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http://www.theguardian.com/healthcare-network/2015/jan/21/domestic-violence-damages-health-shortens-lives

 

DOMESTIC VIOLENCE REFLECTS GENDER INEQUALITY–MORE VULNERABILITY OF WOMEN WITH LESS EDUCATION, DISEMPOWERMENT–MALI +

 

In Mali, 60% of women with no education agree that a husband is right to beat his wife

women and children 

In Mali, 60% of women with no education agree that a husband is justified in beating his wife. Photograph: Ben Curtis/AP

 

By Michael Marmot – 21 January 2015

If a woman tells you a husband has a right to beat his wife if she refuses to have sex with him, how do you react? Do you say that what intimate partners do with each other is up to them? And a woman who condones violence done to her has no one to blame but herself? If this woman is in Mali, do you say: “Well, that’s how they do things over there?”

My answer to these questions is “no, no, no”. A man does not have the right to beat his intimate partner whatever his supposed reason. I will add that a woman’s control of her sexuality should not be a supposed reason. (There are examples of women beating up men. They, too, are wrong but are less common.) No, a woman’s apparent acceptance of domestic violence is not a reason to look away. We should not accept cultural differences as mitigation. The human right of a woman not to be subject to domestic violence surely trumps cultural relativity. Domestic violence is wrong.

It may also damage health and shorten lives. Domestic violence leads to increased risk of low birth weight and premature birth of a woman’s children, an increase in sexually transmitted diseases, and damage to mental health – including a four and half times greater risk of suicide. Globally, 38% of all murdered women are killed by their partners – the equivalent figure for men is 6%.

The staggering statistic shows how common domestic violence is. The World Health Organisation estimates that one in three women will experience intimate partner violence in their lives. In England and Wales there are two million victims a year of domestic abuse.

If you accept that a woman has the right to be protected from being beaten up at home, that must surely lead us to question how we can prevent it. And that, rather directly, leads us to look at the social causes of domestic violence. Evidence shows that the social causes of violence overlap with the social causes of health – we call them social determinants. As with health, domestic violence tends to reflect, and be influenced by, inequalities in society.

We can see this in Mali. Sixty per cent of women with no education agree with the grisly idea that a husband is justified in beating his wife. Just over half of women with primary education agree with this; fewer than 40% of women with secondary or higher education. We call this a social gradient: the more education, the lower the risk. Among the many reasons to champion the cause of education of women in sub-Saharan Africa are improved health and reduction in domestic violence.

We see social gradients in domestic violence in rich countries, too. In the US, for example, the “intimate partner victimisation rate” is six times higher – 12.7 per 1,000 women aged over 12 – among households with incomes of less than $7,500than among households earning $50,000 or more. A similar gradient, perhaps not quite as steep, can be seen in England and Wales. Low income, unemployment, and lack of home ownership are all linked with increased risk of being a victim of violence.

The reasons for the social gradient in domestic violence are complex. They include the fact that women lower down the social gradient lack the resources – financial and other – to leave abusive partners. In lower income countries, women who have a higher level of education are more likely to marry and have children later in life and to have fewer children. Women who marry at a young age and have more children are more likely to report having experienced domestic violence.

Conditions of poverty – housing, unemployment and lack of money – are disempowering.

Disempowerment in the household may lead men to commit violence. Indeed, perceived power relationships play a role. Research in Norway showed that a higher level of education or income was only a protective factor where this was equally true of both members in the relationship. Where women earned more than two thirds of the total household income,psychological and physical abuse against the woman was seven times more likely.

Two approaches to domestic violence, then, are to address the inequalities that increase risk and provide quality services for abused women. The current policy climate is adverse.