasing urgent care-seeking for sexual assault and domestic violence survivors

BACKGROUND

There is little information on care-seeking patterns for sexual assault and domestic violence during the COVID-19 pandemic. The objective of this study was to examine the changes in emergency department (ED) admissions for sexual assault and domestic violence since the COVID-19 pandemic was declared.

METHODS

Observational ED admissions data from The Ottawa Hospital were analyzed from March 4 to May 5 (62 days) in 2020 (COVID-19 period) and compared to the same period in 2018 (pre-COVID-19). Total and mean weekly admissions were calculated for all-cause ED admissions and for sexual and domestic violence cases. A Poisson regression (without offset term) was used to calculate the weekly case count ratio and 95% confidence intervals (CI) between the two time periods. Case characteristics were compared using chi-square tests, and percent differences were calculated.

RESULTS

Compared to pre-COVID-19, total ED admissions dropped by 1111.22 cases per week (32.9% reduction), and the Sexual Assault and Domestic Violence Program cases dropped 4.66 cases per week. The weekly case count ratio for sexual assault cases was 0.47 (95% CI 0.79-0.27), equivalent of 53.49% reduction in cases, and 0.52 (95% CI 0.93-0.29), equivalent to a 48.45% reduction in physical assault cases. The characteristics of presenting cases were similar by age (median 25 years), sex (88.57% female), assault type (57.14% sexual assault, 48.57% physical assault), and location (31.43% patient's home, 40.00% assailant's home). There was a significant increase in psychological abuse (11.69% vs 28.57%) and assaults occurring outdoors (5.19% vs 22.86%).

CONCLUSION

This study found a decrease in ED admissions for sexual assault and domestic violence during COVID-19, despite societal conditions that elevate risk of violence. Trends in care-seeking and assault patterns will require ongoing monitoring to inform the provision of optimal support for individuals experiencing violence, particularly as countries begin to re-open or lock-down again.

Violence against women in the Covid-19 pandemic: A review of the literature and a call for shared strategies to tackle health and social emergencies

The aim of this article was to conduct a rapid critical review of the literature about the relationship between violence against women (VAW) and the current COVID-19 pandemic.

After the screening process, a total of 42 articles were considered. Our review confirmed that the “stay at home” policies to contrast the pandemic have increased the problem of VAW, creating a “shadow pandemic within the pandemic”, as it was called by the United Nations. However, rigorous studies estimating the relationship between VAW and COVID-19 pandemic are scarce; most of the articles are commentaries, letters, editorials, and most of the published data derives from social media, internet, anecdotal evidence and helplines reports.

Health care systems should promote further investigations into the relation between VAW and COVID-19, to identify creative solutions to provide clinical care and forensic services for victims of VAW.

A Life-Course Model of Trauma Exposure and Mental Health Among Low-Income Survivors of Hurricane Katrina

Prior research has provided robust evidence that exposure to potentially traumatic events (PTEs) during a disaster is predictive of adverse postdisaster mental health outcomes, including posttraumatic stress symptoms (PTSS) and nonspecific psychological distress (PD). However, few studies have explored the role of exposure to other PTEs over the life-course in shaping postdisaster mental health. Based on the broader literature on trauma exposure and mental health, we hypothesized a path analytic model linking predisaster PTEs to long-term postdisaster PTSS and PD via predisaster PD, short-term postdisaster symptoms, and disaster-related and postdisaster PTEs. We tested this model using data from the Resilience in Survivors of Katrina study, a longitudinal study of low-income, primarily non-Hispanic Black mothers exposed to Hurricane Katrina and assessed before the disaster and at time points 1, 4, and 12 years thereafter. The models evidenced a good fit with the data, RMSEA < .01-.04, CFIs > .99. In addition, 44.1%-67.4% of the effect of predisaster PTEs on long-term postdisaster symptoms was indirect. Descriptive differences were observed across models that included PTSS versus PD, as well as models that included all pre- and postdisaster PTEs versus only those that involved assaultive violence. The results suggest the importance of incorporating disaster preparedness in clinical work with trauma survivors and the value in attending to other lifetime PTEs when working in postdisaster contexts.

Early Effects of the COVID-19 Pandemic on Relationship Satisfaction and Attributions

How has the COVID-19 pandemic affected intimate relationships? The existing literature is mixed on the effect of major external stressors on couple relationships, and little is known about the early experience of crises. The current study used 654 individuals involved in a relationship who provided data immediately before the onset of the pandemic (December, 2019) and twice during the early stages of the pandemic (March and April, 2020). Results indicate that relationship satisfaction and causal attributions did not change over time, but responsibility attributions decreased on average. Changes in relationship outcomes were not moderated by demographic characteristics or negative repercussions of the pandemic. There were small moderation effects of relationship coping and conflict during the pandemic, revealing that satisfaction increased and maladaptive attributions decreased in couples with more positive functioning, and satisfaction decreased and maladaptive attributions increased in couples with lower functioning.

Another disaster: Access to abortion after Hurricane Harvey

The devastating effects of natural hazards uncover and exacerbate social inequalities, yet reproductive health outcomes are often overlooked. Despite a small but growing literature on gender and disaster-related impacts, there are no studies to date to our knowledge on the intersection of abortion and disasters, which is important because abortion is common in the U.S. and is a critical component of comprehensive reproductive healthcare yet is routinely inaccessible due to a lack of health insurance coverage and other policy barriers. This is a qualitative case study of 8 individuals who required abortion services in Texas at the time of Hurricane Harvey. The study sample comes from caller data from a local Texas abortion fund. We present caller demographics, which reveal nonwhite patients in later trimesters struggling economically. Callers display a need for funding, particularly for travel, and were affected by interpersonal and sexual violence. We conclude with policy and research implications for disaster planners, domestic violence organizations, state and federal officials, and health insurers.

Ecological Disasters and Mental Health: Causes, Consequences, and Interventions

Ecological disasters highlight the importance of understanding natural disasters as they relate to a changing global climate. Such disasters often have a predictable pattern of evolving over time and anticipated psychological and behavioral problems and community disruptions. Various factors enhance transmission of these adverse effects beyond the geographic location of the ecological disaster, with certain populations being particularly vulnerable to these effects. Understanding the range and pattern of these effects can aid in optimizing interventions. The use of evidence-informed interventions can reduce distress, enhance well-being, and improve functioning for affected individuals and communities. Effective preparedness involves an understanding of these factors, incorporation of them at all stages of disaster management, and continuous education and training for disaster planners and responders.

A natural disaster and intimate partner violence: Evidence over time

Natural disasters affect about 200 million people annually. Heightened intimate partner violence (IPV) is a gendered impact of these disruptive events. This study examines prevalence and correlates of IPV in four Indian states-TamilNadu, Kerala, AndhraPradesh, and Karnataka-before and after the Indian Ocean tsunami of 2004. Drawing on three waves of National Family Health Surveys of India-six years before, immediately after, and a decade after disaster, this paper evaluates if TamilNadu and Kerala (severely affected) exhibited higher prevalence of IPV than AndhraPradesh (moderately affected) and Karnataka (not directly affected). Logistic regression analyses determine association between IPV, state of residence (proxy for experience of disaster), and other covariates. To test hypotheses guided by vulnerability theory, IPV was regressed on socio-economic and demographic predictors for states across waves. IPV increased by 48% between 2005 and 2015. Increase in physical (61%) and sexual (232%) violence was highest in TamilNadu; emotional violence increased by 122% in Karnataka. State of residence was associated with IPV in the aftermath of disaster. In 2005, compared to Karnataka, odds of IPV were 98% higher in TamilNadu and 41% higher in Kerala. A decade after, odds were two times higher in TamilNadu than in Karnataka. Belonging to disadvantaged groups predicted higher odds of IPV in the year after disaster. Higher socio-economic status predicted lower odds of IPV, except in Kerala. Data point to ways in which socio-economic and demographic vulnerabilities factor into risk of IPV after disaster. Demographic factors of religion and caste appear to lose significance over time, but socio-economic factors continue to matter. Disaster response strategies seldom work without tackling long-standing inequities. Appropriate support systems for women and minorities in non-disaster situations are critical to ensure their conditions are not exacerbated.

Climate changes reproductive and children's health: a review of risks, exposures, and impacts

Our climate has significantly changed, exceeding what the world has experienced over the last 650,000 years, and has been cited as the most significant health threat of the twenty-first century. Climate change is impacting health in unprecedented ways. While everyone is vulnerable to the health impacts associated with climate change, children are disproportionately affected because of their physical and cognitive immaturity. Climate change impacts that include rising temperatures, extreme weather, rising sea levels, and increasing carbon dioxide levels are associated with a wide range of health issues in children such as asthma, allergies, vector-borne diseases, malnutrition, low birth weight, and post-traumatic stress disorder. Pediatric health providers play a critical role in advancing the science and translating findings to improve public understanding about the link between climate changes and children's health, and establishing strategies to address these issues. This review will provide an overview of research exploring the impact of climate change on children's health impacts, as well as provide recommendations for pediatric research moving forward.

Romantic Relationship Conflict Due to the COVID-19 Pandemic and Changes in Intimate and Sexual Behaviors in a Nationally Representative Sample of American Adults

In early 2020, the novel coronavirus 2019 (COVID-19) spread across the United States and mitigation measures drastically affected the daily lives of Americans. In this study, we assessed the association between COVID-related relationship conflict and changes in intimate and sexual behaviors and experiences. Using data from an online nationally representative probability survey of 1,010 American adults in April 2020, we estimated the impact of coronavirus-related relationship conflict on changes in intimate and sexual behaviors among those in any type of romantic or sexual relationship (N_weighted=742). Further, we assessed the association between conflict and experience of orgasm and feeling emotionally close to partner. Among individuals in relationships, 34% reported some degree of conflict with their romantic partners due to the spread of COVID-19 and its related restrictions. Those experiencing frequent coronavirus-related conflict with their partner were significantly more likely to report decreased frequency of several solo and partnered intimate and sexual behaviors compared to those not experiencing any such conflict, exhibiting a dose-response trend among partnered sexual behaviors. Since the spread of coronavirus and associated social distancing measures in the United States, Americans have experienced escalations in conflict in their romantic partnerships, which was associated with changes to their intimate and sexual lives.

Interpersonal violence and mental health outcomes following disaster

BACKGROUND

Disasters pose a documented risk to mental health, with a range of peri- and post-disaster factors (both pre-existing and disaster-precipitated) linked to adverse outcomes. Among these, increasing empirical attention is being paid to the relation between disasters and violence.

AIMS

This study examined self-reported experiences of assault or violence victimisation among communities affected by high, medium, and low disaster severity following the 2009 bushfires in Victoria, Australia. The association between violence, mental health outcomes and alcohol misuse was also investigated.

METHOD

Participants were 1016 adults from high-, medium- and low-affected communities, 3-4 years after an Australian bushfire disaster. Rates of reported violence were compared by areas of bushfire-affectedness. Logistic regression models were applied separately to men and women to assess the experience of violence in predicting general and fire-related post-traumatic stress disorder, depression and alcohol misuse.

RESULTS

Reports of experiencing violence were significantly higher among high bushfire-affected compared with low bushfire-affected regions. Analyses indicated the significant relationship between disaster-affectedness and violence was observed for women only, with rates of 1.0, 0 and 7.4% in low, medium and high bushfire-affected areas, respectively. Among women living in high bushfire-affected areas, negative change to income was associated with an increased likelihood of experiencing violence (odds ratio, 4.68). For women, post-disaster violence was associated with more severe post-traumatic stress disorder and depression symptoms.

CONCLUSIONS

Women residing within high bushfire-affected communities experienced the highest levels of violence. These post-disaster experiences of violence are associated with post-disaster changes to income and with post-traumatic stress disorder and depression symptoms among women. These findings have critical implications for the assessment of, and interventions for, women experiencing or at risk of violence post-disaster.

Investigating the Increase in Domestic Violence Post Disaster: An Australian Case Study

Interviews with 30 women in two shires in Victoria, Australia, confirmed that domestic violence increased following the catastrophic Black Saturday bushfires on February 7, 2009. As such research is rare, it addresses a gap in the disaster and interpersonal violence literature. The research that exists internationally indicates that increased violence against women is characteristic of a postdisaster recovery in developing countries. The relative lack of published research from primary data in developed countries instead reflects our resistance to investigating or recognizing increased male violence against women after disasters in developed countries. This article begins with an overview of this literature. The primary research was qualitative, using in-depth semistructured interviews to address the research question of whether violence against women increased in the Australian context. The sample of 30 women was aged from 20s to 60s. Recruitment was through flyers and advertisements, and interviews were audio-recorded, transcribed, and checked by participants. Analysis was inductive, using modified grounded theory. Seventeen women gave accounts of new or increased violence from male partners that they attribute to the disaster. A key finding is that, not only is there both increased and new domestic violence but formal reporting will not increase in communities unwilling to hear of this hidden disaster. Findings are reported within a framework of three broad explanations. In conclusion, although causation is not claimed, it is important to act on the knowledge that increased domestic violence and disasters are linked.

PTSD symptom profiles among Louisiana women affected by the 2010 Deepwater Horizon Oil Spill: A latent profile analysis

BACKGROUND

Few prior studies have investigated the latent class structure of PTSD using DSM-5 symptoms.

METHODS

To describe latent PTSD profiles among women who resided in Deepwater Horizon Oil Spill (DHOS)-affected coastal Louisiana communities, we used data from women enrolled in The Women and Their Children's Health (WaTCH) Study. Latent profile analysis was performed on the 20-item PTSD Checklist for DSM-5 (PCL-5) and model fit statistics for 2-class through 6-class solutions were compared. The pseudo-class draws method was employed on the best class solution to compare key covariates (including demographics, mental health indicators, DHOS exposure indicators, and trauma exposures) across classes.

RESULTS

Among 1997 women (mean age 46.63 ± 12.14 years, 56.8% white, mean trauma categories 6.09 ± 2.98, 9.55% previously diagnosed with PTSD), model fit statistics supported a five-class solution: low symptoms (mean PCL-5 = 4.10), moderate without mood alterations (mean = 19.73), moderate with mood alterations (mean = 34.24), severe without risk-taking (mean = 55.75), and severe with risk-taking (mean = 53.80). Women in the low-symptom class were significantly more likely to be white, have finished high school, have an income of at least $40,001 per year, be married or living with a partner, and endorse fewer trauma categories than women in the four symptomatic classes. Women with moderate to severe symptoms often had co-morbid depressive symptoms and no prior PTSD diagnosis.

LIMITATIONS

This study was limited by use of self-reported data and one-time assessment of PTSD symptoms.

DISCUSSION

Five distinct latent profiles of DSM-5 PTSD symptoms consisted of notably different individuals. Most affected women did not report prior PTSD diagnosis. Future research and practice identifying and addressing barriers to care for trauma-affected women in these communities is warranted.

Hurricanes and Indigenous Families: Understanding connections with discrimination, social support, and violence on PTSD

The purpose of this article is to use the culturally grounded Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to examine (a) the experiences and impacts of hurricanes on Indigenous (i.e., Native American) family members in the Gulf Coast and (b) to identify how experiencing hurricanes and natural disasters, family and community support, adverse childhood experiences (ACE), discrimination and intimate partner violence (IPV) may be related to post-traumatic stress disorder (PTSD) among two Southeastern tribes. Results were drawn from a convergent mixed-methodology design, which incorporates ethnographic qualitative data and a culturally grounded quantitative follow-up survey. Thematic analysis of qualitative data with 208 participants from a coastal Indigenous community revealed several emergent themes, namely (a) the Impact of Federal Recognition on Hurricane Affected Communities; (b) Rapidly Changing Landscape, Lives, and Communities; and (C) Family and Personal Effects of Hurricane Experiences. Descriptive and hierarchical regression analysis of 127 participants across two Southeastern tribes indicate that many participants frequently thought of losses from hurricanes and disasters and that over one-third of the sample met the criteria for clinically significant PTSD. Regression results affirmed the independent effects of hurricane experiences, ACE, community and family support as they relate to PTSD; yet IPV and discrimination were the strongest predictors of PTSD. Results reveal the extensive repercussions of hurricanes on Indigenous families of the Southeast, which are inseparable from and exacerbated by the insidious historical oppression, including discrimination, already experienced by these groups.

Violence Against Women and Children Following the 2011 Great East Japan Disaster: Making the Invisible Visible Through Research

This study reports on 82 unduplicated cases of violence against women and children after the Great East Japan Disaster of March 2011. Data were collected using a structured questionnaire from informants who worked with the disaster-affected populations. In addition to domestic violence, reported cases involved sexual assault and unwanted sexual contact, including quid pro quo assault perpetrated by nonintimates. Perpetrators often exploited a sense of fear, helplessness, and powerlessness and used threats to force compliance with sexual demands in exchange for life-sustaining resources. Findings point to the urgent need to develop measures to prevent and respond to postdisaster gender-based violence.

Cumulative effects of the Gulf oil spill and other disasters on mental health among reproductive-aged women: The Gulf Resilience on Women's Health study

OBJECTIVE

To test whether effects of multiple (up to 5) disasters on mental health responses were cumulative (additive effects), or whether an earlier disaster produced sensitization (higher) or habituation (lower) responses to a later one.

METHOD

The Gulf Resilience on Women's Health study interviewed 1,366 southern Louisiana women regarding their exposure to Hurricanes Katrina, Rita, Gustav, and Ike and the Gulf oil spill (measured several ways), and administered validated measures of symptoms of depression and posttraumatic stress disorder (PTSD). Multiple linear and logistic regression with disaster exposures entered singly, combined, and as an interaction were used to model mental health.

RESULTS

Both exposure to the oil spill and hurricane disaster were associated with likely depression and PTSD, consistent with a cumulative model, but we did not find statistical interactions that would suggest sensitization or habituation. When results were examined with continuous symptom measures of depression and PTSD, they were similar, with the exception that exposure to the oil spill and experiencing illness or injury because of the hurricane disaster showed a significant interaction (p < .05) in a manner consistent with a sensitization effect when predicting PTSD symptoms. The results of this study point mainly to a cumulative risk for the mental health effects of multiple disasters, although some indication of sensitization occurred among those with particularly severe experiences. There was no evidence for habituation.

CONCLUSIONS

These findings may guide efforts to assist those in regions experiencing multiple disasters that occur in close sequence. (PsycINFO Database Record

Gendered Vulnerabilities in Times of Natural Disasters: Male-to-Female Violence in the Philippines in the Aftermath of Super Typhoon Haiyan

The precarious situation faced by women and girls in the wake of climate-related disasters is illustrated through fieldwork conducted in Eastern Visayas in the Philippines, one of the regions most affected by Super Typhoon Haiyan in 2013. However, this article illustrates that these heightened levels of gendered violence faced by women and girls are not a result of the disaster alone; rather, they are rooted in the inequalities inherent in the social construction of gender prior to the catastrophe, which then become sharpened as efforts to survive become more urgent.

Projected Behavioral Impacts of Global Climate Change

The projected behavioral impacts of global climate change emanate from environmental changes including temperature elevation, extreme weather events, and rising air pollution. Negative affect, interpersonal and intergroup conflict, and possibly psychological distress increase with rising temperature. Droughts, floods, and severe storms diminish quality of life, elevate stress, produce psychological distress, and may elevate interpersonal and intergroup conflict. Recreational opportunities are compromised by extreme weather, and children may suffer delayed cognitive development. Elevated pollutants concern citizens and may accentuate psychological distress. Outdoor recreational activity is curtailed by ambient pollutants. Limitations and issues in need of further investigation include the following: lack of data on direct experience with climate change rather than indirect assessments related to projected changes; poor spatial resolution in environmental exposures and behavioral assessments; few rigorous quasi-experimental studies; overreliance on self-reports of behavioral outcomes; little consideration of moderator effects; and scant investigation of underlying psychosocial processes to explain projected behavioral impacts.