American Journal of Epidemiology Advance Access published online on March 26, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn049
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Original Contribution |
Domestic Violence and Chronic Malnutrition among Women and Children in India
1 Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
2 Dana-Farber Cancer Institute, Boston, MA
Correspondence to Dr. Leland K. Ackerson, Dana-Farber Cancer Institute, 44 Binney Street, LW703, Boston, MA 02115 (e-mail: lackerso{at}hsph.harvard.edu).
Received for publication October 27, 2007. Accepted for publication February 13, 2008.
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.
anemia; body mass index; child nutrition disorders; domestic violence; India; malnutrition; women
Abbreviations: CI, confidence interval; OR, odds ratio
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