Elsevier

The Lancet

Volume 359, Issue 9315, 20 April 2002, Pages 1423-1429
The Lancet

Series
Intimate partner violence: causes and prevention

https://doi.org/10.1016/S0140-6736(02)08357-5Get rights and content

Summary

Unlike many health problems, there are few social and demographic characteristics that define risk groups for intimate partner violence. Poverty is the exception and increases risk through effects on conflict, women's power, and male identity. Violence is used as a strategy in conflict. Relationships full of conflict, and especially those in which conflicts occur about finances, jealousy, and women's gender role transgressions are more violent than peaceful relationships. Heavy alcohol consumption also increases risk of violence. Women who are more empowered educationally, economically, and socially are most protected, but below this high level the relation between empowerment and risk of violence is nonlinear. Violence is frequently used to resolve a crisis of male identity, at times caused by poverty or an inability to control women. Risk of violence is greatest in societies where the use of violence in many situations is a socially-accepted norm. Primary preventive interventions should focus on improving the status of women and reducing norms of violence, poverty, and alcohol consumption.

Section snippets

Social and demographic characteristics

With the exception of poverty, most demographic and social characteristics of men and women documented in survey research are not associated with increased risk of intimate partner violence. Age, for example, has occasionally been noted to be a risk factor for such violence, with a greater risk attached to youth,18, 19 but in most research a relation with age of either partner has not been seen.7, 9, 11, 20 Similarly, age at marriage is not an associated factor.11

Intimate partner violence is

Poverty

Poverty and associated stress are key contributors to intimate partner violence. Although violence occurs in all socioeconomic groups, it is more frequent and severe in lower groups across such diverse settings as the USA, Nicaragua, and India.8, 11, 18, 19, 20, 24 An influential theory explaining the relation between poverty and intimate partner violence is that it is mediated through stress. Since poverty is inherently stressful, it has been argued that intimate partner violence may result

Poverty, power, and sex identity

Within any setting ideas vary on what it means to be a man and what constitutes successful manhood.30 Gelles25 first postulated that the link between violence and poverty could be mediated through masculine identity. He argued that men living in poverty were unable to live up to their ideas of “successful” manhood and that, in the resulting climate of stress, they would hit women. Some social scientists have become especially interested in the effect of poverty on male identity and relations

Women and power

High levels of female empowerment seem to be protective against intimate partner violence, but power can be derived from many sources such as education, income, and community roles and not all of these convey equal protection or do so in a direct manner. In many studies, high educational attainment of women was associated with low levels of violence.5, 7, 11, 21, 39, 40 The same finding has been noted for men. Education confers social empowerment via social networks, self-confidence, and an

Relationship conflict

The frequency of verbal disagreements and of high levels of conflict in relationships are strongly associated with physical violence.6, 7, 21, 46 Violence is often deployed as a tactic in relationship conflict21 as well as being an expression of frustration or anger.35 Not surprisingly, marital instability—ie, a partner considering leaving the marriage—is a time of especial risk of violence.47, 48 Women who leave relationships are afterwards more at risk of stalking,2, 49 murder, and attempted

Alcohol

Alcohol consumption is associated with increased risk of all forms of interpersonal violence.51, 52 Heavy alcohol consumption by men (and often women)7 is associated with intimate partner violence,6, 9, 53 if not consistently.6 Alcohol is thought to reduce inhibitions, cloud judgment, and impair ability to interpret social cues.54 However, biological links between alcohol and violence are complex.55 Research on the social anthropology of alcohol drinking suggests that connections between

Social norms

Many researchers have discussed intimate partner violence as a learned social behaviour for both men and women. The intergenerational cycling of violence has been documented in many settings. The sons of women who are beaten are more likely to beat their intimate partners8, 10 and, in some settings, to have been beaten themselves as children. The daughters of women who are beaten are more likely to be beaten as adults.7, 20 Women who are beaten in childhood by parents are also more likely to be

Conclusions and implications for prevention

The causes of intimate partner violence are complex. However, two factors seem to be necessary in an epidemiological sense: the unequal position of women in a particular relationship (and in society) and the normative use of violence in conflict. Without either of these factors, intimate partner violence would not occur. These factors interact with a web of complementary factors to produce intimate partner violence (figure 3). The figure shows how ideologies of male superiority legitimise

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