Domestic Violence and Chronic Malnutrition among Women and Children in India

Abstract

Domestic violence has harmful physical and psychological health correlates, but there is little evidence regarding a relation between domestic violence and malnutrition. To investigate this relation, the authors analyzed data from 69,072 women aged 15-49 years and 14,552 children aged 12-35 months in the 1998-1999 Indian National Family Health Survey. Physical domestic violence victimization was self-reported by the women. Aspects of nutritional status included in this study were anemia and underweight. Anemia was measured with a blood test for hemoglobin. Underweight was calculated from anthropometric measurements and was determined as body mass index for women, and it included stunting and wasting for children. Results indicate associations of multiple incidents of domestic violence in the previous year with anemia (odds ratio = 1.11, 95% confidence interval: 1.04, 1.18) and underweight (odds ratio = 1.21, 95% confidence interval: 1.13, 1.29) in women and a suggested relation among children. Possible mechanisms for this relation include withholding of food as a form of abuse and stress-mediated influences of domestic violence on nutritional outcomes. These findings indicate that reducing domestic violence is important not only from a moral and intrinsic perspective but also because of the instrumental health benefits likely to accrue.

Effect of physical intimate partner violence on body mass index in low-income adult women

“…As seen above, our data showed an important negative association between physical intimate partner violence and BMI. This finding corroborates at least two of the four studies that addressed the theme 16,17 , besides suggesting a different picture from that found in studies focusing on the repercussions of witnessing intimate violence in childhood and violence against children and adolescents, by refuting the alternative hypothesis that physical intimate partner violence is a risk factor for weight gain.…”

“…The lack of consensus in the literature may result from the fact that the current study and those by Sethuraman et al 16 and Ackerson & Subramanian 17 , conducted in India, specifically and exclusively assessed intimate partner violence of the physical type, while the other two studies focused on intimate partner violence in its different manifestations. Although they also used CTS2 27 to characterize violence in the study on Egyptian women, Yount & Li 14 explored psychological, physical, and sexual violence jointly, thus hindering a more accurate conclusion on the specific effect of physical violence.…”

“…Another explanation for the conflicting results would be that the relations between intimate partner violence and the woman's nutritional status depend on the study population's socioeconomic context. The current study and those by Sethuraman et al 16 and Ackerson & Subramanian 17 , in India, were conducted in low-income and low-schooling populations, unlike the studies in Egypt and the United States, which worked mainly with middle-income populations.…”

“…According to Ackerson & Subramanian 17 , the negative association between physical intimate partner violence and BMI results from the physically violent partner's intent to withhold food as a form of psychological abuse, ultimately preventing the woman from maintaining normal nutritional status. One can also conjecture that chronic daily stress for a poor woman suffering violence would lead to sleep disorders, alcohol and drug abuse, smoking, and reduced food intake 1,14,40 .…”

“…The first focused on women (n = 747) in poor rural and tribal communities in southern India, showing an association between underweight and psychological abuse and sexual coercion 16 . The other, based on the Indian National Family Health Survey and including 69,072 women, showed an association between malnutrition and physical intimate partner violence 17 .…”