1
|
Stöckl H, Sorenson SB. Violence Against Women as a Global Public Health Issue. Annu Rev Public Health 2024; 45:277-294. [PMID: 38842174 DOI: 10.1146/annurev-publhealth-060722-025138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Violence against women, especially intimate partner violence, is recognized as a global public health issue due to its prevalence and global reach. This article outlines the scope of the issue, with respect to its prevalence, health outcomes, and risk factors, and identifies key milestones that led to its global recognition: methodological and data advances, acknowledgment as a criminal justice and health issue, support by the global women's movement, and the robust evidence demonstrating that intimate partner violence is preventable. Key issues for the future include recognition and consideration of intersectionality in research, improvements in the measurement of other forms of violence against women, and the need to scale up prevention efforts that have documented success. Violence against women is an urgent priority as it affects individuals, their families and surroundings, and the entire global health community.
Collapse
Affiliation(s)
- Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, Munich, Germany;
- Pettenkofer School of Public Health, Munich, Germany
| | - Susan B Sorenson
- School of Social Policy & Practice; Program in Health & Sciences, School of Arts & Sciences; and Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
2
|
Macassa G. Does Structural Violence by Institutions Enable Revictimization and Lead to Poorer Health Outcomes?-A Public Health Viewpoint. Ann Glob Health 2023; 89:58. [PMID: 37720339 PMCID: PMC10503529 DOI: 10.5334/aogh.4137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/25/2023] [Indexed: 09/19/2023] Open
Abstract
Although structural violence is known to interact with and reinforce direct violence in the form of interpersonal violence (e.g., intimate partner violence), little debate takes place in public health on how it can lead to revictimization, leading to even poorer health outcomes (including psychological ill health). This viewpoint aims to discuss this issue using examples from empirical studies to elucidate how structural violence (perpetrated through institutions) contributes to revictimization among people who are already suffering direct violence. Public health professionals (and researchers) need to make efforts to theorize and measure structural violence to aid efforts toward the study of how it intersects with interpersonal violence to influence health outcomes. This will ultimately contribute to better prevention and intervention efforts to curb interpersonal violence and improve population health and well-being. In addition, there is a need to include structural violence in the academic curriculum when training future generations of public health professionals. Increased education on structural violence will bring about an awareness of the grave consequences of the potential additional harm that institutions could inflict on the lives of people they should be protecting or care for.
Collapse
Affiliation(s)
- Gloria Macassa
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 80176 Gävle, Sweden
- EPIUnit–Instituto de Saude Publica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, nº135, 4050-600 Porto, Portugal
- Department of Public Health, School of Health Sciences, University of Skövde, 541 28 Skövde, Sweden
| |
Collapse
|
3
|
Johnson KA, Hunt T, Puglisi L, Chapman B, Epa-Llop A, Elumn J, Braick P, Bhagat N, Ko E, Nguyen A, Johnson R, Graham HK, Gilbert L, El-Bassel N, Morse DS. HIV/STI/HCV Risk Clusters and Hierarchies Experienced by Women Recently Released from Incarceration. Healthcare (Basel) 2023; 11:1066. [PMID: 37107900 PMCID: PMC10137919 DOI: 10.3390/healthcare11081066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
This study examines cross-sectional clusters and longitudinal predictions using an expanded SAVA syndemic conceptual framework-SAVA MH + H (substance use, intimate partner violence, mental health, and homelessness leading to HIV/STI/HCV risks)-among women recently released from incarceration (WRRI) (n = 206) participating in the WORTH Transitions (WT) intervention. WT combines two evidence-based interventions: the Women on the Road to Health HIV intervention, and Transitions Clinic. Cluster analytic and logistic regression methods were utilized. For the cluster analyses, baseline SAVA MH + H variables were categorized into presence/absence. For logistic regression, baseline SAVA MH + H variables were examined on a composite HIV/STI/HCV outcome collected at 6-month follow-up, controlling for lifetime trauma and sociodemographic characteristics. Three SAVA MH + H clusters were identified, the first of which had women with the highest overall levels of SAVA MH + H variables, 47% of whom were unhoused. Hard drug use (HDU) was the only significant predictor of HIV/STI/HCV risks in the regression analyses. HDUs had 4.32-fold higher odds of HIV/STI/HCV outcomes than non-HDUs (p = 0.002). Interventions such as WORTH Transitions must differently target identified SAVA MH + H syndemic risk clusters and HDU to prevent HIV/HCV/STI outcomes among WRRI.
Collapse
Affiliation(s)
- Karen A. Johnson
- School of Social Work, University of Alabama, Tuscaloosa, AL 35487, USA
| | - Timothy Hunt
- Social Intervention Group, School of Social Work, Columbia University, New York, NY 10027, USA
| | - Lisa Puglisi
- SEICHE Center for Health and Justice, School of Medicine, Yale University, New Haven, CT 06520, USA
| | - Ben Chapman
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
| | - Amali Epa-Llop
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
| | - Johanna Elumn
- SEICHE Center for Health and Justice, School of Medicine, Yale University, New Haven, CT 06520, USA
| | - Peter Braick
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
| | - Navya Bhagat
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
| | - Elizabeth Ko
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
| | - Antoinette Nguyen
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
| | - Rachel Johnson
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
| | - Heather K. Graham
- Educational Studies in Psychology, University of Alabama, Tuscaloosa, AL 35487, USA
| | - Louisa Gilbert
- Social Intervention Group, School of Social Work, Columbia University, New York, NY 10027, USA
| | - Nabila El-Bassel
- Social Intervention Group, School of Social Work, Columbia University, New York, NY 10027, USA
| | - Diane S. Morse
- Department of Psychiatry, University of Rochester School of Medicine, Rochester, NY 14642, USA
- Department of Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA
| |
Collapse
|
4
|
Turkstra LS, Salanki K, MacIntyre E, Kim N, Jin J, Sprague S, Scott T, Bhandari M. What Is the Prevalence of Intimate Partner Violence and Traumatic Brain Injury in Fracture Clinic Patients? Clin Orthop Relat Res 2023; 481:132-142. [PMID: 36200843 PMCID: PMC9750668 DOI: 10.1097/corr.0000000000002329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Individuals in violent intimate relationships are at a high risk of sustaining both orthopaedic fractures and traumatic brain injury (TBI), and the fracture clinic may be the first place that concurrent intimate partner violence (IPV) and TBI are recognized. Both IPV and TBI can affect all aspects of fracture management, but prevalence of TBI and comorbid TBI and IPV is unknown. QUESTIONS/PURPOSES (1) What are the previous-year and lifetime prevalence of IPV and TBI in women presenting to an outpatient orthopaedic fracture clinic? (2) What are the conditional probabilities of TBI in the presence of IPV and the reverse, to explore whether screening for one condition could effectively identify patients with the other? (3) Do patients with TBI, IPV, or both have worse neurobehavioral symptoms than patients without TBI and IPV? METHODS The study was completed in the fracture clinic at a community Level 1 trauma center in Southern Ontario from July 2018 to March 2019 and included patients seen by three orthopaedic surgeons. Inclusion criteria were self-identification as a woman, age 18 years or older, and the ability to complete forms in English without assistance from the person who brought them to the clinic (for participant safety and privacy). We invited 263 women to participate: 22 were ineligible (for example, they were patients of a surgeon who was not on the study protocol), 87 declined before hearing the topic of the study, and data from eight were excluded because the data were incomplete or lost. Complete data were obtained from 146 participants. Participants' mean age was 52 ± 16 years, and the most common diagnosis was upper or lower limb fracture. Prevalence of IPV was calculated as the number of women who answered "sometimes" or "often" to direct questions from the Woman Abuse Screening Tool, which asks about physical, emotional, and sexual abuse in the past year or person's lifetime. The prevalence of TBI was calculated as the number of women who reported at least one head or neck injury that resulted in feeling dazed or confused or in loss of consciousness lasting 30 minutes or less on the Ohio State University Traumatic Brain Injury Identification Method, a standardized procedure for eliciting lifetime history of TBI through a 3- to 5-minute structured interview. Conditional probabilities were calculated using a Bayesian analysis. Neurobehavioral symptoms were characterized using the Neurobehavioral Symptom Inventory, a standard self-report measure of everyday emotional, somatic, and cognitive complaints after TBI, with total scores compared across groups using a one-way ANOVA. RESULTS Previous-year prevalence of physical IPV was 7% (10 of 146), and lifetime prevalence was 28% (41 of 146). Previous-year prevalence of TBI was 8% (12 of 146), and lifetime prevalence was 49% (72 of 146). The probability of TBI in the presence of IPV was 0.77, and probability of IPV in the presence of TBI was 0.36. Thus, screening for IPV identified proportionately more patients with TBI than screening for TBI, but the reverse was not true. Neurobehavioral Symptom Inventory scores were higher (more symptoms) in patients with TBI only (23 ± 16) than those with fractures only (12 ± 11, mean difference 11 [95% CI 8 to 18]; p < 0.001), in those with IPV only (17 ± 11) versus fractures only (mean difference 5 [95% CI -1 to -11]; p < 0.05), and in those with both TBI and IPV (25 ± 14) than with fractures only (mean difference 13 [95% CI 8 to 18]; p < 0.001) or those with IPV alone (17 ± 11, mean difference 8 [95% CI -1 to 16]; p < 0.05). CONCLUSION Using a brief screening interview, we identified a high self-reported prevalence of TBI and IPV alone, consistent with previous studies, and a novel finding of high comorbidity of IPV and TBI. Given that the fracture clinic may be the first healthcare contact for women with IPV and TBI, especially mild TBI associated with IPV, we recommend educating frontline staff on how to identify IPV and TBI as well as implementing brief screening and referral and universal design modifications that support effective, efficient, and accurate communication patients with TBI-related cognitive and communication challenges. LEVEL OF EVIDENCE Level II, prognostic study.
Collapse
Affiliation(s)
- Lyn. S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Krista Salanki
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Emily MacIntyre
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Noel Kim
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Jonathan Jin
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Sheila Sprague
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Taryn Scott
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Mohit Bhandari
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
5
|
Oliveira TMFD, Ferreira HLOC, Freitas VCAD, Lima FDSS, Vasconcelos FX, Costa ND, Pinheiro AKB. Vulnerabilidades associadas à violência contra a mulher antes do ingresso no sistema prisional. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0167pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
RESUMO Objetivo: analisar as vulnerabilidades individuais e sociais de mulheres privadas de liberdade para violência sofrida antes da entrada no sistema prisional. Método: estudo transversal analítico, realizado com 272 internas de uma unidade prisional feminina, na Região Metropolitana de Fortaleza, Ceará. Foram aplicados dois instrumentos: formulário para análise de informações sociodemográficas e da violência sofrida previamente à entrada no presídio e o Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), que analisou o histórico do uso de substâncias psicoativas. Resultados: 44,5% das mulheres sofreram violência. A maior parte da amostra total apresentava idade entre 18 e 29 anos, com filhos, baixa escolaridade e renda, início precoce da vida sexual e histórico de uso de drogas ilícitas. A idade entre 18 e 29 anos mostrou ser fator protetor da violência (OR = 0,632). Uso de cocaína e crack (p = 0,002), anfetaminas e êxtase (p = 0,018) aumenta a chance de violência de 2,2 a 3,3 vezes. Conclusão: aspectos das dimensões individuais e sociais da vulnerabilidade estão associadas à ocorrência de violência em mulheres internas do sistema prisional feminino. Estratégias efetivas necessitam ser traçadas com base nas vulnerabilidades, para prevenir violência contra a mulher.
Collapse
|
6
|
de Oliveira TMF, Ferreira HLOC, de Freitas VCA, Lima FDSS, Vasconcelos FX, da Costa N, Pinheiro AKB. Vulnerabilities associated with violence against women before entering the prison system. Rev Esc Enferm USP 2022; 56:e20220167. [PMID: 36197029 PMCID: PMC10085637 DOI: 10.1590/1980-220x-reeusp-2022-0167en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/16/2022] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVE to analyze the individual and social vulnerabilities of women deprived of their liberty for violence suffered before entering the prison system. METHOD an analytical crosssectional study, carried out with 272 inmates of a female prison unit, in the Metropolitan Region of Fortaleza, Ceará. We applied two instruments: a form to analyze sociodemographic information and the violence suffered prior to entering the prison and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), which analyzed the history of psychoactive substance use. RESULTS 44.5% of women suffered violence. Most of the total sample was between 18 and 29 years old, with children, low education and income, early onset of sexual life and history of illicit drug use. Age between 18 and 29 years proved to be a protective factor against violence (OR = 0.632). Cocaine and crack use (p =0.002), amphetamines and ecstasy (p =0.018) increase the chance of violence by 2.2 to 3.3 times. CONCLUSION aspects of the individual and social dimensions of vulnerability are associated with the occurrence of violence in women in the female prison system. Effective strategies need to be designed based on vulnerabilities to prevent violence against women.
Collapse
Affiliation(s)
| | | | - Vívien Cunha Alves de Freitas
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem. Fortaleza, CE, Brazil
| | - Fabiane da Silva Severino Lima
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem. Fortaleza, CE, Brazil
| | - Flávia Ximenes Vasconcelos
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem. Fortaleza, CE, Brazil
| | - Nicolau da Costa
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem. Fortaleza, CE, Brazil
| | - Ana Karina Bezerra Pinheiro
- Universidade Federal do Ceará, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem. Fortaleza, CE, Brazil
| |
Collapse
|
7
|
Cyrus E, Sanchez J, Madhivanan P, Lama JR, Bazo AC, Valencia J, Leon SR, Villaran M, Vagenas P, Sciaudone M, Vu D, Coudray MS, Atice FL. Prevalence of Intimate Partner Violence, Substance Use Disorders and Depression among Incarcerated Women in Lima, Perú. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111134. [PMID: 34769653 PMCID: PMC8583326 DOI: 10.3390/ijerph182111134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/03/2022]
Abstract
Background: Globally, there is evidence supporting the co-occurrence of intimate partner violence (IPV), substance use disorders (SUD) and mental health disorders among women in prisons, however, there is limited research investigating these domains in the Andean region where rates of female incarceration have increased. The study objective was to explore the prevalence of IPV, SUD and depression among incarcerated women in a Peruvian prison and explore associations among these variables and related correlates. Methods: 249 incarcerated women responded to a questionnaire about IPV, substance use, depression, and sexual behavior, and were screened for HIV/sexually transmitted diseases (STDs). Univariate analysis and logistic regression were used to estimate relative risk and the influence of substance use and depression on IPV rates. Results: Twelve months prior to incarceration, of the women with sexual partners pre-incarceration (n = 212), 69.3% experienced threats of violence, 61.4% experienced ≥1 acts of physical violence, and 28.3% reported ≥1 act of sexual aggression. Pre-incarceration, 68.1% of drug-using women had a SUD, and 61.7% of those who consumed alcohol reported hazardous/harmful drinking. There were 20 (8.0%) HIV/STD cases; and 67.5% of the women reported depressive symptoms. Compared to women with no experiences of physical violence, a greater proportion of women who experienced least l violent act had depressive symptoms and engaged in sex work pre-incarceration. Depression was associated with physical violence (adjusted relative risk = 1.35, 95% confidence interval: 1.14–1.58). Recommendations: The findings provide evidence of a syndemic of IPV, substance abuse and depression among incarcerated women in a Peruvian prison. To help guide policy makers, further research is needed to determine if this is indicative of trends for other at-risk women in the region, and viable options to treat these women during incarceration to prevent recidivism and other long-term negative sequalae.
Collapse
Affiliation(s)
- Elena Cyrus
- Department of Population Health Sciences, College of Medicine, University of Central Florida (UCF), Orlando, FL 32827, USA; (D.V.); (M.S.C.)
- School of Public Health, Yale University, New Haven, CT 06520, USA;
- Correspondence:
| | - Jorge Sanchez
- Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, Callao 07006, Peru;
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- Public Health Research Institute of India, Mysore 560020, Karnataka, India
| | - Javier R. Lama
- Asociación Civil Impacta Salud y Educación, Lima 15603, Peru; (J.R.L.); (J.V.); (M.V.)
| | - Andrea Cornejo Bazo
- International Degrees Department, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru;
| | - Javier Valencia
- Asociación Civil Impacta Salud y Educación, Lima 15603, Peru; (J.R.L.); (J.V.); (M.V.)
| | - Segundo R. Leon
- Office of Research and Technology Transfer, Universidad Privada San Juan Bautista, Chorrillos 15067, Peru;
| | - Manuel Villaran
- Asociación Civil Impacta Salud y Educación, Lima 15603, Peru; (J.R.L.); (J.V.); (M.V.)
| | - Panagiotis Vagenas
- Berkeley Research Development Office, University of California, Berkeley, CA 94704, USA;
| | - Michael Sciaudone
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
- Tulane School of Medicine, New Orleans, LA 70112, USA
| | - David Vu
- Department of Population Health Sciences, College of Medicine, University of Central Florida (UCF), Orlando, FL 32827, USA; (D.V.); (M.S.C.)
| | - Makella S. Coudray
- Department of Population Health Sciences, College of Medicine, University of Central Florida (UCF), Orlando, FL 32827, USA; (D.V.); (M.S.C.)
| | | |
Collapse
|