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Patrizia P, Pingault JB, Eley TC, McCrory E, Viding E. Causal and common risk pathways linking childhood maltreatment to later intimate partner violence victimization. RESEARCH SQUARE 2024:rs.3.rs-4409798. [PMID: 38883746 PMCID: PMC11177992 DOI: 10.21203/rs.3.rs-4409798/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Childhood maltreatment and intimate partner violence (IPV) victimization are major psychiatric risk factors. Maltreatment substantially increases the likelihood of subsequent IPV victimization, but what drives this association is poorly understood. We analyzed retrospective self-reports of maltreatment and IPV in 12794 participants (58% women, 42% men) from the Twins Early Development Study at ages 21 and 26 using quantitative genetic methods. We estimated the etiological influences common to maltreatment and IPV, and the direct causal effect of maltreatment on IPV beyond such common influences. Participants exposed to maltreatment (~7% of the sample) were 3 times more likely to experience IPV victimization than their peers at age 21, 4 times more likely at 26. The association between maltreatment and IPV was mostly due to environmental influences shared by co-twins (42-43%) and genetic influences (30-33%). The association between maltreatment and IPV was similar for women and men, but its etiology partly differed by sex. Maltreatment had a moderate-to-large effect on IPV in phenotypic models (β = 0.23-0.34), decreasing to a small-to-moderate range in causal models accounting for their common etiology (β = 0.15-0.21). Risk factors common to maltreatment and IPV victimization are largely familial in origin, environmental and genetic. Even considering common risk factors, experiencing maltreatment is causally related to subsequent IPV victimization. Interventions promoting safe intimate relationships among young adults exposed to maltreatment are warranted and should address family-level environmental risk and individual-level risk shaped by genetics.
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Affiliation(s)
- Pezzoli Patrizia
- Division of Psychology and Language Sciences, University College London (UCL)
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London (UCL)
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Thalia C Eley
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London (UCL)
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London (UCL)
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Kim C, Bai Y, O'Campo P, Chum A. Impact of the minimum wage increase on intimate partner violence (IPV): a quasi-experimental study in South Korea. J Epidemiol Community Health 2024; 78:235-240. [PMID: 38262734 DOI: 10.1136/jech-2023-221339] [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: 08/25/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Poverty is associated with intimate partner violence (IPV), but whether exogenous increases in wage could reduce IPV among low-income women is still unclear. We examined whether the 2018 minimum wage hike led to a reduction in IPV risk among women. METHODS Using the 2015-2019 Korean Welfare Panel Study, we employed a difference-in-differences (DID) approach to assess the effect of the minimum wage hike on IPV. The analysis focused on married women aged 19 or older. We categorised participants into a target group (likely affected by the minimum wage increase) and a comparison group based on their hourly wage. Three IPV outcomes were examined: verbal abuse, physical threat and physical assault. We conducted DID analyses with two-way fixed-effects models. RESULTS The increase in minimum wage was correlated with a 3.2% decrease in the likelihood of experiencing physical threat among low-income female workers (95% CI: -6.2% to -0.1%). However, the policy change did not significantly influence the risk of verbal abuse, physical assault or a combined IPV outcome. The study also highlights a higher incidence of all IPV outcomes in the target group compared with the comparison group. CONCLUSIONS The 2018 minimum wage increase in Korea was associated with a modest reduction in physical threat among low-income female workers. While economic empowerment through minimum wage policies may contribute to IPV prevention, additional measures should be explored. Further research is needed to understand the intricate relationship between minimum wage policies and IPV, and evidence-based prevention strategies are crucial to address IPV risk.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Yihong Bai
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- University of Western Ontario, London, Ontario, Canada
| | - Patricia O'Campo
- Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Swilley-Martinez ME, Coles SA, Miller VE, Alam IZ, Fitch KV, Cruz TH, Hohl B, Murray R, Ranapurwala SI. "We adjusted for race": now what? A systematic review of utilization and reporting of race in American Journal of Epidemiology and Epidemiology, 2020-2021. Epidemiol Rev 2023; 45:15-31. [PMID: 37789703 DOI: 10.1093/epirev/mxad010] [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: 05/16/2022] [Revised: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 10/05/2023] Open
Abstract
Race is a social construct, commonly used in epidemiologic research to adjust for confounding. However, adjustment of race may mask racial disparities, thereby perpetuating structural racism. We conducted a systematic review of articles published in Epidemiology and American Journal of Epidemiology between 2020 and 2021 to (1) understand how race, ethnicity, and similar social constructs were operationalized, used, and reported; and (2) characterize good and poor practices of utilization and reporting of race data on the basis of the extent to which they reveal or mask systemic racism. Original research articles were considered for full review and data extraction if race data were used in the study analysis. We extracted how race was categorized, used-as a descriptor, confounder, or for effect measure modification (EMM)-and reported if the authors discussed racial disparities and systemic bias-related mechanisms responsible for perpetuating the disparities. Of the 561 articles, 299 had race data available and 192 (34.2%) used race data in analyses. Among the 160 US-based studies, 81 different racial categorizations were used. Race was most often used as a confounder (52%), followed by effect measure modifier (33%), and descriptive variable (12%). Fewer than 1 in 4 articles (22.9%) exhibited good practices (EMM along with discussing disparities and mechanisms), 63.5% of the articles exhibited poor practices (confounding only or not discussing mechanisms), and 13.5% were considered neither poor nor good practices. We discuss implications and provide 13 recommendations for operationalization, utilization, and reporting of race in epidemiologic and public health research.
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Affiliation(s)
- Monica E Swilley-Martinez
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Serita A Coles
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7440, United States
| | - Vanessa E Miller
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Ishrat Z Alam
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Kate Vinita Fitch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Theresa H Cruz
- Prevention Research Center, Department of Pediatrics, Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, United States
| | - Bernadette Hohl
- Penn Injury Science Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6021, United States
| | - Regan Murray
- Center for Public Health and Technology, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, United States
| | - Shabbar I Ranapurwala
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
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Solis-Trapala I, Campbell P, Lacey R, Rowlands G, Dunn K, Protheroe J. Are childhood factors predictive of adult health literacy? A longitudinal birth cohort analysis. SSM Popul Health 2023; 23:101426. [PMID: 37252287 PMCID: PMC10220279 DOI: 10.1016/j.ssmph.2023.101426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/31/2023] Open
Abstract
Health literacy (HL), defined as the ability of an individual to understand and appraise health information to make informed decisions on their health, helps maintain and improve one's health and thus reduce the use of healthcare services. There is a recognised global effort to address insufficient HL in early life and understand how HL develops. This study examined the association of a range of factors including educational, speech and language ability, health and healthcare engagement, sleep problems, mental health, demographic, environmental, and maternal factors at different childhood stages (from 5 years to 11 years) with later adult HL at age 25. HL was measured using a HL ordinal score (insufficient, limited, or sufficient) derived from the European Literacy Survey Questionnaire-short version (HLS-EU-Q16) within a large UK based birth cohort (Avon Longitudinal Study of Parents and Children: ALSPAC study). Univariate proportional odds logistic regression models for the probability of having higher levels of HL were developed. Results of analysis of 4248 participants showed that poorer speech and language ability (aged 9 years, OR 0.18 95% CI 0.04 to 0.78), internalising in child (age 11 years, OR 0.62 95% CI 0.5 to 0.78), child depression (age 9 years, OR 0.67 95% CI 0.52 to 0.86), and the presence of maternal depression (child age 5, OR 0.80 95% CI 0.66 to 0.96), reduced the odds of sufficient HL when adult. Our results suggest some useful markers to identify children at potential risk of low HL that could be targeted for research into future interventions within school settings, for example, child's speech and language capability. In addition, this study identified child and maternal mental health as factors associated with later development of limited HL and future research should consider what potential mechanisms might explain this link.
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Affiliation(s)
- I. Solis-Trapala
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - P. Campbell
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Midlands Partnership NHS Foundation Trust, St Georges' Hospital, Stafford, ST16 3AG, UK
| | - R.J. Lacey
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - G. Rowlands
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK
| | - K.M. Dunn
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - J. Protheroe
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
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Kajal F, Mishra RM, Mehrotra A, Chattu VK. Pandemic within a pandemic! Policy Implications of community-based Interventions to mitigate violence against women during COVID-19 in Urban Slums of Lucknow, India. AIMS Public Health 2023; 10:297-309. [PMID: 37304584 PMCID: PMC10251050 DOI: 10.3934/publichealth.2023022] [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] [Received: 11/17/2022] [Revised: 03/22/2023] [Accepted: 04/03/2023] [Indexed: 06/13/2023] Open
Abstract
Background The COVID-19 pandemic has brought an unprecedented adverse impact on women's health. Evidence from the literature suggests that violence against women has increased multifold. Gender-based violence in urban slums has worsened due to a lack of water and sanitation services, overcrowding, deteriorating conditions and a lack of institutional frameworks to address gender inequities. Methods The SAMBHAV (Synchronized Action for Marginalized to Improve Behaviors and Vulnerabilities) initiative was launched between June 2020 to December 2020 by collaborating with the Uttar Pradesh state government, UNICEF and UNDP. The program intended to reach 6000 families in 30 UPS (Urban Poor settlements) of 13 city wards. These 30 UPS were divided into 5 clusters. The survey was conducted in 760 households, 397 taken from randomly selected 15 interventions and 363 households from 15 control UPS. This paper utilized data from a baseline assessment of gender and decision-making from a household survey conducted in the selected UPS during July 03-15, 2020. A sample size of 360 completed interviews was calculated for intervention and control areas to measure changes attributable to the SAMBHAV intervention in the behaviours and service utilization (pre- and post-intervention). Results The data analysis showed a significant difference (p-value < 0.001) between respondents regarding women's freedom to move alone in the control and intervention area. It also reflected a significant difference between control and intervention areas as the respondents in the intervention area chose to work for the cause of gender-based violence. Conclusion The SAMBHAV initiative brought an intersectional lens to gender issues. The community volunteers were trained to approach issues based on gender-based violence with the local public, and various conferences and meetings were organized to sensitize the community. The initiative's overall impact was that it built momentum around the issue of applying the concept of intersectionality for gender issues and building resilience in the community. There is still a need to bring multi-layered and more aggressive approaches to reduce the prevalence of gender-based violence in the community.
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Affiliation(s)
- Fnu Kajal
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ 85719, USA
| | | | | | - Vijay Kumar Chattu
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5G 1V7, Canada
- Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai- 600077; India
- Center for Evidence-Based Strategies, Global Health Research and Innovations Canada Inc. (GHRIC), ON, Toronto, Canada
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Jewkes R, Chirwa E, Alangea DO, Addo-Lartey A, Christofides N, Dunkle K, Ramsoomar L, Gibbs A. Pooled analysis of the association between food insecurity and violence against women: Evidence from low- and middle-income settings. J Glob Health 2023; 13:04021. [PMID: 36896806 PMCID: PMC9999307 DOI: 10.7189/jogh.13.04021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Background Intimate partner violence impacts relationships across the socioeconomic spectrum, nonetheless its prevalence is reported to be highest in areas that are most socio-economically deprived. Poverty has direct and indirect impacts on intimate partner violence (IPV) risk, however, one of the postulated pathways is through food insecurity. The aim of this paper is to describe the association between food insecurity (household hunger) and women's experiences, and men's perpetration, of intimate partner violence and non-partner sexual violence in data from Africa and Asia. Methods We conducted a pooled analysis of data from baseline interviews with men and women participating in six Violence Against Women prevention intervention evaluations and present a meta-analysis using mixed-effects Poisson regression models. Data were from South Africa (two studies), Ghana, Rwanda (two data sets), and Afghanistan and comprised interviews with 6545 adult women and 8104 adult men. We assessed food insecurity with the Household Hunger Scale. Results Overall, 27.9% of women experienced moderate food insecurity (range from 11.1% to 44.4%), while 28.8% of women reported severe food insecurity (range from 7.1 to 54.7%). Overall food insecurity was associated with an increased likelihood of women experiencing physical intimate partner violence, adjusted incidence rate ratio (aIRR) = 1.40 (95% CI = 1.23 to 1.60) for moderate food insecurity and aIRR = 1.73 (95% CI = 1.41 to 2.12) for severe food insecurity. It was also associated with an increased likelihood of men reporting perpetration of physical IPV, with aIRR = 1.24 (95% CI = 1.11 to 1.39) for moderate food insecurity and aIRR = 1.18 (95% CI = 1.02 to 1.37) for severe food insecurity. Food insecurity was not significantly associated with women's experience of non-partner sexual violence, aIRR = 1.27 (95% CI = 0.93 to 1.74) for moderate or severe food insecurity vs none, nor men's perpetration of non-partner sexual violence aIRR = 1.02 (95% CI = 0.90 to 1.15). Conclusions Food insecurity is associated with increased physical intimate partner violence perpetration and experience reported by men and women. It was not associated with non-partner sexual violence perpetration, although there was some evidence to suggest an elevated risk of non-partner sexual violence among food-insecure women. Prevention programming needs to embrace food insecurity as a driver of intimate partner violence perpetration, however, non-partner sexual violence prevention needs to be shaped around a separate understanding of its drivers.
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Affiliation(s)
- Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Pretoria, Gauteng, South Africa
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | | | | | - Nicola Christofides
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Pretoria, Gauteng, South Africa
| | - Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health and Health Systems, University of the Pretoria, Pretoria, Gauteng, South Africa
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Department of Psychology, University of Exeter, Exeter, Devon, UK
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Moser DA, Graf S, Glaus J, Urben S, Jouabli S, Pointet Perrizolo V, Suardi F, Robinson J, Rusconi Serpa S, Plessen KJ, Schechter DS. On the complex and dimensional relationship of maternal posttraumatic stress disorder during early childhood and child outcomes at school-age. Eur Psychiatry 2023; 66:e20. [PMID: 36734250 PMCID: PMC9970153 DOI: 10.1192/j.eurpsy.2023.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Several studies have shown associations between maternal interpersonal violence-related posttraumatic stress disorder (PTSD), child mental health problems, and impaired socioemotional development. However, the existing literature lacks evidence linking constellations of risk factors such as maternal interpersonal-violence-related PTSD, psychopathology, and interactive behavior with toddlers and outcome measures at school-age. METHODS This study involved a prospective, longitudinal investigation of 62 mothers and examined the relationship between maternal variables measured when children were in early childhood (mean age 27 months), and child outcomes when children were school-age (age mean = 83.2 months) while retaining a focus on the context of maternal PTSD. To identify and weigh associated dimensions comparatively, we employed sparse canonical correlation analysis (sCCA) aimed at associating dimensions of a dataset of 20 maternal variables in early childhood with that of more than 20 child outcome variables (i.e., child psychopathology, life-events, and socioemotional skills) at school-age. RESULTS Phase 1 variables with the highest weights were those of maternal psychopathology: PTSD, depressive and dissociative symptoms, and self-report of parental stress. The highest weighted Phase 2 child outcome measures were those of child psychopathology: PTSD, anxiety, and depressive symptoms as well as peer bullying and victimization. CONCLUSIONS sCCA revealed that trauma-related concepts in mothers were significantly and reliably associated with child psychopathology and other indicators of risk for intergenerational transmission of violence and victimization. The results highlight the dimensional and multifaceted nature-both for mothers as well as children-of the intergenerational transmission of violence and associated psychopathology.
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Affiliation(s)
- Dominik Andreas Moser
- Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Shannen Graf
- Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Jennifer Glaus
- Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Sébastien Urben
- Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Sondes Jouabli
- Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Francesca Suardi
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - JoAnn Robinson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Sandra Rusconi Serpa
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Kerstin Jessica Plessen
- Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Daniel Scott Schechter
- Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.,Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, New York, USA
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Samadoulougou S, Letarte L, Lebel A. Association between Neighbourhood Deprivation Trajectories and Self-Perceived Health: Analysis of a Linked Survey and Health Administrative Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:486. [PMID: 36612807 PMCID: PMC9819741 DOI: 10.3390/ijerph20010486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Life course exposure to neighbourhood deprivation may have a previously unstudied relationship with health disparities. This study examined the association between neighbourhood deprivation trajectories (NDTs) and poor reported self-perceived health (SPH) among Quebec's adult population. Data of 45,990 adults with complete residential address histories from the Care-Trajectories-Enriched Data cohort, which links Canadian Community Health Survey respondents to health administrative data, were used. Accordingly, participants were categorised into nine NDTs (T1 (Privileged Stable)-T9 (Deprived Stable)). Using multivariate logistic regression, the association between trajectory groups and poor SPH was estimated. Of the participants, 10.3% (95% confidence interval [CI]: 9.9-10.8) had poor SPH status. This proportion varied considerably across NDTs: From 6.4% (95% CI: 5.7-7.2) for Privileged Stable (most advantaged) to 16.4% (95% CI: 15.0-17.8) for Deprived Stable (most disadvantaged) trajectories. After adjustment, the likelihood of reporting poor SPH was significantly higher among participants assigned to a Deprived Upward (odds ratio [OR]: 1.77; 95% CI: 1.48-2.12), Average Downward (OR: 1.75; CI: 1.08-2.84) or Deprived trajectory (OR: 1.81; CI: 1.45-2.86), compared to the Privileged trajectory. Long-term exposure to neighbourhood deprivation may be a risk factor for poor SPH. Thus, NDT measures should be considered when selecting a target population for public-health-related interventions.
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Affiliation(s)
- Sékou Samadoulougou
- Evaluation Platform on Obesity Prevention (PEPO), Quebec Heart and Lung Institute, Quebec, QC G1V 4G5, Canada
- Centre for Research on Planning and Development (CRAD), Université Laval, Quebec, QC G1V 0A6, Canada
| | - Laurence Letarte
- Evaluation Platform on Obesity Prevention (PEPO), Quebec Heart and Lung Institute, Quebec, QC G1V 4G5, Canada
- Centre for Research on Planning and Development (CRAD), Université Laval, Quebec, QC G1V 0A6, Canada
| | - Alexandre Lebel
- Evaluation Platform on Obesity Prevention (PEPO), Quebec Heart and Lung Institute, Quebec, QC G1V 4G5, Canada
- Centre for Research on Planning and Development (CRAD), Université Laval, Quebec, QC G1V 0A6, Canada
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Shour AR, Hamberger LK, Meurer J, Kostelac C, Cassidy L. Context Matters: Assessing the Association Between Area Deprivation and the Severity of Injury and Types of Domestic Violence Victimization Among Women. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22352-NP22374. [PMID: 35098777 DOI: 10.1177/08862605211072209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To analyze the association between social determinants of health (SDOH), as measured by the Area Deprivation Index (ADI), and the severity of injury and types of domestic violence (DV) victimization among women (≥18 years of age) in Milwaukee, Wisconsin. METHODS Neighborhood ADI data from the American Community Survey (2014-2018) were merged with Milwaukee Police Department DV data (2013-2017). ADI included multiple SDOH domains (education, employment, income/poverty, and housing quality). Types of DV were classified using an adaptation of the FBI-Uniform Crime Reporting-Hierarchy Rule, including Crimes Against Persons (homicide/negligent manslaughter, sexual assault/rape, and aggravated battery/assault). Chi-square, Anova tests, and logistic regression analyses were performed using Stata v.14.2; p-values ≤ .05 were considered statistically significant. FINDINGS Except for aggravated battery/assault (OR: 1.003, 95% CI: 1.001-1.010), there was no statistically significant relationship between neighborhood disadvantage and DV victimization in 21,095 DV incidents between 2013 and 2017. Adjusted model results indicate that with each increase in neighborhood disadvantage (by ADI), there was a 1.003 increase in the likelihood for aggravated battery/assault (OR: 1.003, 95% CI: 1.001-1.005). Severity of DV injury was not significantly associated with ADI (OR: 1.002, 95% CI: 0.999-1.004). However, non-Hispanic Black women were 1.3 times more likely than non-Hispanic Whites to be victims of aggravated battery/assault (OR: 1.321, 95% CI: 1.189-1.469). Hispanic women were more likely than non-Hispanic Whites to sustain a more severe injury (OR: 0.841, 95% CI: 0.732-0.970]). CONCLUSION The likelihood of DV-aggravated battery/assault increased with neighborhood deprivation, and significant associations (and highly lopsided prevalence) were found in types of DV victimization by race/ethnicity, with non-Hispanic Black women experiencing higher prevalence than others. This study adds to the body of knowledge by looking at how macro-level neighborhood-SDOH characteristics influence women's exposure to various forms of DV victimization and demonstrated the feasibility of linking law enforcement DV data to SDOH metrics, providing context for law enforcement DV victimizations.
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Affiliation(s)
- Abdul R Shour
- Department of Public Health, 8445Carroll University, Waukesha, WI, USA
- Center for Advancing Population Science, 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - L Kevin Hamberger
- Department of Family Medicine, Division of Residency, 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - John Meurer
- Institute for Health and Equity, 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Constance Kostelac
- Institute for Health and Equity, 5506Medical College of Wisconsin, Milwaukee, WI, USA
| | - Laura Cassidy
- Institute for Health and Equity, 5506Medical College of Wisconsin, Milwaukee, WI, USA
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10
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Yakubovich AR, Heron J, Barter C, Humphreys DK. Trajectories of Exposure to Neighborhood Deprivation and the Odds of Experiencing Intimate Partner Violence Among Women: Are There Sensitive Periods for Exposure? JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP5728-NP5746. [PMID: 32960156 PMCID: PMC8980452 DOI: 10.1177/0886260520959626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Neighborhood disadvantage is commonly hypothesized to be positively associated with intimate partner violence (IPV) against women. However, longitudinal investigation of this association has been limited, with no studies on whether the timing of exposure matters. We used data from 2,115 women in the UK-based Avon Longitudinal Study of Parents and Children. Exposure to neighborhood-level deprivation was measured at 10-time points from baseline (gestation) until age 18. Family-level socioeconomic characteristics were measured at baseline. At age 21, participants self-reported whether they had experienced any IPV since age 18. We used a three-step bias-adjusted longitudinal latent class analysis to investigate how different patterns of neighborhood deprivation exposure were associated with the odds of experiencing IPV. A total of 32% of women experienced any IPV between ages 18 and 21. Women who consistently lived in deprived neighborhoods (chronic high deprivation) or spent their early childhoods in more deprived neighborhoods and later moved to less deprived neighborhoods (decreasing deprivation) had higher odds of experiencing IPV compared to those who consistently lived in non-deprived neighborhoods. The odds of experiencing IPV did not consistently differ between women who lived in non-deprived neighborhoods during early childhood and later moved to deprived neighborhoods (increasing deprivation) and those stably in non-deprived neighborhoods. Living in more deprived neighborhoods during early childhood, regardless of later exposure, was associated with higher odds of experiencing later IPV. This is congruent with prior research demonstrating the persistent effects of early neighborhood disadvantage on health and well-being. Replication, and underlying mechanisms, should be assessed across contexts.
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Affiliation(s)
- Alexa R. Yakubovich
- University of Oxford, Oxford, United Kingdom
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Jon Heron
- University of Bristol, Bristol, United Kingdom
| | - Christine Barter
- University of Central Lancashire, Preston, Lancashire, United Kingdom
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Gilsanz P, Young JG, Glymour MM, Tchetgen Tchetgen EJ, Eng CW, Koenen KC, Kubzansky LD. Marginal Structural Models for Life-Course Theories and Social Epidemiology: Definitions, Sources of Bias, and Simulated Illustrations. Am J Epidemiol 2022; 191:349-359. [PMID: 34668974 PMCID: PMC8897994 DOI: 10.1093/aje/kwab253] [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: 06/10/2020] [Revised: 09/09/2021] [Accepted: 10/08/2021] [Indexed: 11/14/2022] Open
Abstract
Social epidemiology aims to identify social structural risk factors, thus informing targets and timing of interventions. Ascertaining which interventions will be most effective and when they should be implemented is challenging because social conditions vary across the life course and are subject to time-varying confounding. Marginal structural models (MSMs) may be useful but can present unique challenges when studying social epidemiologic exposures over the life course. We describe selected MSMs corresponding to common theoretical life-course models and identify key issues for consideration related to time-varying confounding and late study enrollment. Using simulated data mimicking a cohort study evaluating the effects of depression in early, mid-, and late life on late-life stroke risk, we examined whether and when specific study characteristics and analytical strategies may induce bias. In the context of time-varying confounding, inverse-probability-weighted estimation of correctly specified MSMs accurately estimated the target causal effects, while conventional regression models showed significant bias. When no measure of early-life depression was available, neither MSMs nor conventional models were unbiased, due to confounding by early-life depression. To inform interventions, researchers need to identify timing of effects and consider whether missing data regarding exposures earlier in life may lead to biased estimates.
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Affiliation(s)
- Paola Gilsanz
- Correspondence to Dr. Paola Gilsanz, Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612 (e-mail: )
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Hufnagel DH, Khabele D, Yull FE, Hull PC, Schildkraut J, Crispens MA, Beeghly-Fadiel A. Increasing Area Deprivation Index negatively impacts ovarian cancer survival. Cancer Epidemiol 2021; 74:102013. [PMID: 34438316 DOI: 10.1016/j.canep.2021.102013] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION While individual-level measures of socioeconomic status have been well-studied in relation to ovarian cancer survival, no studies to date have examined both state and national-level Area Deprivation Indices (ADIs), which incorporate neighborhood affluence and resources. METHODS We abstracted clinical data from medical records for ovarian cancer cases from the Vanderbilt University Medical Center and obtained ADIs from the Neighborhood Atlas®. Associations with clinical characteristics were assessed with Spearman correlations and Kruskal-Wallis tests; associations with progression-free survival (PFS) and overall survival (OS) were assessed with Cox proportional-hazards regression. RESULTS Among 184 cases, state and national ADIs were highly correlated, but not related to any cancer characteristics. In multivariable adjusted regression models, both were significantly associated with OS; each decile increase in state or national ADI corresponded to a 9 % or 10 % greater risk of death, respectively. CONCLUSIONS Increasing area-level deprivation may negatively impact ovarian cancer survival.
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Affiliation(s)
- Demetra H Hufnagel
- Vanderbilt University School of Medicine, Nashville, TN 37240, USA; Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Dineo Khabele
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO 63130, USA
| | - Fiona E Yull
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37212, USA; Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA
| | - Pamela C Hull
- Division of Population Science and Community Impact, University of Kentucky, Markey Cancer Center, Lexington, KY 40536, USA
| | - Joellen Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Marta A Crispens
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA
| | - Alicia Beeghly-Fadiel
- Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA.
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Chronic high risk of intimate partner violence against women in disadvantaged neighborhoods: An eight-year space-time analysis. Prev Med 2021; 148:106550. [PMID: 33848525 DOI: 10.1016/j.ypmed.2021.106550] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 02/25/2021] [Accepted: 04/08/2021] [Indexed: 01/10/2023]
Abstract
We conducted a small-area ecological longitudinal study to analyze neighborhood contextual influences on the spatio-temporal variations in intimate partner violence against women (IPVAW) risk in a southern European city over an eight-year period. We used geocoded data of IPVAW cases with associated protection orders (n = 5867) in the city of Valencia, Spain (2011-2018). The city's 552 census block groups were used as the neighborhood units. Neighborhood-level covariates were: income, education, immigrant concentration, residential instability, alcohol outlet density, and criminality. We used a Bayesian autoregressive approach to spatio-temporal disease mapping. Neighborhoods with low levels of income and education and high levels of residential mobility and criminality had higher relative risk of IPVAW. Spatial patterns of high risk of IPVAW persisted over time during the eight-year period analyzed. Areas of stable low risk and with increasing or decreasing risk were also identified. Our findings link neighborhood disadvantage to the existence and persistence over time of spatial inequalities in IPVAW risk, showing that high risk of IPVAW can become chronic in disadvantaged neighborhoods. Our analytic approach provides specific risk estimates at the small-area level that are informative for intervention purposes, and can be useful to assess the effectiveness of prevention efforts in reducing IPVAW.
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Herbert A, Heron J, Barter C, Szilassy E, Barnes M, Howe LD, Feder G, Fraser A. Risk factors for intimate partner violence and abuse among adolescents and young adults: findings from a UK population-based cohort. Wellcome Open Res 2021; 5:176. [PMID: 33553678 PMCID: PMC7848855 DOI: 10.12688/wellcomeopenres.16106.3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 12/04/2022] Open
Abstract
Background: Approximately one-third of young people in the UK have suffered intimate partner violence and abuse (IPVA) on reaching adulthood. We need interventions to prevent IPVA in this population, but there is a lack of evidence on who is at greatest risk. Methods: We analysed questionnaire data from 3,279 participants of the Avon Longitudinal Study of Parents and Children population-based birth cohort. We estimated the prevalence of IPVA victimisation and perpetration by age 21, by sex, demographic, parenting, mental health, externalising behaviour (e.g. smoking), educational, employment, and adverse childhood factors. Results: Overall, 29% of males and 41% of females reported IPVA victimisation, with 20% and 25% reporting perpetration, respectively (16% and 22% both). The most common type of IPVA was emotional, followed by physical, then sexual. History of anxiety, self-harm, anti-social behaviour, cannabis or illicit (non-cannabis) drug use, or risky sexual behaviour among males and females were associated with a 50% increase in likelihood of IPVA (victimisation or perpetration). Males reporting depression, sexual abuse (not by an intimate partner), witnessing domestic violence, or parental separation were also more likely to experience IPVA. Extreme parental monitoring, high academic achievement during adolescence, and NEET (not being in education, employment, or training) status in young adulthood were associated with reduced risks of IPVA. Conclusions: A range of demographic, mental health, and behavioural factors were associated with increased prevalence of IPVA victimisation or perpetration. Further study of likely complex pathways from these factors to IPVA, to inform primary prevention, is needed.
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Affiliation(s)
- Annie Herbert
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jon Heron
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Christine Barter
- University of Central Lancashire, Preston, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Eszter Szilassy
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Maria Barnes
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Laura D Howe
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Gene Feder
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Abigail Fraser
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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Brown SJ, Conway LJ, FitzPatrick KM, Hegarty K, Mensah FK, Papadopoullos S, Woolhouse H, Giallo R, Gartland D. Physical and mental health of women exposed to intimate partner violence in the 10 years after having their first child: an Australian prospective cohort study of first-time mothers. BMJ Open 2020; 10:e040891. [PMID: 33371030 PMCID: PMC7754634 DOI: 10.1136/bmjopen-2020-040891] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To investigate mental and physical health of mothers exposed to recent and early postpartum intimate partner violence (IPV) in the 10 years after having their first child. DESIGN Prospective pregnancy cohort study. SETTING Women were recruited at six metropolitan public maternity hospitals in Melbourne, Australia and followed up at 1, 4 and 10 years post partum. STUDY MEASURES Exposure to physical and/or emotional IPV was measured using the Composite Abuse Scale at 1, 4 and 10 years. At 10-year follow-up, mothers reported on physical and mental health, and functional health status. PARTICIPANTS 1507 first-time mothers enrolled at mean of 15 weeks' gestation. RESULTS One in three women experienced IPV during the 10 years after having their first child. Women experiencing recent IPV (19.1%) reported worse physical and mental health than women not reporting IPV. Compared with women not reporting IPV, women experiencing recent IPV had higher odds of poor functional health status (Adj OR=4.5, 95% CI 3.2 to 6.3), back pain (Adj OR=2.0, 95% CI 1.4 to 2.9), incontinence (Adj OR=1.8, 95% CI 1.2 to 2.6), depressive symptoms (Adj OR=4.9, 95% CI 3.2 to 7.5), anxiety (Adj OR=5.1, 95% CI 3.0 to 8.6) and post-traumatic stress symptoms (Adj OR=7.2, 95% CI 4.6 to 11.1) at 10 years. Women with past IPV at 1 and/or 4 years (15.7% of the cohort) also had higher odds of physical and mental health problems. There was evidence of a gradient in health outcomes by recency of exposure to IPV. CONCLUSIONS Both recent and past exposure to IPV are associated with poor maternal physical and mental health 10 years after a first birth. Health services and advocacy organisations providing support to women need to be aware of the consistent relationship between IPV and a range of physical and mental health conditions, which may persist even after IPV appears to have ceased.
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Affiliation(s)
- Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Laura J Conway
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Kelly M FitzPatrick
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Kelsey Hegarty
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Sandra Papadopoullos
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Hannah Woolhouse
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rebecca Giallo
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Herbert A, Heron J, Barter C, Szilassy E, Barnes M, Howe LD, Feder G, Fraser A. Risk factors for intimate partner violence and abuse among adolescents and young adults: findings from a UK population-based cohort. Wellcome Open Res 2020; 5:176. [PMID: 33553678 PMCID: PMC7848855 DOI: 10.12688/wellcomeopenres.16106.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 04/01/2024] Open
Abstract
Background: Approximately one-third of young people in the UK have suffered intimate partner violence and abuse (IPVA) on reaching adulthood. We need interventions to prevent IPVA in this population, but there is a lack of evidence on who is at greatest risk. Methods: We analysed questionnaire data from 3,279 participants of the Avon Longitudinal Study of Parents and Children population-based birth cohort. We estimated the prevalence of IPVA victimisation and perpetration by age 21, by sex, demographic, parenting, mental health, externalising behaviour (e.g. smoking), educational, employment, and adverse childhood factors. Results: Overall, 29% of males and 41% of females reported IPVA victimisation, with 20% and 25% reporting perpetration, respectively (16% and 22% both). The most common sub-type was emotional, followed by physical, then sexual. History of self-harm, anti-social behaviour, cannabis or illicit (non-cannabis) drug use among males and females were associated with a two-fold increase in likelihood of IPVA (victimisation or perpetration). Males reporting risky sexual behaviour, sexual abuse (not by an intimate partner), or witnessing domestic violence, and females reporting sexual minority status in adolescence were also twice as likely to experience IPVA. Extreme parental monitoring during adolescence was associated with a reduced risk of IPVA in males and females, as was high academic achievement, and NEET (not being in education, employment, or training) status for young adult men. Conclusions: A range of demographic, mental health, and behavioural factors were associated with increased prevalence of IPVA victimisation or perpetration. Further study of likely complex pathways from these factors to IPVA, to inform primary prevention, is needed.
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Affiliation(s)
- Annie Herbert
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jon Heron
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Christine Barter
- University of Central Lancashire, Preston, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Eszter Szilassy
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Maria Barnes
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Laura D. Howe
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Gene Feder
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Abigail Fraser
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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Herbert A, Heron J, Barter C, Szilassy E, Barnes M, Howe LD, Feder G, Fraser A. Risk factors for intimate partner violence and abuse among adolescents and young adults: findings from a UK population-based cohort. Wellcome Open Res 2020; 5:176. [PMID: 33553678 PMCID: PMC7848855 DOI: 10.12688/wellcomeopenres.16106.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 07/22/2023] Open
Abstract
Background: Approximately one-third of young people in the UK have suffered intimate partner violence and abuse (IPVA) on reaching adulthood. We need interventions to prevent IPVA in this population, but there is a lack of evidence on who is at greatest risk. Methods: We analysed questionnaire data from 3,279 participants of the Avon Longitudinal Study of Parents and Children population-based birth cohort. We estimated the prevalence of IPVA victimisation and perpetration by age 21, by sex, demographic, parenting, mental health, externalising behaviour (e.g. smoking), educational, employment, and adverse childhood factors. Results: Overall, 29% of males and 41% of females reported IPVA victimisation, with 20% and 25% reporting perpetration, respectively (16% and 22% both). The most common sub-type was emotional, followed by physical, then sexual. History of self-harm, anti-social behaviour, cannabis or illicit (non-cannabis) drug use among boys and girls was associated with a two-fold increase in likelihood of IPVA (victimisation or perpetration). Males reporting risky sexual behaviour, sexual abuse (not by an intimate partner), or witnessing domestic violence, and females reporting sexual minority status in adolescence were also twice as likely to experience IPVA. Extreme parental monitoring during adolescence was associated with a reduced risk of IPVA in males and females, as was not being in education, employment, or training for young adult men. Conclusions: A range of demographic, mental health, and behavioural factors were associated with increased prevalence of IPVA victimisation or perpetration. Further study of likely complex pathways from these factors to IPVA, to inform primary prevention, is needed.
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Affiliation(s)
- Annie Herbert
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jon Heron
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Christine Barter
- University of Central Lancashire, Preston, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Eszter Szilassy
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Maria Barnes
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Laura D. Howe
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Gene Feder
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Abigail Fraser
- Department of Population Health Sciences, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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Bhavsar V, Sanyal J, Patel R, Shetty H, Velupillai S, Stewart R, Broadbent M, MacCabe JH, Das-Munshi J, Howard LM. The association between neighbourhood characteristics and physical victimisation in men and women with mental disorders. BJPsych Open 2020; 6:e73. [PMID: 32669154 PMCID: PMC7443921 DOI: 10.1192/bjo.2020.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/15/2020] [Accepted: 06/02/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND How neighbourhood characteristics affect the physical safety of people with mental illness is unclear. AIMS To examine neighbourhood effects on physical victimisation towards people using mental health services. METHOD We developed and evaluated a machine-learning-derived free-text-based natural language processing (NLP) algorithm to ascertain clinical text referring to physical victimisation. This was applied to records on all patients attending National Health Service mental health services in Southeast London. Sociodemographic and clinical data, and diagnostic information on use of acute hospital care (from Hospital Episode Statistics, linked to Clinical Record Interactive Search), were collected in this group, defined as 'cases' and concurrently sampled controls. Multilevel logistic regression models estimated associations (odds ratios, ORs) between neighbourhood-level fragmentation, crime, income deprivation, and population density and physical victimisation. RESULTS Based on a human-rated gold standard, the NLP algorithm had a positive predictive value of 0.92 and sensitivity of 0.98 for (clinically recorded) physical victimisation. A 1 s.d. increase in neighbourhood crime was accompanied by a 7% increase in odds of physical victimisation in women and an 13% increase in men (adjusted OR (aOR) for women: 1.07, 95% CI 1.01-1.14, aOR for men: 1.13, 95% CI 1.06-1.21, P for gender interaction, 0.218). Although small, adjusted associations for neighbourhood fragmentation appeared greater in magnitude for women (aOR = 1.05, 95% CI 1.01-1.11) than men, where this association was not statistically significant (aOR = 1.00, 95% CI 0.95-1.04, P for gender interaction, 0.096). Neighbourhood income deprivation was associated with victimisation in men and women with similar magnitudes of association. CONCLUSIONS Neighbourhood factors influencing safety, as well as individual characteristics including gender, may be relevant to understanding pathways to physical victimisation towards people with mental illness.
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Affiliation(s)
- Vishal Bhavsar
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Jyoti Sanyal
- Clinical Informatics, BRC Nucleus, South London and Maudsley NHS Foundation Trust, UK
| | - Rashmi Patel
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Hitesh Shetty
- Clinical Informatics, BRC Nucleus, South London and Maudsley NHS Foundation Trust, UK
| | | | - Robert Stewart
- BRC Nucleus, South London and Maudsley NHS Foundation Trust, UK
| | - Matthew Broadbent
- Clinical Informatics, BRC Nucleus, South London and Maudsley NHS Foundation Trust, UK
| | | | - Jayati Das-Munshi
- Department of Health Services and Population Research, King's College London, UK
| | - Louise M. Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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