Association of Ambient Temperature With the Prevalence of Intimate Partner Violence Among Partnered Women in Low- and Middle-Income South Asian Countries

Author:

Zhu Yixiang1,He Cheng123,Bell Michelle4,Zhang Yuqiang5,Fatmi Zafar6,Zhang Ying7,Zaid Maryam1,Bachwenkizi Jovine8,Liu Cong12,Zhou Lu1,Chen Renjie12,Kan Haidong129

Affiliation:

1. School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education, and National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China

2. IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China

3. Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany

4. School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut

5. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Durham

6. Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

7. School of Public Health, University of Sydney, Sydney, New South Wales, Australia

8. Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

9. Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China

Abstract

ImportanceIntimate partner violence (IPV), including physical, sexual, and emotional violence, constitutes a critical public health problem, particularly in low- and middle-income countries. While climate change could escalate violent events, data quantifying its possible association with IPV are scant.ObjectiveTo evaluate the association of ambient temperature with the prevalence of IPV among partnered women in low- and middle-income countries in South Asia, and to estimate the association of future climate warming with IPV.Design, Setting, and ParticipantsThis cross-sectional study used data from the Demographic and Health Survey and included 194 871 ever-partnered women aged 15 to 49 years from 3 South Asian countries (India, Nepal, and Pakistan). The study applied the mixed-effect multivariable logistic regression model to investigate the association of ambient temperature with IPV prevalence. The study further modeled the change in IPV prevalence under various future climate change scenarios. The data included in the analyses were collected from October 1, 2010, to April 30, 2018, and the current analyses were performed from January 2, 2022, to July 11, 2022.ExposureAnnual ambient temperature exposure for each woman, estimated based on an atmospheric reanalysis model of the global climate.Main Outcomes and MeasuresThe prevalence of IPV and its types (physical, sexual, and emotional violence) were assessed based on self-reported questionnaires from October 1, 2010, to April 30, 2018, and the changes in the prevalence with climate changes were estimated through the 2090s.ResultsThe study included 194 871 ever-partnered women aged 15 to 49 years (mean [SD] age, 35.4 [7.6] years; overall IPV prevalence, 27.0%) from 3 South Asian countries. The prevalence of physical violence was highest (23.0%), followed by emotional (12.5%), and sexual violence (9.5%). The annual temperature ranges were mostly between 20 °C and 30 °C. A significant association was found between high ambient temperature and the prevalence of IPV against women, with each 1 °C increase in the annual mean temperature associated with a mean increase in IPV prevalence of 4.49% (95% CI, 4.20%-4.78%). According to the study’s projections under the unlimited emissions scenarios (SSPs [shared socioeconomic pathways], as defined by the Intergovernmental Panel on Climate Change] 5-8.5), IPV prevalence would increase by 21.0% by the end of the 21st century, while it would only moderately increase under increasingly stricter scenarios (SSP2-4.5 [9.8%] and SSP1-2.6 [5.8%]). In addition, the projected increases in the prevalence of physical (28.3%) and sexual (26.1%) violence were greater than that of emotional violence (8.9%). In the 2090s, India was estimated to experience the highest IPV prevalence increase (23.5%) among the 3 countries, compared with Nepal (14.8%) and Pakistan (5.9%).Conclusions and RelevanceThis cross-sectional, multicountry study provides ample epidemiological evidence to support that high ambient temperature may be associated with the risk of IPV against women. These findings highlight the vulnerabilities and inequalities of women experiencing IPV in low- and middle-income countries in the context of global climate warming.

Publisher

American Medical Association (AMA)

Subject

Psychiatry and Mental health

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