Cumulative Lifetime Violence Severity: Does it Make a Difference to the Health of Canadian Men?

Abstract

Background and Objective: Interpersonal violence is a major public health problem that is among the top 25 causes of years of life lost worldwide. But how cumulative lifetime violence affects the health of men has received little attention. Our objective was to explore differences in men’s health and health behaviors according to cumulativelifetime violence severity as target and/or perpetrator in a community sample of Canadian men.
 Materials and Methods: Data are from a convenience community sample of 590 men, ages 19 to 65, who completed an online survey for the Men’s Violence, Gender and Health Study(MVGHS). The survey included questions about social location, health behaviours, and health status. Validated measures of depression, anxiety, chronic pain, posttraumatic stress disorder and alcohol use also were included. Perceived cumulative lifetime violence severity (LVS) was measured with 64 study-specific items. Based on the median LVS score, the sample was divided into two groups, lower and higher LVS, and compared for significant differences on social location, health behavior, and health variables. Using logistic regression, odds ratios for higher LVS and three selected health outcomes (depression, chronic pain, daily cannabis use) were calculated and adjusted for potential confounders.
 Results: On most measures, men with higher LVS had significantly poorer health than those with lower LVS. Alcohol use was not significantly different between groups but was higher than expected for all men. Those with higher LVS had significant odds ratios for depression (OR= 3.71;CI= 2.59, 5.31), daily cannabis use (OR= 3.20;CI= 2.07, 4.92) and chronic pain (OR= 3.19;CI= 1.98, 5.14). In odds ratio models adjusted for confounders, higher LVS remained significant only for daily cannabis use (aOR= 2.07; CI = 1.23, 3.43) and other significant aORsincluded current smoking, unemployment and difficulty living on current income. In the depression and chronic pain models, common indicators of dysregulation of the body’s natural stress response by violence severity, posttraumatic stress disorder and anxiety respectively, were significant predictors. Number of chronic health problems and being overwhelmed by daily stress frequently were also significant in the depression model. For chronic pain, number of chronic health problems and injury with permanent disability were both significant predictors.
 CONCLUSIONS: These findings provide some of the first comparative evidence from a community sample that men with higher cumulativelifetime violence severityare more likely to have poorer health than men with lower LVS. The adjusted models suggest more complex relationships among higher LVS and health outcomes that indicate the need for further exploration of how biophysical consequences of violence, social location and/or comorbidities may moderate or mediate how cumulative violence severity affects men’s health.

Patterns and correlates of cannabis use by cumulative lifetime violence severity as target and/or perpetrator in a community sample of eastern Canadian men

“…Despite violence exposure not being a criterion for taking part in this study, 97.5% of participants reported experiences of violence on the CLVS scale. This high prevalence is consistent with violence being a major public health problem for men (Haegerich and Hall 2011) and may be attributed to the CLVS scale measuring a comprehensive range of violence experiences as target and/or perpetrator across the lifespan (Scott-Storey et al 2018). Nonetheless, applicability of findings may be limited to men living primarily in widely dispersed medium-sized cities, towns, and rural areas similar to the province of NB.…”

“…After receiving approval from the Research Ethics Board of the affiliated university and informed consent from each participant, we collected data for the MVGHS using an online survey with a community convenience sample of individuals who self-identified as men, were ages 19 to 65 years, and lived in NB (Scott-Storey et al 2018 ). Exposure to violence in one’s lifetime was not an inclusion criterion for taking part.…”

“…There are no such studies of which we are aware, possibly because no measure of lifetime cumulative violence existed. To address this limitation we developed the Cumulative Lifetime Violence Severity (CLVS) scale (Scott-Storey et al 2018 ).…”

“…The Men’s Violence, Gender and Health Study (MVGHS) was designed to explore differences in men’s health according to lifetime cumulative violence (Scott-Storey et al 2018 ). We conducted the MVGHS in New Brunswick (NB), Canada from April 2016 to September 2017, prior to cannabis legalization for non-medical use, in a community sample of 589 men and measured CLVS and cannabis use in the past 12 months as well as a range of other socio-demographic and health indicators.…”

Cumulative lifetime violence severity scale: development and initial testing among men

“…Despite accumulating evidence that violence is adversely related to health, knowledge of this complex relationship is flawed by narrow conceptualization and measurement of violence in health research [1]. There is urgent need to consider how health is affected by the accumulation of co-occurring and interconnecting multiple experiences of violence across the lifespan as perpetrator and target [2][3][4]. Yet measurement primarily relies on presence/absence or frequency of one or two types (i.e., physical, psychological, sexual) or contexts (intimate partner relationships, workplaces, families) at a particular point in time (e.g., childhood, adulthood) and ignores other dimensions of violence severity [5,6].…”