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Lee H. State-level structural sexism and adolescent sexual violence victimization in the US. CHILD ABUSE & NEGLECT 2024; 158:107096. [PMID: 39423595 DOI: 10.1016/j.chiabu.2024.107096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/17/2024] [Accepted: 10/08/2024] [Indexed: 10/21/2024]
Abstract
BACKGROUND Adolescent sexual violence victimization is a significant public health issue in the United States. Structural sexism, a form of gender inequality at the societal level, may play a crucial role in influencing the prevalence of sexual violence victimization among adolescents. OBJECTIVE This study aims to examine the association between state-level structural sexism and sexual violence victimization among adolescents and to explore how this relationship varies between male and female adolescents. PARTICIPANTS AND SETTING Data was derived from a nationally representative sample of high school students in grades 9-12 across the United States who participated in the Youth Risk Behavior Surveillance System (YRBS) in 2017 and 2019. METHODS A state-level structural sexism index was created from nine different items to reflect the multidimensional nature of structural sexism. This study employs multi-level regression analysis to investigate the impact of state-level structural sexism on three types of sexual violence victimization: sexual violence, sexual dating violence, and physical dating violence. RESULTS This study revealed a significant interaction between structural sexism and gender. In states with higher levels of structural sexism, female adolescents reported increased likelihood of sexual violence (β = 0.013, p < .001), sexual dating violence (β = 0.006, p < .001), and physical dating violence (β = 0.006, p < .001) compared to males. Conversely, male adolescents in these states reported lower rates of victimization. CONCLUSIONS The results underscore the role of structural sexism in influencing sexual violence victimization among adolescents. Addressing structural sexism may be essential in mitigating the risk of sexual violence victimization, especially for female adolescents.
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Affiliation(s)
- Heeyoung Lee
- Department of Sociology, University at Albany, SUNY, Albany, NY, USA.
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Okafor N, Okoro E, Bojerenu MM, Umeani N, Udegbe DC, Omeh CK, Nwume CG, Alabi TD, Fouhad IA, Okpujie V, Andibanbang FA, Uwumiro FE. National Case Volumes and Gender Disparities in Emergency Department Utilization for Psychiatric Emergencies: A Population-Based Claims Data Analysis. Cureus 2024; 16:e66502. [PMID: 39247026 PMCID: PMC11380797 DOI: 10.7759/cureus.66502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction The utilization of emergency departments (EDs) for managing psychiatric emergencies has significantly increased in the United States because of the increasing prevalence of mental health disorders. This study examined national case volumes and sex disparities in ED visits for psychiatric emergencies using data from the Nationwide Emergency Department Sample (NEDS). Methods This retrospective analysis included adult ED visits for psychiatric emergencies identified using relevant International Classification of Diseases, 10th Revision (ICD-10) codes. Primary endpoints included national case volumes by sex. Hospitalizations with age < 18 years and those with missing data on sex were excluded. Secondary endpoints included inpatient mortality, ED and inpatient costs, admission rates, discharge disposition, length of stay (LOS), and number of procedures. Results In 2021, there were approximately 143.5 million ED visits in the United States, with 7,978,490 of these being for psychiatric emergencies. The most common presentations were substance abuse and intoxication (5,119,086 (64.2%)), severe bipolar disorder (1,912,670 (24%)), and anxiety or panic attacks (1,015,486 (12.7%)). Approximately 3,997,223 (50.1%) were women, and 3,981,267 (49.9%) were men. Men were older (mean age: 45 versus 43 years; P<0.001), were more likely to be uninsured (712,647 (17.9%) versus 497,658 (12.5%); P<0.001), and had a higher Charlson Comorbidity Index (CCI) (CCI ≥ 2: 792,272 (19.9%) versus 643,552 (16.1%); P<0.001). More men than women presented to the ED with acute substance abuse or intoxication (3,196,945 (80.3%) versus 1,922,142 (48.1%)), bipolar disorder with or without psychosis (958,275 (24.1%) versus 954,395 (23.9%); P<0.001), and suicidal ideation (267,638 (6.7%) versus 208,989 (5.2%); P<0.001). More women than men presented with severe depression (455,683 (11.4%) versus 441,921 (11.1%)), anxiety and panic attacks (615,572 (15.4%) versus 402,108 (10.1%)), acute stress reaction (35,975 (0.9%) versus 23,888 (0.6%)), eating disorders (3,997 (0.1%) versus 27,869 (0.07%)), and a history of abuse (21,164 (0.53%) versus 19,569 (0.49%); P<0.001). Women had lower mortality rates (27,980 (0.7%) versus 63,956 (1.6%); P<0.001), lower mean ED costs (adjusted mean difference (AMD): $1,189; P<0.001), fewer in-hospital admissions (1,211,158 (30.3%) versus 1,453,162 (36.5%); P<0.001), and a higher number of prolonged hospitalizations (1,442,998 (36.1%) versus 1,194,380 (30%); P<0.001) compared with men. Conclusion This study highlights significant sex disparities in ED utilization for psychiatric emergencies. Men more frequently present with substance abuse and severe comorbidities, leading to higher healthcare costs and inpatient admissions. Women, while more likely to present with anxiety and depressive disorders, incur lower costs and have better overall outcomes.
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Affiliation(s)
- Nnenna Okafor
- Psychiatry, All Saints University College of Medicine, Kingstown, VCT
| | - Esther Okoro
- Psychiatry, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, GBR
| | | | - Nnaedozie Umeani
- Psychiatry, College of Medicine, University of Lagos, Lagos, NGA
| | - Daniel C Udegbe
- Psychiatry, Godfrey Okoye University Teaching Hospital, Enugu, NGA
| | | | - Chuka G Nwume
- Family Medicine, University of Port Harcourt, Port Harcourt, NGA
| | | | - Ishola A Fouhad
- Psychiatry, College of Medicine, Lagos State University, Lagos, NGA
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Ahmed DS, Elela AMA, Ismail SS, Almowafy AA, Abou-Elyazid H. Violence and its related factors among infertile women attending assisted reproductive technique unit at Al-Azhar University, Cairo. BMC Public Health 2024; 24:2063. [PMID: 39085845 PMCID: PMC11293121 DOI: 10.1186/s12889-024-19433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/10/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Violence against women is a distressing issue particularly when they are infertile. Nevertheless, many women who are infertile and exposed to violence continue their marriage and justify such choice. AIM The current study aimed to assess the prevalence of violence against infertile women and its associated factors. PARTICIPANTS AND METHODS This cross-sectional study involved 364 Egyptian women with primary infertility; they were randomly selected from the assisted reproductive technique unit of Al-Azhar University's International Islamic Center for Population Studies and Research. The data were collected through an interview questionnaire including the Infertile Women's Exposure to Violence Determination Scale (IWEVDS), socio-demographic, conception, and community-related factors. RESULTS Moderate/high violence level was detected among 50.5% (95% CI = 45.3- 55.8%) of the studied infertile women, the mean ± SD of total score of IWEVDS was 48.27 ± 21.6. Exclusion was the most frequent type of violence among them. Binary logistic regression revealed that wives who had lower-educated husbands, lived in low-income families, had undergone prior IVF treatment, and who perceived gender inequality acceptance in society were more likely to expose to violence than others (OR = 3.76, 4.25, 2.05, and 2.08 respectively) (P value < 0.05). CONCLUSION AND RECOMMENDATIONS Infertile women have frequent exposure to different types of violence and many factors were implicated in such condition. Despite exposure to violence, infertile women refused divorce because they had no alternative financial sources as well as they were afraid of loneliness. A community mobilization approach to control this problem through a collaboration of all stakeholders is recommended.
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Affiliation(s)
- Doaa Sadek Ahmed
- Community and Occupational medicine department, faculty of medicine for girls Al-Azhar University, Cairo, Egypt
| | - Asmaa Mohammed Abo Elela
- Community and Occupational medicine department, faculty of medicine for girls Al-Azhar University, Cairo, Egypt
| | - Samar Samy Ismail
- Community and Occupational medicine department, faculty of medicine for girls Al-Azhar University, Cairo, Egypt
| | - Abeer A Almowafy
- International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt.
| | - Hanaa Abou-Elyazid
- Community and Occupational medicine department, faculty of medicine for girls Al-Azhar University, Cairo, Egypt
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Einarsdottir TS, Asgeirsdottir BB, Sigurvinsdottir R, Ullman SE, Gudmundsdottir B. Prevalence of trauma exposure and PTSD symptoms among the Icelandic population: gender and regional differences. Scand J Public Health 2023:14034948231217019. [PMID: 38153117 DOI: 10.1177/14034948231217019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM The primary aim of this cross-sectional study was to provide descriptive data about the lifetime prevalence of trauma exposure with a particular focus on sexual violence and natural disasters and to assess the prevalence of symptoms of post-traumatic stress disorder (PTSD) in the Icelandic population. In addition, the aim was to investigate whether PTSD symptoms, trauma types and prevalence differed by gender and geographical location. METHOD A representative sample of the population between the ages of 18 and 80 years was randomly selected from the Icelandic National Registrar. The study included a total of 1766 participants consisting of 930 (52.7%) women and 836 (47.3%) men, with an overall mean age of 49.9 years (standard deviation 16.1). Participants were contacted by phone and asked questions from the Lifetime Events Checklist (LEC-5) to assess lifetime exposure to traumatic events. Individuals who had experienced traumatic events completed the PTSD Checklist for DSM-5 (PCL-5) to assess PTSD symptoms. RESULTS Exposure to trauma is common among the Icelandic population, with 84.3% of the participants experiencing at least one kind of trauma. Of those exposed to trauma, 10.5% fulfilled criteria indicating a higher risk of PTSD. The prevalence of sexual violence and other unwanted sexual experiences was relatively high (16.2% and 24.4%, respectively) compared with other national studies. Women were almost four times more likely than men to have been exposed to sexual violence (24.9% vs 6.4%), and were more likely to have been exposed to other unwanted sexual experience (35.1% vs 12.4%, respectively). Exposure to natural disasters is frequent but with great geographical variation. CONCLUSIONS This study highlights the high prevalence of trauma in Iceland, revealing significant gender disparities in sexual violence and geographical variations in natural disaster exposure.
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Affiliation(s)
| | | | | | - Sarah E Ullman
- Criminology, Law and Justice Faculty, University of Illinois, USA
| | - Berglind Gudmundsdottir
- Faculty of Medicine, University of Iceland and Landspitali University Hospital of Iceland, Iceland
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Ma N, Chen S, Kong Y, Chen Z, Geldsetzer P, Zeng H, Wu L, Wehrmeister FC, Lu C, Subramanian SV, Song Y, Li Z. Prevalence and changes of intimate partner violence against women aged 15 to 49 years in 53 low-income and middle-income countries from 2000 to 2021: a secondary analysis of population-based surveys. Lancet Glob Health 2023; 11:e1863-e1873. [PMID: 37973337 DOI: 10.1016/s2214-109x(23)00417-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND In low-income and middle-income countries (LMICs), intimate partner violence poses a substantial barrier to accomplishing target 5.2 of the Sustainable Development Goals: to eliminate all forms of violence against women and girls. Our study aimed to assess the prevalence and changes of intimate partner violence against women in LMICs. We also explored the association between women's empowerment and intimate partner violence. METHODS In this secondary analysis of population-based surveys, we obtained data from the nationally representative Demographic and Health Surveys conducted in LMICs between 2000 and 2021. We selected countries with available data on the domestic violence module, and women aged 15 to 49 years who currently or formerly had a husband or partner, and who had provided information about intimate partner violence, were included in the analysis. We first estimated the weighted prevalence of intimate partner violence in LMICs with available data, and then we assessed the average annual rate of change using Poisson regression with robust error variance in a subset of countries with at least two surveys. We used multilevel analysis to investigate the association between intimate partner violence and women's empowerment measured at both the country and individual levels. Country-level empowerment was measured by gender inequality index, while individual-level empowerment considered social independence, decision making, and attitude to violence. FINDINGS A total of 359 479 women aged 15 to 49 years were included from 53 LMICs. 336 811 women from 21 countries with two surveys provided data for assessing the trends of intimate partner violence. The weighted prevalence of any type of intimate partner violence was 37·2% (95% CI 36·6 to 37·8). A significant overall decline in the prevalence of any type of intimate partner violence was observed with an average annual rate of change of -0·2% (95% CI -0·4 to -0·03); however six countries showed significant increasing trends, with average annual rates of change ranging from 1·2% (95% CI 0·7 to 1·7) in Nigeria to 6·6% (5·3 to 7·8) in Sierra Leone. Notably, the prevalence of psychological intimate partner violence has risen (average annual rate of change, 2·3% [95% CI 2·1 to 2·6]), reflected in increased rates across eight countries. Higher levels of country-level women's empowerment were associated with a lower risk of intimate partner violence: women from countries with the highest tertile of gender inequality index had an increased odds of any type of intimate partner violence (odds ratio 1·58 [95% CI 1·12 to 2·23]). Similarly, better individual-level women's empowerment also showed significant associations with a lower risk of intimate partner violence. INTERPRETATION The prevalence of intimate partner violence remains high, and some countries have shown an increasing trend. The strong relationship between both country-level and individual-level women's empowerment and the prevalence of intimate partner violence suggests that accelerating women's empowerment could be one strategy to further reduce intimate partner violence against women. FUNDING National Natural Science Foundation; Vanke School of Public Health, Tsinghua University; and Sanming Project of Medicine in Shenzhen.
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Affiliation(s)
- Ning Ma
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Shaoru Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuhao Kong
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zekun Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Chan Zuckerberg Biohub- San Francisco, San Francisco, CA, USA
| | - Huatang Zeng
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Liqun Wu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Fernando C Wehrmeister
- International Center for Equity in Health, Post-Graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil; Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Chunling Lu
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Division of Global Health Equity, Brigham & Women's Hospital, Boston, MA, USA
| | - S V Subramanian
- Harvard Center for Population & Development Studies, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China; National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China.
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Reidy DE, Baumler ER, Temple JR. Sexual violence against sexual minority women in STEM: Compound backlash. Soc Sci Med 2023; 338:116366. [PMID: 37949019 DOI: 10.1016/j.socscimed.2023.116366] [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: 06/29/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Recent research has found that gender parity (i.e., the ratio of women to men) in Science, Technology, Engineering, and Math (STEM) disciplines is associated with sexual violence (SV) victimization for women. This finding may reflect a type of backlash wherein SV is a means of punishing women who are perceived to be violating their gender roles and threatening the male hegemony. Sexual minorities, who are likewise disproportionately victims of SV, report experiencing heterosexist hostility and harassment in STEM disciplines. There is reason to suspect that the combination of these marginalized identity positions (e.g., a sexual minority woman in gender-balanced STEM) may amplify perceived gender role violations and exacerbate the risk of SV victimization. METHODS Data were collected from undergraduate women at five institutions of higher education in the United States. Sampling was stratified by STEM vs. non-STEM majors and male-dominated vs. gender-balanced majors. Sexual violence was measured via the revised Sexual Experiences Survey. We tested the interaction of sexual minority status and gender parity in STEM on SV via fixed effects OLS regression. RESULTS Sexual minority women in gender-balanced STEM were most frequently victims of SV. Women in male-dominated STEM majors were at no greater risk of SV victimization, regardless of sexual minority status, than their peers in non-STEM majors. IMPLICATIONS These findings suggest the possibility of a compound form of backlash, wherein women are exponentially victimized because their sexual identity and their membership in these STEM fields are seen as dual challenges to the male hegemony. If true, this could exacerbate health disparities rather than promote health equity for these sexual minority women. Findings point to the ongoing need to challenge hegemonic gender norms, focus prevention programs on populations most at risk, and ensure they are provided the appropriate resources for support.
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Affiliation(s)
- Dennis E Reidy
- School of Public Health & Center for Research on Interpersonal Violence, Georgia State University, United States.
| | - Elizabeth R Baumler
- Center for Violence Prevention, University of Texas Medical Branch, United States
| | - Jeff R Temple
- Center for Violence Prevention, University of Texas Medical Branch, United States
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Graham M, Haintz GL, Bugden M, de Moel-Mandel C, Donnelly A, McKenzie H. Re-defining reproductive coercion using a socio-ecological lens: a scoping review. BMC Public Health 2023; 23:1371. [PMID: 37461078 DOI: 10.1186/s12889-023-16281-8] [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: 02/09/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Reproductive coercion is a significant public health issue in Australia which has mainly been conceptualised as a form of violence at the interpersonal level. This limited scope ignores the role of the gendered drivers of violence and fails to encompass a socio-ecological lens which is necessary to consider the multiple interacting layers that create the context in which reproductive coercion occurs. The aim of the scoping review was to explore how the reproductive coercion is defined by international research. Specifically, how is reproductive coercion defined at the social-cultural-systems-structural levels, and are the definitions of reproductive coercion inclusive of the conditions and contexts in which reproductive coercion occurs? METHODS A scoping review was undertaken to explore existing definitions of reproductive coercion. Searches were conducted on Embase, Cochrane Library, Informit Health Collection, and the EBSCOHost platform. Google was also searched for relevant grey literature. Articles were included if they were: theoretical research, reviews, empirical primary research, grey literature or books; published between January 2018 and May 2022; written in English; and focused on females aged 18-50 years. Data from eligible articles were deductively extracted and inductively thematically analysed to identify themes describing how reproductive coercion is defined. RESULTS A total of 24 articles were included in the scoping review. Most research defined reproductive coercion at the interpersonal level with only eight articles partially considering and four articles fully considering the socio-cultural-systems-structural level. Thematic analysis identified four main themes in reproductive coercion definitions: Individual external exertion of control over a woman's reproductive autonomy; Systems and structures; Social and cultural determinants; and Freedom from external forces to achieve reproductive autonomy. CONCLUSIONS We argue for and propose a more inclusive definition of reproductive coercion that considers the gendered nature of reproductive coercion, and is linked to power, oppression and inequality, which is and can be perpetrated and/or facilitated at the interpersonal, community, organisational, institutional, systems, and societal levels as well as by the state.
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Affiliation(s)
- Melissa Graham
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia.
| | - Greer Lamaro Haintz
- School of Health and Social Development, Deakin University, Locked Bag 20, Geelong, 000, 3220, Australia
| | - Megan Bugden
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Caroline de Moel-Mandel
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Arielle Donnelly
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Hayley McKenzie
- School of Health and Social Development, Deakin University, 221 Burwood Highway, Burwood, 3125, VIC, Australia
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Reidy DE, Salazar LF, Baumler E, Wood L, Daigle LE. Sexual Violence against Women in STEM: A Test of Backlash Theory Among Undergraduate Women. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8357-8376. [PMID: 36803036 DOI: 10.1177/08862605231155124] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It has been argued that increasing the number of women in the science, technology, engineering, and math (STEM) fields could mitigate violence against women by advancing gender equality. However, some research points to a "backlash" effect wherein gains in gender equality are associated with heighted sexual violence (SV) against women. In this study, we compare SV against undergraduate women majoring in STEM disciplines to those majoring in non-STEM disciplines. Data were collected between July and October of 2020 from undergraduate women (N = 318) at five institutions of higher education in the United States. Sampling was stratified by STEM versus non-STEM majors and male-dominated versus gender-balanced majors. SV was measured using the revised Sexual Experiences Survey. Results indicated that women majoring in STEM disciplines that are gender balanced reported more SV victimization in the form of sexual coercion, attempted sexual coercion, attempted rape, and rape compared to their peers in both gender-balanced and male-dominated non-STEM and male-dominated STEM majors. These associations held even after controlling for age, race/ethnicity, victimization prior to college, sexual orientation, college binge drinking, and hard drug use during college. These data suggest that the risk of repeated SV victimization within STEM populations may be a threat to sustained gender parity in these fields and ultimately to gender equality and equity. Gender balance in STEM should not be furthered without addressing the potential use of SV as a potential means of social control over women.
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Affiliation(s)
| | | | | | - Leila Wood
- The University of Texas Medical Branch, Galveston, TX, USA
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Chhabra N, Hernandez S, Christian E, Rizvanolli L. Previous exposure to violence among emergency department patients without trauma-related complaints: A cross sectional analysis. Am J Emerg Med 2023; 68:92-97. [PMID: 36958095 DOI: 10.1016/j.ajem.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/20/2023] [Accepted: 03/04/2023] [Indexed: 03/13/2023] Open
Abstract
INTRODUCTION The Emergency Department (ED) is a critical setting for the treatment of acute violence-related complaints and violent victimization is associated with numerous long-term negative health outcomes. A trauma-informed care framework can prevent re-traumatization of victims within the healthcare setting, but currently there are insufficient mechanisms to detect previous exposures to community violence within the ED. The current study sought to determine the prevalence of community violence and characterize the types of violence exposures among adult ED patients without trauma-related complaints to determine if there may be a need for expanded screening for previous exposure to violence for ED patients. METHODS This was a prospective cross-sectional observational study of adult ED patients without a trauma-related chief complaint at an urban public hospital. Adult patients were approached by trained research staff and answered questions adapted from the Survey of Exposure to Community Violence (SECV), which measures lifetime exposure to community violence, including both witnessing and victimization. The SECV was modified for clarity, brevity, and to assess exposure to violence within the previous 3 months and 3 years from enrollment, in addition to lifetime exposure. Enrollment occurred from June 2019 to September 2022 with a 19-month gap due to the COVID-19 pandemic. Demographics and results within SECV domains were analyzed using descriptive statistics. Comparisons between males and females in types of violence experienced during one's lifetime were made by fitting logistic regression models adjusting for age. RESULTS A total of 222 respondents completed some or all of the modified SECV. Ages ranged from 19 to 88, with 47.7% of respondents identifying as female and 50.9% as male. Of all respondents, 43.7% reported directly witnessing violence during their lifetime, 69.4% being personally victimized by violence, and 55.4% personally knowing someone killed by a violent act. Of those personally victimized, 47.4% occurred within the preceding 3 years and 20.1% within 3 months. Among all respondents, lifetime victimization was reported in the following domains: slapping, hitting, or punching (45.9%); robbings or muggings (33.8%); physical threats (28.8%); verbal or emotional abuse (27.5%); being shot at (18.0%); uncomfortable physical touch (15.3%); forced entry while home (14.4%); sexual assault, molestation, or rape (13.5%); or being attacked with a knife (13.5%). Comparing male and female respondents, 63.5% of females and 76.6% of males reported any violent victimization over their lifetime (aOR 1.88; 95% CI 1.04-3.43). Additionally, 31.7% of females and 56.3% of males reported witnessing violence (aOR 2.86; 95% CI 1.64-5.06). Males were more commonly exposed to physical violence, violence with weapons, and threats while females more commonly reported sexual assault, molestation, and rape. CONCLUSION Both lifetime and recent exposure to community violence was common among adult ED patients without trauma-related complaints. Broader adoption of a trauma-informed care framework and the development of efficient ED screening tools for previous exposure to trauma is reasonable in areas where community violence exposure is highly prevalent.
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Affiliation(s)
- Neeraj Chhabra
- Department of Emergency Medicine, Cook County Health, 1950 W Polk Street, 7(th) Floor, Chicago, IL 60612, United States of America; University of Illinois at Chicago, Chicago, IL, United States of America.
| | - Samantha Hernandez
- Department of Emergency Medicine, Cook County Health, 1950 W Polk Street, 7(th) Floor, Chicago, IL 60612, United States of America; University of Illinois at Chicago, Chicago, IL, United States of America
| | - Errick Christian
- Department of Emergency Medicine, Cook County Health, 1950 W Polk Street, 7(th) Floor, Chicago, IL 60612, United States of America
| | - Lum Rizvanolli
- Department of Emergency Medicine, Cook County Health, 1950 W Polk Street, 7(th) Floor, Chicago, IL 60612, United States of America
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Sherman ADF, Cimino AN, Balthazar M, Johnson KB, Burns DD, Verissimo ADO, Campbell JC, Tsuyuki K, Stockman JK. Discrimination, Sexual Violence, Depression, Post-traumatic Stress Disorder, and Social Support among Black Women. J Health Care Poor Underserved 2023; 34:35-57. [PMID: 37464480 PMCID: PMC10356991 DOI: 10.1353/hpu.2023.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND Black Americans face significant discrimination associated with mental health disorder, which may be exacerbated among sexually victimized people. Social support may buffer that relationship. METHODS Cross-sectional data from a retrospective cohort study were analyzed to examine if discrimination and sexual victimization overlap to exacerbate symptoms of depression and post-traumatic stress disorder (PTSD) and to determine the extent to which social support moderated that association among Black women living in Baltimore, Maryland [138 non-abused (no physical/sexual victimization) and 98 abused (sexually victimized) since age 18]. RESULTS Symptoms of depression and PTSD were independently associated with discrimination. Multilinear regression showed social support from friends moderated the association between discrimination and depressive symptoms among sexually abused participants only. CONCLUSION Discrimination may exacerbate symptoms of depression and PTSD more for sexually victimized Black women, but sources of informal social support may attenuate adverse effects of discrimination on depressive symptoms among members of that group.
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Kachi Y, Fujiwara T, Inoue A, Baba S, Eguchi H, Ohta H, Tsutsumi A. The effects of pregnancy discrimination on postpartum depressive symptoms: a follow-up study. BMC Pregnancy Childbirth 2022; 22:825. [PMCID: PMC9641687 DOI: 10.1186/s12884-022-05148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pregnancy discrimination in the workplace is prevalent worldwide. However, few studies have examined the effects of pregnancy discrimination on mothers’ perinatal mental health. We aimed to investigate the association between pregnancy discrimination and postpartum depressive symptoms, and the mediation effects of prenatal depressive symptoms on this association.
Methods
Our sample consisted of 285 Japanese women employed during pregnancy who completed a baseline online survey in May 2020 and a follow-up mail survey two months postpartum. Pregnancy discrimination was defined as exposure to any of 16 forms of disadvantageous treatment or harassment related to pregnancy, prohibited by national guidelines. Prenatal (assessed at baseline) and postpartum (assessed at follow-up) depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Multiple linear regression and mediation analyses were performed overall and stratified by regular (permanent) and non-regular (precarious) employees.
Results
Overall, 23.9% of participants experienced pregnancy discrimination during pregnancy. After adjusting for potential confounders, pregnancy discrimination was significantly associated with postpartum depressive symptoms (coefficient 1.76, 95% confidence interval [CI] 0.65–2.88). When stratified by employment type, these effects were observable among non-regular employees (coefficient 2.51, 95% CI 0.45–4.57) but not regular employees. Mediation analysis showed that prenatal depressive symptoms mediated 57.1% (95% CI 20.1–94.1%) of the association between pregnancy discrimination and postpartum depressive symptoms among all participants, with a greater effect among non-regular employees (64.1% [95% CI 18.5–109.8%]).
Conclusions
Pregnancy discrimination has adverse effects on postpartum depressive symptoms, partially through prenatal depressive symptoms, especially among non-regular employees. To prevent perinatal depression in female workers, employers should comply with legislation and take preventive measures against pregnancy discrimination, while considering vulnerable employees.
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Reidy DE, Edwards KM. Don’t dismiss gender equality: A response to Cid & Leguisamo (2022) “Gender Equality does not Prevent Sexual Abuse of Women”. Health Care Women Int 2022; 43:1133-1139. [DOI: 10.1080/07399332.2022.2107647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Dennis E. Reidy
- School of Public Health, Georgia State University
- Center for Research on Interpersonal Violence, Georgia State University
| | - Katie M. Edwards
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska
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Uslu N, Erenoğlu R. Does the gender course have any effects on young people's gender equality perceptions, dating violence, and problem-solving behaviours in romantic relationships?: A mixed-method study. Perspect Psychiatr Care 2022; 58:471-481. [PMID: 34114229 DOI: 10.1111/ppc.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 03/31/2021] [Accepted: 05/30/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aims to evaluate the effects of the gender course (GC) on nursing students' gender equality perceptions, dating violence attitudes, and problem-solving behaviors in romantic relationships. DESIGN AND METHODS Using a sequential explanatory mixed-methods design, this study utilized Sociodemographic Form, Gender Equality Scale (GES), Dating Violence Attitudes Scale (DVAS), Problem-solving in Romantic Relationships Scale (PSRRS), and students' written accounts to collect data. FINDINGS GES and PSRRS scores demonstrated no differences between the experimental and control groups; DVAS scores indicated differences. The quantitative findings were supported through the qualitative findings. The GC increased students' awareness about gender equality and dating violence and had positive effects problem-solving skills in romantic relationships. PRACTICE IMPLICATIONS GC could be utilized to raise awareness about gender-based violence.
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Affiliation(s)
- Nevin Uslu
- Department of Pediatric Nursing, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Rabiye Erenoğlu
- Department of Obstetrics and Gynecology Nursing, Hatay Mustafa Kemal University, Hatay, Turkey
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14
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Ilabaca Baeza P, Gaete Fiscella JM, Hatibovic Díaz F, Roman Alonso H. Social, Economic and Human Capital: Risk or Protective Factors in Sexual Violence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020777. [PMID: 35055599 PMCID: PMC8775641 DOI: 10.3390/ijerph19020777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/30/2021] [Accepted: 01/06/2022] [Indexed: 12/10/2022]
Abstract
In Chile, studies on protective factors and risk factors for sexual violence are limited and very few have incorporated analysis of different types of capital (social, economic, human) as social resources in the protection against sexual violence. The objective of this research is to evaluate to what extent the stock of different capitals act together, as either protective or risk factors in sexual violence in different interpersonal environments. The sample consisted of 1665 women between 15 and 30 years of age (M = 23.47, SD = 4.41). Artificial neural network analysis and social network analysis were used. The nodes representative of human and economic capital have a protective role of low relevance due to their position in the network, while the nodes of social capital acquire a structural relevance due to the central positions of the network. It is concluded that the structural social capital of neighborhood networks constitutes the main protective factor for sexual violence in all areas, and in turn, the structural social capital of networks with non-significant others was the main risk factor in sexual victimization.
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Affiliation(s)
- Paola Ilabaca Baeza
- School of Psychology, School of Juridical and Social Sciences, Miraflores Campus, Universidad Viña del Mar, Valparaíso 2520000, Chile
- Correspondence:
| | - José Manuel Gaete Fiscella
- Career of Sociology, Faculty of Social Sciences, Campus FACSO UV, Universidad de Valparaíso, Valparaíso 2340000, Chile;
| | - Fuad Hatibovic Díaz
- Career of Psychology, Faculty of Social Sciences, Campus FACSO UV, Universidad de Valparaíso, Valparaíso 2340000, Chile;
| | - Helena Roman Alonso
- School of Social Work, Faculty of Social and Economic Sciences, Campus San Miguel, Universidad Católica del Maule, Talca 3466706, Chile;
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Humbert AL, Strid S, Hearn J, Balkmar D. Undoing the 'Nordic Paradox': Factors affecting rates of disclosed violence against women across the EU. PLoS One 2021; 16:e0249693. [PMID: 33951041 PMCID: PMC8099076 DOI: 10.1371/journal.pone.0249693] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 03/24/2021] [Indexed: 11/19/2022] Open
Abstract
Measuring violence against women raises methodological questions, as well as the wider question of how to understand violence and locate it in relation to a societal context. This is all the more relevant given that measurement of violence against women in the EU has made an interesting phenomenon apparent, the so-called 'Nordic Paradox', whereby prevalence is higher in more gender equal countries. This article examines this phenomenon by exploring a range of factors-methodological, demographic and societal-to contextualise disclosed levels of violence. The analysis makes use of a multilevel analytic approach to take into account how macro and micro levels contribute to the prevalence of violence. The intercepts are then used to illustrate how taking these into account might provide an alternative ranking of levels of violence against women in EU countries. The results show that the 'Nordic Paradox' disappears-and can be undone-when factors at individual and country levels are considered. We conclude that the 'Nordic Paradox' cannot be understood independently from a wider pattern of violence in society, and should be seen as connected and co-constituted in specific formations, domains or regimes of violence. Our results show that the use of multi-level models can provide new insights into the factors that may be related to disclosed prevalence of violence against women. This can generate a better understanding of how violence against women functions as a system, and in turn inform better policy responses.
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Affiliation(s)
- Anne Laure Humbert
- Centre for Diversity Policy Research and Practice, Oxford Brookes Business School, Oxford Brookes University, Oxford, United Kingdom
| | - Sofia Strid
- Division of Gender Studies and Sociology, School of Humanities, Education and Social Sciences, Örebro University, Örebro, Sweden
| | - Jeff Hearn
- Division of Gender Studies and Sociology, School of Humanities, Education and Social Sciences, Örebro University, Örebro, Sweden
- Department of Management and Organisation, Hanken School of Economics, Helsinki, Finland
- Department of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
- Institute for Social and Health Sciences, University of South Africa, Lenasia, Republic of South Africa
| | - Dag Balkmar
- Division of Gender Studies and Sociology, School of Humanities, Education and Social Sciences, Örebro University, Örebro, Sweden
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Kefale B, Yalew M, Damtie Y, Arefaynie M, Adane B. Predictors of sexual violence among female students in higher education institutions in Ethiopia: A systematic review and meta-analysis. PLoS One 2021; 16:e0247386. [PMID: 33606841 PMCID: PMC7894927 DOI: 10.1371/journal.pone.0247386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 02/06/2021] [Indexed: 11/18/2022] Open
Abstract
Background Sexual violence is a profound social and public health problem in Ethiopia. Female students in institutions of higher education are highly vulnerable to sexual violence. Different studies conducted on sexual violence at higher education institutions lack consistency and inclusiveness. Thus, this systematic review and meta-analysis were conducted to estimate the lifetime and twelve-month prevalence, and predictors of sexual violence among female students in institutions of higher education in Ethiopia. Methods This study used a systematic review and meta-analysis of studies conducted from January 1, 2000, to June 1, 2020, in Ethiopia. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health were searched using relevant search terms. Meta-analysis was performed using STATA 14 software. The I2 statistics and Egger’s test were used to assess heterogeneity and publication bias, respectively. Forest plots were used to present the prevalence and odds ratio (OR) with a 95% confidence interval (CI). Results This systematic review and meta-analysis included 10 studies, 5790 study participants. The pooled lifetime and twelve-month prevalence of sexual violence among female students in Ethiopia was 49.4% (95%CI: 37.87, 60.96) and 36.02% (95%CI: 26.42, 45.62) respectively. Rural residence (OR = 2.13;95%CI: 1.33, 3.42), alcohol drinking (OR = 2.03; 95%CI: 1.44, 2.87), and ever had a boyfriend (OR = 2.07; 95%CI: 1.32, 3.62) were factors associated with sexual violence. Conclusions The lifetime prevalence of sexual violence among female students in institutions of higher education in Ethiopia was high. Place of residence, alcohol drinking, and ever had a boyfriend were statistically significant factors of sexual violence. Life skill training and law enforcement are needed to control alcohol consumption. Additionally, more focused interventions should be done in rural settings. Registration This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42020155894.
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Affiliation(s)
- Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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