A Global Overview of Intimate Partner Violence

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

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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

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.

Separating parents and children at US border is inhumane and sets the stage for a public health crisis

Statement from the American Public Health Association and Trust for America’s Health

Washington, D.C., June 15, 2018

“The Trump administration’s policy of separating parents and children at the U.S.-Mexico border will have a dire impact on their health, both now and into the future.

“As public health professionals we know that children living without their parents face immediate and long-term health consequences. Risks include the acute mental trauma of separation, the loss of critical health information that only parents would know about their children’s health status, and in the case of breastfeeding children, the significant loss of maternal child bonding essential for normal development. Parents’ health would also be affected by this unjust separation.

“More alarming is the interruption of these children’s chance at achieving a stable childhood. Decades of public health research have shown that family structure, stability and environment are key social determinants of a child’s and a community’s health.

“Furthermore, this practice places children at heightened risk of experiencing adverse childhood events and trauma, which research has definitively linked to poorer long-term health. Negative outcomes associated with adverse childhood events include some of society’s most intractable health issues: alcoholism, substance misuse, depression, suicide, poor physical health and obesity.

“There is no law requiring the separation of parents and children at the border. This policy violates fundamental human rights. We urge the administration to immediately stop the practice of separating immigrant children and parents and ensure those who have been separated are rapidly reunited, to ensure the health and well-being of these children.”

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APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization influence federal policy, has a nearly 150-year perspective and brings together members from all fields of public health. Visit us at www.apha.org.

Mid-Year Message from Our Chair

Dear International Health (IH) Section members,

At the half-year mark since our 2017 annual meeting in Atlanta, I hope this finds you well and starting plans to attend the 2018 annual meeting in San Diego.  Registration and Housing open on June 4!  Also – please vote for new IH Section leaders – online voting opens any day now!

First, a quick note to summarize global health news from Washington this year.  Despite the Administration request for a one-third reduction for foreign assistance in the federal FY2018 budget proposal (which was not taken to a vote until well into 2018), Congress decided to continue funding at nearly the same level as for FY2017.  For the FY2019 foreign assistance budget, we again face the same 30% reduction request from the Administration which would take effect on Oct. 1, 2018.  Please plan to call your congressional representatives to state your opinion when this comes up for a vote in Congress!

As for IH Section business, we have several new initiatives this year with the objective to improve involvement of global health professionals in our Section.   These initiatives have evolved through active discussions among IH Section leaders in our standing and ad-hoc committees since the last annual meeting.  These are:

(1)   A new program to provide Travel Scholarships to eligible IH members in the category of Early Career Professionals (ECPs).  Winners of the scholarships will be the top-ranked abstracts submitted to the IH Section, based on scoring by blinded reviewers.   Section Council members will coordinate special recognition for scholarship winners at the annual meeting.  The purpose of this program is to promote submission of high quality abstracts by ECP members and to help defray costs of their attendance at the annual meeting for presentation of their work.

(2)   A new Young Professional Award for an outstanding IH Section member who is under 30 years of age.  The awardee will be someone who has shown special initiative in global health.   Nominees must be IH Section members.   Our Awards Committee, in charge of nominations and voting, will recognize the 2018 winner of this new award at the IH Awards Ceremony and Reception in San Diego on Tuesday, November 13, 2018.      Other IH awards given annually are the Carl E. Taylor Lifetime Achievement Award, the Mid-Career Award, the Gordon-Wyon Award for Community-Oriented Public Health, Epidemiology and Practice, and the IH Section Distinguished Service Award.

(3)   A renewal from past years of regional Mid-year Meet-ups, organized for the benefit of Section members in various cities across the U.S.  The successful Washington DC meet-up in April, co-sponsored with the Global Health Council, was held at APHA headquarters.  A San Francisco gathering will be held in June for IH members in conjunction with the Public Health Institute.  Many thanks to event organizers Jessica Keralis (DC), Jean Armas (SF), Theresa Majeski (LA), and Brianne Riggins-Pathak (Albuquerque).

San Diego promises to provide us again with a great opportunity for learning, networking, and reconnecting with old friends. Our volunteer section members have been actively organizing the hundreds of details for the annual meeting. Just a few highlights on the upcoming meeting:

(1)   Our active IH Program Committee handled 473 scientific abstracts that were submitted to IH by February of this year and were evaluated online by 181 volunteer reviewers.  Abstract acceptances for presentation in San Diego have been announced.

(2)   Our IH Policy Committee fielded the review and editing of a good number of policy statement proposals developed by our Section members, some jointly with other sections.  Proposals that successfully transit the APHA Joint Policy Committee (JPC) review and are approved by vote of the Governing Council at the annual meeting will become official policy of APHA!

(3)   Our Community-Based Primary Health Care Working Group is preparing their annual pre-conference in San Diego with the theme this year, Community Health Workers, in a collaborative effort with the APHA Community Health Worker (CHW) Section.  You can soon register to attend this workshop (all day Saturday and half-day Sunday) on November 10-11, 2018.

(4)   A special presentation is planned to commemorate the 40th Anniversary of the Declaration of Alma Alta on Primary Health Care!

Please connect to us through www.aphaih.org (the [Unofficial] Home of APHA’s International Health Section) where you can sign up to receive IH Connect by email and link to our other social media via Facebook and Twitter for job postings and items of interest, as well as receive our excellent Global Health Connections Newsletter with features on IH members and section leaders.

As always, we hope that you are able to seek out and discover ways in which you can engage with your professional association, APHA, as an International Health Section (IH) member.  Your feedback is always welcomed.

Best regards,
Laura C. Altobelli, DrPH, MPH
Chair, International Health Section
American Public Health Association

A Highlight from National Public Health Week: North Dakota State University’s “New Perspective on Refugees Roundtable”

Every April, the public health community celebrates National Public Health Week.  National Public Health Week is a time in which we recognize the amazing contributions of public health professionals and highlight the pressing public health issues important to improving our nation’s health. This year’s National Public Health Week theme was Changing our Future Together.

IH Section Councilor Mark Strand organized a roundtable entitled A New Perspective on Refugees in the Community: Changing our Future Together at North Dakota State University where he is a professor. 40 attendees from 12 countries participated in this National Public Health Week event which was held on April 3rd. Attendees learned many things they didn’t know before:

(1) At least one member of the family is working within 6 months of arriving in the U.S.

(2) Over an adult’s first 20 years here, a refugee pays approximately $21,000 more in taxes than they receive in social service benefits.

(3) There is no evidence for increased crime rates among refugees.

(4) There are many positive impacts resettled refugees make on their new communities.

Visit their Facebook post for a look at some of the photos from their event:  https://www.facebook.com/ndsu.chp/posts/10160362153045694

Share your National Public Health Week highlights with us for a chance to be featured on our blog!

Read the latest issue of the IH newsletter, Section Connection!

The latest issue of Section Connection, the IH Section quarterly e-newsletter, is now available!

You can find the latest issue of the newsletter here: http://bit.ly/SectionConnection7

If you can’t access the newsletter for any reason please email Theresa Majeski, Global Health Connections Chair, at theresa.majeski@gmail.com.