Can evidence drive health equity in the COVID-19 pandemic and beyond?

Using scoping review methods, we systematically searched multiple online databases for publications in the first year of the pandemic that proposed pragmatic population or health system-level solutions to health inequities. We found 77 publications with proposed solutions to pandemic-related health inequities. Most were commentaries, letters, or editorials from the USA, offering untested solutions, and no robust evidence on effectiveness. Some of the proposed solutions could unintentionally exacerbate health inequities. We call on health policymakers to co-create, co-design, and co-produce equity-focussed, evidence-based interventions with communities, focussing on those most at risk to protect the population as a whole. Epidemiologists collaborating with people from other relevant disciplines may provide methodological expertise for these processes. As epidemiologists, we must interrogate our own methods to avoid propagating any unscientific biases we may hold. Epidemiology must be used to address, and never exacerbate, health inequities-in the pandemic and beyond.

Ethnic-specific prevalence rates of intimate partner violence against women in New Zealand.

OBJECTIVE: This study presents age-standardised ethnic-specific prevalence rates of intimate partner violence against women in New Zealand, by physical and/or sexual intimate partner violence, psychological intimate partner violence, controlling behaviours and economic abuse. METHODS: Data are from 1,431 ever-partnered women in the representative and cross-sectional He Koiora Matapopore, the 2019 New Zealand Family Violence Study. RESULTS: High lifetime prevalence of intimate partner violence is present across all ethnic groups in NZ, with over half of all women reporting any intimate partner violence (55.8%). Substantial ethnic disparities exist in intimate partner violence rates, with Maori women reporting the highest prevalence of intimate partner violence (64.6%), followed by NZ European women (61.6%). CONCLUSIONS: Intimate partner violence prevention and intervention services are needed at the population-level, and services must be culturally responsive and attuned to the needs of communities that bear the greatest burden. IMPLICATIONS FOR PUBLIC HEALTH: Ethnic differences in intimate partner violence prevalence likely contribute to health disparities at the population-level, reinforcing calls for prevention and necessitating healthcare systems to be culturally informed and mobilised to address intimate partner violence as a priority health issue.

Simulating carbon accumulation and loss in the central Congo peatlands.

Peatlands of the central Congo Basin have accumulated carbon over millennia. They currently store some 29 billion tonnes of carbon in peat. However, our understanding of the controls on peat carbon accumulation and loss and the vulnerability of this stored carbon to climate change is in its infancy. Here we present a new model of tropical peatland development, DigiBog_Congo, that we use to simulate peat carbon accumulation and loss in a rain-fed interfluvial peatland that began forming ~20,000 calendar years Before Present (cal. yr BP, where 'present' is 1950 CE). Overall, the simulated age-depth curve is in good agreement with palaeoenvironmental reconstructions derived from a peat core at the same location as our model simulation. We find two key controls on long-term peat accumulation: water at the peat surface (surface wetness) and the very slow anoxic decay of recalcitrant material. Our main simulation shows that between the Late Glacial and early Holocene there were several multidecadal periods where net peat and carbon gain alternated with net loss. Later, a climatic dry phase beginning ~5200 cal. yr BP caused the peatland to become a long-term carbon source from ~3975 to 900 cal. yr BP. Peat as old as ~7000 cal. yr BP was decomposed before the peatland's surface became wetter again, suggesting that changes in rainfall alone were sufficient to cause a catastrophic loss of peat carbon lasting thousands of years. During this time, 6.4 m of the column of peat was lost, resulting in 57% of the simulated carbon stock being released. Our study provides an approach to understanding the future impact of climate change and potential land-use change on this vulnerable store of carbon.

Evidence of Gender Asymmetry in Intimate Partner Violence Experience at the Population-Level.

Claims of "gender symmetry" in intimate partner violence (IPV) prevalence are contested, with resolution of the issue complicated by methodological and measurement challenges. This study explores gendered differences in the distribution of IPV exposure at the population-level, considering multiple types of IPV exposure. The subjects comprised of 1,431 ever-partnered women and 1,355 ever-partnered men. Data from a nationally representative population-based cross-sectional survey were used to compare men and women's IPV experiences. Twenty-three IPV acts were assessed across IPV types (moderate physical, severe physical, sexual, psychological, controlling behaviors, economic). Proportions were presented by gender for the number of individual IPV acts experienced per IPV type, and the frequency of these acts (none, once, few times, or many times). A composite exposure score was developed to assess the number of acts and their frequency within types by comparing scores in tertiles and across types by correlations. Women reported greater overall prevalence of 20 of the 23 individual IPV acts assessed. Across all assessed acts, women comprised a substantially greater proportion of those who reported experiencing individual acts "many times." Women experienced more severe and more frequent IPV than men based on self-reported experience of IPV acts, and by the frequency with which acts were experienced. Significant differences between men and women's exposure scores were observed for all six assessed types, with greater proportions of women scoring in the upper tertiles. This study provides evidence of gender asymmetry in experiences of IPV at the population level. While men do experience IPV victimization, there remains need for directed and substantial resource allocation for intervention and therapeutic responses to women's exposure to IPV, and for primary prevention with men. Going forward, IPV measurement tools that consider frequency, severity, or co-occurring types of IPV are needed.

Association Between Women's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand.

Importance: Intimate partner violence (IPV) is increasingly recognized as a contributing factor for long-term health problems; however, few studies have assessed these health outcomes using consistent and comprehensive IPV measures or representative population-based samples. Objective: To examine associations between women's lifetime IPV exposure and self-reported health outcomes. Design, Setting, and Participants: The cross-sectional, retrospective 2019 New Zealand Family Violence Study, adapted from the World Health Organization's Multi-Country Study on Violence Against Women, assessed data from 1431 ever-partnered women (63.7% of eligible women contacted) in New Zealand. The survey was conducted from March 2017 to March 2019, across 3 regions, which accounted for approximately 40% of the New Zealand population. Data analysis was performed from March to June 2022. Exposures: Exposures were lifetime IPV by types (physical [severe/any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types. Main Outcomes and Measures: Outcome measures were poor general health, recent pain or discomfort, recent pain medication use, frequent pain medication use, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Weighted proportions were used to describe the prevalence of IPV by sociodemographic characteristics; bivariate and multivariable logistic regressions were used for the odds of experiencing health outcomes by IPV exposure. Results: The sample comprised 1431 ever-partnered women (mean [SD] age, 52.2 [17.1] years). The sample was closely comparable with New Zealand's ethnic and area deprivation composition, although younger women were slightly underrepresented. More than half of the women (54.7%) reported any lifetime IPV exposure, of whom 58.8% experienced 2 or more IPV types. Compared with all other sociodemographic subgroups, women who reported food insecurity had the highest IPV prevalence for any IPV (69.9%) and all specific types. Exposure to any IPV and specific IPV types was significantly associated with increased likelihood of reporting adverse health outcomes. Compared with those unexposed to IPV, women who experienced any IPV were more likely to report poor general health (adjusted odds ratio [AOR], 2.02; 95% CI, 1.46-2.78), recent pain or discomfort (AOR, 1.81; 95% CI, 1.34-2.46), recent health care consultation (AOR, 1.29; 95% CI, 1.01-1.65), any diagnosed physical health condition (AOR, 1.49; 95% CI, 1.13-1.96), and any mental health condition (AOR, 2.78; 95% CI, 2.05-3.77). Findings suggested a cumulative or dose-response association because women who experienced multiple IPV types were more likely to report poorer health outcomes. Conclusions and Relevance: In this cross-sectional study of women in New Zealand, IPV exposure was prevalent and associated with an increased likelihood of experiencing adverse health. Health care systems need to be mobilized to address IPV as a priority health issue.

Association Between Men's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand.

Importance: Health implications of intimate partner violence (IPV) against men is relatively underexplored, although substantial evidence has identified associations between IPV and long-term physical health problems for women. Given the gendered differences in IPV exposure patterns, exploration of men's IPV exposure and health outcomes using population-based samples is needed. Objective: To assess the association between men's lifetime IPV exposure and self-reported health outcomes. Design, Setting, and Participants: This cross-sectional study analyzed data from the 2019 New Zealand Family Violence Study, which was conducted across 3 regions of New Zealand. The representative sample included ever-partnered men aged 16 years or older. Data analysis was performed between May and September 2022. Exposures: Lifetime IPV against men by types (physical [severe or any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types experienced. Main Outcomes and Measures: The 7 health outcomes were poor general health, recent pain or discomfort, recent use of pain medication, frequent use of pain medication, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Results: The sample comprised 1355 ever-partnered men (mean [SD] age, 51.3 [16.9] years), who predominantly identified as heterosexual (96.9%; 95% CI, 95.7%-97.8%). Half of the sample (49.9%) reported experiencing any lifetime IPV, of whom 62.1% reported at least 2 types. Of all sociodemographic subgroups, unemployed men had the greatest prevalence of reporting exposure to any IPV (69.2%) and all IPV types. After adjustment for sociodemographic factors, men's exposure to any lifetime IPV was associated with an increased likelihood of reporting 4 of the 7 assessed health outcomes: poor general health (adjusted odds ratio [AOR], 1.78; 95% CI, 1.34-2.38), recent pain or discomfort (AOR, 1.65; 95% CI, 1.21-2.25), recent use of pain medication (AOR, 1.27; 95% CI, 1.00-1.62), and any diagnosed mental health condition (AOR, 1.66; 95% CI, 1.11-2.49). Specific IPV types were inconsistently associated with poor health outcomes. Any physical IPV exposure was associated with poor general health (AOR, 1.80; 95% CI, 1.33-2.43), recent pain or discomfort (AOR, 2.23; 95% CI, 1.64-3.04), and frequent use of pain medication (AOR, 1.69; 95% CI, 1.08-2.63), which appeared to be associated with exposure to severe physical IPV. Exposure to sexual IPV, controlling behaviors, and economic abuse was not associated with any assessed outcomes after sociodemographic adjustment. Experience of a higher number of IPV types did not show a clear stepwise association with number of health outcomes. Conclusions and Relevance: Results of this study indicate that exposure to IPV can adversely affect men's health but is not consistently a factor in men's poor health at the population level. These findings do not warrant routine inquiry for IPV against men in clinical settings, although appropriate care is needed if IPV against men is identified.

Which Aspects of Social Support Enhance Positive Mental Health in the Context of Intimate Partner Violence?

While there is evidence that social support can mitigate mental illness symptoms associated with intimate partner violence (IPV), there is a need to explore if social support can promote positive mental health. In this New Zealand (NZ) population-based study of women who had experienced physical and/or sexual violence (n = 453), structural equation modeling (SEM) showed that most facets of social support (friends, family, and neighbors) had a significant correlation with each dimension of positive mental health, as measured by Keyes' Mental Health Continuum Short Form (MHC-SF). Safety from IPV (no recent IPV experience) is a prerequisite before social support can assist women to attain positive mental health. Further work is required to ensure friends, family, and communities have the knowledge and resources to provide effective social support.

Hydroclimatic vulnerability of peat carbon in the central Congo Basin.

The forested swamps of the central Congo Basin store approximately 30 billion metric tonnes of carbon in peat1,2. Little is known about the vulnerability of these carbon stocks. Here we investigate this vulnerability using peat cores from a large interfluvial basin in the Republic of the Congo and palaeoenvironmental methods. We find that peat accumulation began at least at 17,500 calibrated years before present (cal. yr BP; taken as AD 1950). Our data show that the peat that accumulated between around 7,500 to around 2,000 cal. yr BP is much more decomposed compared with older and younger peat. Hydrogen isotopes of plant waxes indicate a drying trend, starting at approximately 5,000 cal. yr BP and culminating at approximately 2,000 cal. yr BP, coeval with a decline in dominant swamp forest taxa. The data imply that the drying climate probably resulted in a regional drop in the water table, which triggered peat decomposition, including the loss of peat carbon accumulated prior to the onset of the drier conditions. After approximately 2,000 cal. yr BP, our data show that the drying trend ceased, hydrologic conditions stabilized and peat accumulation resumed. This reversible accumulation-loss-accumulation pattern is consistent with other peat cores across the region, indicating that the carbon stocks of the central Congo peatlands may lie close to a climatically driven drought threshold. Further research should quantify the combination of peatland threshold behaviour and droughts driven by anthropogenic carbon emissions that may trigger this positive carbon cycle feedback in the Earth system.

Family violence experts in the criminal court: the need to fill the void.

This paper describes the role of family violence expert evidence and argues for the need for adequately trained and experienced specialists to provide that evidence within the criminal jurisdiction of the District Court and High Court in Aotearoa New Zealand. Court processes for the criminal jurisdiction were reviewed to consider the roles and the requirements of expert witnesses in cases of family violence. Given the lack of expert witness training in Aotearoa New Zealand, components of best practice in other jurisdictions, including examples of international expert witness skills and knowledge were sought. Unique skills and experience are necessary for an accurate description of a history of family violence. Experience working with survivors and offenders provides an understanding of the nature and dynamics of violence experienced within a relationship and allows experts to address myths and misconceptions, particularly in relation to the effective nature of the current family violence safety system. Without a contemporary, comprehensive understanding of family violence across police prosecution, judges and lawyers, expert evidence from trained and experienced specialists is required. To enhance the educative role of family violence expert evidence, such evidence should be called by the Court.

Gender Patterns in the Use of Physical Violence Against a Violent Partner: Results of a Cross-Sectional Population-Based Study in New Zealand.

We examine gendered patterns in the use of violence in response to the partner's violence ("fighting back"). Within each gender, we examined if socio-demographic differences in prevalence were present, and if contextual factors influenced the use of violence against a violent partner. Data from a large, population-based sample of New Zealand adults was used to identify ever-partnered respondents who had experienced physical IPV (n = 407 women, and n = 391 men). Weighted percentages and 95% confidence intervals (95%CIs) were calculated for the use of violence against a violent partner, stratified by gender. Multivariable logistic regression was used to assess the association between each contextual risk factors and the use of violence against a violent partner. For both men and women, at the multivariable level, use of violence against a violent partner was associated with contextual factors related to the abuse. However, for almost all of these variables a higher proportion of women than men experienced the risk factor; for example, a higher proportion of women than men reported having experienced severe IPV (57.6% women; 43.7% men), injuries resulting from IPV (44.5% women, 15.0% men), and fear of a partner (22.7% women, 4.9% men). Women were also more likely to report experiencing other types of IPV (particularly sexual IPV) and were more likely to report that their children were present at the time of violence. These factors contributed to the higher proportion of women who reported fighting back at least once (53.4% of women and 22.3% of men). Health, social, and legal services need to conduct appropriate and thorough assessment of nature and context (current and historical) of the violence that individuals have been exposed to as part of service provision. Assessments need to be carried out with a gender-lens in order to provide comprehensive and appropriate responses.

Prevalence of interpersonal violence against women and men in New Zealand: results of a cross-sectional study.

OBJECTIVE: To determine prevalence rates of non-partner and partner violence (IPV) in men and women from a population-based study. METHODS: We recruited 2,887 randomly selected respondents (1,464 women and 1,423 men) from three regions of New Zealand between 2017 and 2019. Face-to-face interviews using a questionnaire adapted from the WHO multi-country study on violence against women was used for data collection. RESULTS: Physical violence by non-partners was most commonly experienced by men (39.9% lifetime exposure) compared with 11.9% of women. More women (8.2%) experienced lifetime non-partner sexual violence compared with men (2.2%). About 29% of men and women reported at least one act of physical-IPV in their lifetime, and about 12.4% of women and 2.1% of men reported at least one act of lifetime sexual IPV. More women than men reported serious injuries, fear, and physical and mental health impacts following IPV experience. CONCLUSIONS: These findings indicate high prevalence of interpersonal violence exposure in the population, with marked gender differences in the types and impacts of violence reported. IMPLICATIONS FOR PUBLIC HEALTH: Study results call for the urgent implementation of violence prevention programs, and funding for both services to rehabilitate people who have perpetrated violence and services to support recovery of those affected.

Missing cases of injury death: use of quantitative methods and case reviews to inform future improvements in case definition.

BACKGROUND: Knowledge of fatal injuries is required to inform prevention activities. Where hospital patients with an injury principal diagnosis (PDx) died and were certified to a medical underlying cause of death (UCoD), there is the potential to underestimate injury mortality. We sought to characterise injury/non-injury (NI) mismatches between PDx and UCoD by identifying which subgroups had small/large mismatches, and to understand why mismatches had occurred using informative examples. METHOD: Hospital records (n=10 234) with a PDx of injury were linked to the mortality collection using a unique personal identifier. Percentages UCoD coded to a NI were tabulated, for three follow-up periods and by selected variables. Additionally, we reviewed a sample of 70 records for which there was a mismatch. RESULTS: %NIs were 39%, 66% and 77% for time from injury to death of <1 week, <90 days and <1 year, respectively. Variations in %NI were found for all variables. Illustrative examples of 70 medical UCoD deaths showed that for 12 cases the injury event was unequivocally judged to have resulted in premature death. A further 16 were judged as injury deaths using balance of probability arguments. CONCLUSION: There is variation in rates of mismatch between PDx of injury and UCoD of NI. While legitimate reasons exist for mismatches in certain groups, a material number of injury deaths are not captured using UCoD alone; a new operational definition of injury death is needed. Early solutions are proposed. Further work is needed to investigate operational definitions with acceptable false positive and negative detection rates.

Getting the Story Right: Reflecting on an Indigenous Rubric to Guide the Interpretation of Mortality Data.

The Family Violence Death Review Committee (FVDRC) is one of five Mortality Review Committees (MRCs) that sit within the Health Quality & Safety Commission, Aotearoa, New Zealand. A key goal of the work of these committees is the reduction of the unequal burden of disparities shouldered by Maori (Indigenous peoples). Guidance to the committees on interpreting and reporting Maori mortality comes from Te Pou (the pillar/post), a Maori responsiveness rubric published in 2019 by Nga Pou Arawhenua (the caucus of Maori MRC members). This guidance was called upon by the FVDRC in the preparation of its sixth report, "Men who use violence," published in 2020. In this article, the FVDRC reflects on how it strove to uphold responsibilities toward Te Titiriti o Waitangi1 in its sixth report to get the story right (Tika-to be correct or true), be culturally and socially responsive (Manaakitanga-hospitability, kindness, support), advance equity, self-determination and social justice (Mana-prestige, authority, spiritual power), and establish relationship for positive change (Mahi Tahi-working together). Opportunities for improved responsiveness in FVDRC reporting are identified, alongside suggestions for extending the guidance in Te Pou. Reflective practice on responsiveness to Maori/Indigenous peoples is recommended more generally for MRCs.

Social-Level Factors Related to Positive Mental Health Outcomes Following Intimate Partner Violence: Results from a Population-Based Aotearoa New Zealand Sample.

Intimate partner violence (IPV) continues to be an issue for women globally. There remains a gap in research about what contributes to better mental health following IPV. The sociodemographic characteristics and other factors associated with positive mental health were explored among a sample of 454 women aged 16 years and over who reported previous exposure to physical and/or sexual IPV. Sixty-six percent of women reported positive mental health. The cessation of violence, support at disclosure, and ongoing informal support were factors significantly associated with positive mental health. Greater community outreach to improve responses to disclosure and practical support is needed.

Relational Mobility and Other Contributors to Decline in Intimate Partner Violence.

This study explored whether changes in risk and protective factors of intimate partner violence (IPV) can account for the noted reduction in 12-month IPV prevalence in New Zealand between 2003 and 2019. Changes in relational mobility over time were also explored. Data from two population-based surveys of 18-64 year-old ever-partnered women in New Zealand that were conducted according to identical procedures in 2003 (n=2764) and 2019 (n=944) were used. Changes in a variety of potential risk and protective factors over time and their possible contribution to IPV reduction were assessed. The findings indicated that there was no change in the prevalence of the strongest risk and protective factors of IPV victimisation and perpetration over time (e.g. partner concurrent relationship, previous exposure to violence for both respondent and partner, and partner's problematic alcohol/drug use). However, a combination of factors including decline in women's problematic alcohol or drug use, decline in the number of children within families, and increases in the proportion of women and partners with a qualification higher than secondary education are likely to be associated with the reduction in IPV prevalence. A greater degree of relational mobility, demonstrated through a greater proportion of women who left their abusive partner permanently and increased numbers of relationships that women had, was also observed between two study years. Overall, these results indicate that changes in 12-month IPV prevalence over time are likely to be linked with changes that increase women's autonomy and ability to move out of violent relationships. To achieve sustained reductions in IPV, more comprehensive and planned efforts are needed to address other underlying and exacerbating causes, including problematic alcohol/drug use and previous exposure to violence during childhood and adulthood.

Factors influencing help-seeking by those who have experienced intimate partner violence: Results from a New Zealand population-based study.

BACKGROUND: There is limited information about what influences help-seeking following experience of intimate partner violence (IPV). This study investigated determinants of formal and informal help-seeking by those who had experienced lifetime physical, sexual or psychological IPV. METHODS: A cross-sectional population-based New Zealand study conducted from 2017 to 2019 recruited 2,887 participants (1,464 women and 1,423 men) aged 16 years and older. Face-to-face interviews were conducted. Of these, 1,373 participants experienced physical, sexual or psychological IPV. Two series of logistic regressions were conducted: 1) comparing those who sought help with those who did not, and 2) comparing those who had not sought help with those who sought informal help only, or with those who also sought formal help. RESULTS: Of the 1,373 participants who reported experience of physical, sexual or psychological IPV 835 participants (71.3% of women and 49.0% of men) sought some form of help. In both genders self-reported physical and mental health or work-related IPV impacts were significantly associated with help-seeking. Experiencing only one form of IPV was associated with lower odds of seeking formal help by women (Adjusted odds ratio = 0.38; 95%CI = 0.15, 0.92 for physical/sexual only and AOR = 0.37, 95%CI = 0.22, 0.64 for psychological only) compared to those experiencing concurrent types of IPV. CONCLUSION AND IMPLICATIONS: Although there were gender differences in help-seeking, for both women and men the experience of greater impacts associated with IPV exposure increased the likelihood of help-seeking. Agencies providing services for people who are experiencing IPV need to be equipped to identify and respond to multiple forms of IPV, and prepared to address the suite of impacts experienced.

Exploring the health burden of cumulative and specific adverse childhood experiences in New Zealand: Results from a population-based study.

BACKGROUND: Adverse childhood experiences (ACEs) can influence later health, but there are gaps in understanding how ACEs may interact with Positive Childhood Experiences (PCEs). Additionally, there are gaps in understanding how ACEs impact on positive markers of health. OBJECTIVES: To explore associations of ACEs with both negative and positive markers of physical and mental health in adulthood and to examine whether positive childhood experiences (PCEs) can mitigate the negative effects of ACEs on health. PARTICIPANTS AND SETTING: 2887 participants (1464 female, 1423 male) from the 2019 New Zealand Family Violence Survey, a population-based study conducted in New Zealand between March 2017-March 2019. METHODS: Multivariable logistic regressions were conducted to ascertain how both ACE score and ACE subtypes influenced the odds of experiencing adverse and positive mental and physical health after adjusting for socio-demographic predictors. A combined ACE-PCE variable was created and included in the multivariable logistic regression models to examine whether PCEs can mitigate the negative effects of ACEs. RESULTS: Findings indicated that respondents with higher ACE scores had an increased likelihood of reporting each adverse outcome. Higher ACE scores had the strongest association with poor mental health followed by disability and chronic physical health conditions. Respondents with higher ACE scores had a decreased likelihood of reporting each positive health outcome. Exposure to ACEs was detrimental to health even in the presence of PCEs, with minimal effects observed from PCEs given the limited variance observed from its assessment. CONCLUSION: This study documents the deleterious impacts of ACEs on a wide range of health outcomes and demonstrates that these effects are persistent. Findings should provide the impetus for widespread prevention and intervention initiatives that seek to address ACEs. Further exploration of PCEs with a more complete assessment is needed to determine if they can mitigate the detrimental consequences of ACEs.

Lifetime Prevalence of Intimate Partner Violence and Disability: Results From a Population-Based Study in New Zealand.

INTRODUCTION: There is no population-based study on prevalence rates for all forms of intimate partner violence experienced by people with different types of disabilities in New Zealand. This study compares the reported lifetime prevalence of intimate partner violence (physical, sexual, psychological, controlling behaviors, and economic abuse) for people with different types of disabilities with that reported by those without disabilities and tests whether there is a gender difference. METHODS: From March 2017 to March 2019, a total of 2,888 women and men aged ≥16 years participated in a cross-sectional study in New Zealand using a cluster random sampling method. Face-to-face interviews were used for data collection. The WHO Multi-country Study questionnaire was employed as the data collection tool. Logistic regression was conducted, and AORs were reported. RESULTS: Those with any disability reported significantly higher rates of most forms of intimate partner violence than those without disabilities, among both genders, including physical intimate partner violence (AOR=1.80, 95% CI=1.32, 2.47 for women, AOR=2.44, 95% CI=1.72, 3.45 for men) and psychological and economic abuse. Women with disabilities were more likely to report experiences of sexual intimate partner violence than men (range =13.5-17.1% vs 4.0%-21.2% in men). Men with intellectual disability were more likely to report physical intimate partner violence than women with intellectual disability (60.5% in men and 36.0% in women). CONCLUSIONS: People with disabilities report experiencing a significantly high lifetime prevalence of intimate partner violence compared with people without disabilities. The results warrant policy and practice changes to identify early signs of abuse and intervene accordingly and warrant an investment in targeted violence prevention programs.

Prevalence of Nonpartner Physical and Sexual Violence Against People With Disabilities.

INTRODUCTION: This study aims to determine the prevalence rates of nonpartner physical and sexual violence in men and women with different disabilities compared with those in people without disabilities. METHODS: Face-to-face interviews were conducted in 3 regions of New Zealand (2017-2019), and 2,887 randomly selected respondents participated (1,464 women, 1,423 men). Respondents provided information on the disability types (physical, intellectual, psychological, none) experienced and on the experience of physical and sexual violence since age 15 years. Analysis was conducted in 2020-2021. RESULTS: More people with disabilities reported nonpartner physical and sexual violence experience than those without disabilities. For women, 15.4% of those with disabilities experienced lifetime nonpartner physical violence, and 11.1% experienced lifetime nonpartner sexual violence. For men with disabilities, 56.2% experienced lifetime nonpartner physical violence, and 5.6% experienced lifetime nonpartner sexual violence. Women and men with psychological disabilities reported the highest prevalence rates of nonpartner physical and sexual violence. The main perpetrators of nonpartner physical violence for women with disabilities were parents and relatives (59.7%), whereas for men with disabilities, strangers (59.3%) were the main perpetrators. Among people with disabilities who reported nonpartner sexual violence, 43.5% of women and 60.0% of men never sought help. CONCLUSIONS: This is one of the few studies globally reporting on the prevalence of nonpartner violence in both men and women with different disability types. It contributes information on the gender and relationships of those who perpetrated the violence. Findings highlight the need for violence prevention and intervention programs that are inclusive of and responsive to those with different disability types.