This is a guest blog post by Evangeline Wang, a public health student at Arcadia University and Dr. Heather F. de Vries McClintock PhD MSPH MSW, IH Section Member and Assistant Professor in the Department of Public Health in the College of Health Sciences at Arcadia University. It is the first in a three-part series the IH Blog will feature this summer called Intimate Partner Violence: Global Burden, Risk Factors and Outcomes.
Part I: A Global Overview of Intimate Partner Violence
Intimate partner violence, or IPV, as defined by the Centers for Disease Control (CDC), is violence that manifests as physical, sexual, or psychological harm inflicted by a current or former partner/spouse (CDC, 2018).
For my friend, it was psychological abuse. Last fall, my friend, a headstrong, independent woman, had just gotten out of an emotionally abusive relationship. As we were discussing it, she stated that although she knew some aspects were bad at the time, she found it difficult to leave the relationship. In this relationship, her partner would text her repeatedly, asking where she was, who she was with, and accusing her of unfaithfulness when she did not respond. She justified this behavior because she thought the constant text messages meant he was in love with her and was showing commitment toward her. One day during a fight he followed her home and despite her protests, entered her home spewing hurtful language. It was at this point she realized how harmful the relationship was and that she could not be in the relationship anymore. She decided to end it. When talking to me about it she expressed how challenging it was to leave and her thankfulness for having done so. She related to other victims and their challenges in ending an abusive relationship with a manipulative partner. Unfortunately, like many others, my friend fell victim to intimate partner violence, a pervasive global public health issue.
Globally, in 2016, the World Health Organization (WHO) reported that 30% of women are physically and/or sexually abused by their partner as the global lifetime prevalence. This means that nearly 1 in 3 women will experience intimate partner violence during their lifetime. In the United States, the median prevalence of physical abuse is 30% (Violence Info, 2018). The prevalence of physical abuse is much higher in countries like Ethiopia (45%), Jordan (43%), and Bosnia and Herzegovina (76%).
Regional estimates range from 24.6% in the WHO Western Pacific region to 37.7% in the WHO South East Asia region. A more nuanced assessment by sub regions shows that the highest prevalence of lifetime intimate partner violence is found in central sub-Saharan Africa, with a prevalence of 65.6%. All regions in sub-Saharan Africa have lifetime prevalence estimates that are greater than the global average (WHO Global and Regional Estimates, 2013).
The consequences of intimate partner violence are severe with research showing that exposure to intimate partner violence ultimately increases risk for disability and death. Persons exposed to intimate partner violence are more likely to experience physical and psychological trauma and stress. Such experiences are often characterized by musculoskeletal injuries, genital trauma, mental health problems, substance abuse, non-communicable diseases, somatoform disorders and/or many other adverse consequences. Concurrently, victims may have compromised access to health care due to a lack of autonomy as well as limited decision making power regarding their sexual and reproductive health. Intergenerational effects are common with victims experiencing greater risk for having premature and low birth weight babies as well as pregnancy loss (WHO Global and Regional Estimates, 2013).
Intimate partner violence is a pervasive public health problem that discriminates against no one. From underdeveloped countries to developing countries, this is a major public health issue that cannot be ignored. However, many people lack knowledge about the basic components of intimate partner violence. Furthermore, professionals seeking research on this topic have struggled to compile and access comprehensive information. Greater accessibility of knowledge can enhance global prevention, management and treatment efforts.
The World Health Organization developed an interactive app in response to these needs. This app allows for the public to access online violence studies by country and type of violence (e.g. physical abuse, sexual abuse, and psychological abuse). The purpose of the app is to consolidate and centralize academic journals and various reports about violence in order to make this information more accessible and easier for the public to understand. Not only does it allow journal article access, but it provides important information like prevalence, risk factors, consequences as well as prevention and response strategies. The prevention tab is especially helpful because it allows the user to see the effectiveness of given prevention initiatives based on prior research. Additionally, there are multiple graphs and other visuals that users can click on for more information making this an interactive and user-friendly app. This app can be accessed here: WHO Violence Info App.
Please stay tuned for Part II in this series: Risk Factors for Global Intimate Partner Violence
Dr. Heather F. de Vries McClintock, is an IH Section Member and Assistant Professor in the Department of Public Health, College of Health Sciences at Arcadia University. She earned her Master of Science in Public Health from the Department of Global Health and Population at the Harvard School of Public Health. Dr. McClintock received her PhD in Epidemiology from the University of Pennsylvania with a focus on health behavior and promotion. Her research broadly focuses on the prevention, treatment, and management of chronic disease and disability globally. Recent research aims to understand and reduce the burden of intimate partner violence in Sub-Saharan Africa. Prior to completing her doctorate she served as a Program Officer at the United States Committee for Refugees and Immigrants and a Senior Project Manager in the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania. At the University of Pennsylvania she led several research initiatives that involved improving patient compliance and access to quality healthcare services including the Spectrum of Depression in Later Life and Integrating Management for Depression and Type 2 Diabetes Mellitus Studies.
Evangeline Wang is a public health major at Arcadia University. She is the president of the Public Health Society and has volunteered and interned with various public health agencies such as Prevention Point Philadelphia and HIPS in Washington D.C. After graduation, Evangeline hopes to attend graduate school and continue her studies in global public health.