Domestic Violence: A Global Public Health Issue

Domestic violence is a social menace and is endemic all countries irrespective of their economic progress. Both Eastern and western societies are affected by the malady. The reasons are often clear when we socioeconomic and cultural reasons are looked into. Poverty, crowded homes, unemployment, low education are often the causes that are understood to aggravate the problem. With women and children at the receiving end, a culture of gender bias, where women are considered to be the weaker sex appears to be the underlying cause.

Domestic violence occurs away from the public eye and remains hidden from us. But,
unfortunately it is a common form of violence and is now recognised as a global public health
issue. It is an insidious form of violence and violates human rights. The impact on health and
wellbeing of the victims is enormous and the economic implications for nations and
communities are immense. The socioeconomic reasons for domestic violence include
crowded homes, low education, poverty, unemployment, alcohol abuse and cultural biases
that consider women to be the weaker gender. The psychological impact of domestic violence
on women and children is enormous. Depression, anxiety, low self esteem and delayed
cognitive development are often deleterious consequences. Even in affluent societies where
male dominance is prevalent domestic violence is a problem.
The problem of domestic violence has been recognised as a public health issue all
over the world. Victims include women and children but men may also suffer from violence
at home. Also called intimate partner violence, 35% of women around the world have
experienced violence in homes. Such women are twice as likely to suffer from depression
than women who have not experienced domestic violence. And over 50% of women have not
been able to seek help from formal services. (WHO). Violence in homes occurs across age
groups and across social groups. The consequences on the mental health, physical health of
the victims are detrimental.
Socioeconomic factors
Studies have reported that there may be some impact of the socioeconomic
background on the extent of domestic violence. Unemployment and low per capita income in
a neighbourhood increase the risk of domestic violence. Lower household income, poverty,
education, households with larger number of children are also known to increase the risk of
intimate partner violence (Beyer, Wallis, & Hamberger, 2015). In a Vietnamese study, ageing

population, better economic level and building awareness against domestic violence have
changed attitudes towards domestic violence, but a lot remains to be done (Trinh, Oh, Choi,
To, & & Van Do, 2016). The impact of patriarchal ideology discourages women to report the
incidence of violence by the husbands because they must cover-up his misdeeds in order to fit
the role of a 'good wife'.
An Australian study found that people who are socially disadvantaged, economically
dependent on their partners, belong to Asian or African ethnicities and young, are more likely
to encounter domestic violence. Social norms also shape a person's attitude towards the
incidence of violence at home. Support for gender equality is more likely among migrants to
Australia if they are of European descent rather than Asian descent. In Asian culture the
dominance of the male gender, and status of men as the head of the household makes them
more likely to be perpetrators of violence. And sadly, domestic violence is a recognised but
accepted form of violence (Vichealth, 2013). In many cultures in Asia, the belief systems of
practising harmony and self-restraint by women actually facilitate intimate partner violence
rather than discourage. Women are perceived as submissive and vulnerable and this leads to
both genders treating violence in homes against women as legitimate action (Do, Weiss, &
Pollack, 2013).
In Australia, domestic violence among the indigenous community is high. In a study the
correlation between high degree of alcohol consumption followed by violence in homes.
Alcohol related domestic abuse is also a cause of homicides in indigenous people's homes
and a high incidence of domestic violence is reported as compared to that in urban areas
(Ramamoorthy, Jayraj, Notaras, & Thomas, 2014). The women and children in indigenous
homes bear the brunt of alcohol consumption induced violence and trauma. More than 1800
hospital admissions per 100,000 women were reported from among indigenous women in the
Northern Territory because they were assaulted by drunk husbands. The rate of violence

against these women is 40 times higher than non-indigenous women. Overcrowding of
women and children often makes them easy targets of domestic violence. Reporting by the
victims is rare because of their social value systems.
The prevalence of economic abuse in Australia and elsewhere is also a form of violence that
severely impacts the wellbeing of women. It is easy to hide economic abuse because there is
a smaller chance of finding evidence (Kutin, Russell, & Reid, 2017). It usually involves
taking away the partner's earnings or savings and not providing money for household
expenses. Those with low levels of education and without employment are more likely to be
victims due to their economic dependence (Mahenge, Stöckl, Abubakari, Mbwambo, & Jahn,
2016). A multicountry review agrees that while physical, emotional and mental abuse are
widely recognised, the recognition of economic or financial abuse is still in its infancy, but its
deleterious effects on the health of victims are being widely recognised and understood
(Postmus, Hoge, Breckenridge, Sharp-Jeffs, & Chung, 2018).
Psychological effect on the victims of domestic violence
When the violence perpetrated is sexual in nature, the victims suffer from depression,
anxiety, low self-esteem and are more likely to attempt suicide. Depression is consequence
of physical emotional and economic abuse also but the victims of sexual intimate partner
violence are more depressed (Trinh, Oh, Choi, To, & & Van Do, 2016). Even minor incidents
of violence, such as pushing or shoving impact mental health and the victims can become
depressed Depression is known to reduce appetite, causes low energy and a reduced ability to
function. Inability to sleep well is also common (Karakurt, Smith, & Whiting, 2014). 34.7%
battered women suffered from depression, 27.3% of them were anxious and 10.7% of them
had suicide ideation (Dillon, Hussain, Loxton, & Rahman, 2013). Many women display
symptoms of major depressive disorder. Social stigma and the inability to report violence or

seek treatment due to poor mental health aggravates the problems of women who do not even
think about leaving an abusive partner.
Post traumatic stress disorder is commonly diagnosed among women who have been
subjected to violence in homes. The constant fear about safety and the inability to control the
situation cause additional trauma. The replay of the violence through nightmares and
flashbacks in their minds, avoiding recall of events, emotional numbing and increased startle
response and having difficulty while sleeping are symptoms of PTSD (Karakurt, Smith, &
Whiting, 2014). If the nature of abuse, violence and control experienced by women is severe
and chronic the impact on their mental health is grave.
The impact of violence in homes on children is particularly detrimental, they feel a
sense of shame, hopelessness, fear, inability to concentrate at school due to the violence they
have witnessed at home (Chepuka, Chirwa, & Tolhurst, 2014). Another study suggests that
the impact of violence on young sons is so serious that they begin to imitate the father's
violent ways and become violent towards the siblings (Rakovec-Felser, 2014). Exposure to
violence in homes and its impact on infants is rather severe. The infants may suffer from
disturbed sleep, poor food intake, delayed physical and mental development and lack of
attachment towards the caregiver (Pregnancybirthbaby, 2018). The risk of physical injury
during episodes of violence also affects the infants.
Older children who witness violence at home exhibit symptoms that are similar to
children suffering from abuse. Their symptoms include, social withdrawal, difficulty making
friends, aggressive behaviour, bed wetting, depression, anxiety, low self esteem and low
school attendance (Pregnancybirthbaby, 2018).Children exposed to violence in perinatal
stages also risk mental illness later in life. Through all the developmental stages, exposure to
family violence during infancy, childhood and adolescence exposes the children to harm.

Australian mothers have reported that 31% of the family violence occurs in the presence of
children under five years of age because they have less opportunity to be away at school or
day care (Bunston, Franich-Ray, & Tatlow, 2017). Socio-emotional difficulties and delayed
cognitive development are serious mental health impacts on the psychology of children.
Studies have reported increased levels of catecholamines and neurotransmitters like
dopamine and norepinephrine that are released in response to severe stress. These can cause
children to remain a state of hyperarousal that is detrimental to development and reduces
cognitive function (Carrion, Wong, & Kletter, 2013). The effects of PTSD therefore affect
the lives of children in the long term.
In conclusion, it is evident that domestic violence is a social menace and is endemic
all countries irrespective of their economic progress. Both Eastern and western societies are
affected by the malady. The reasons are often clear when we socioeconomic and cultural
reasons are looked into. Poverty, crowded homes, unemployment, low education are often the
causes that are understood to aggravate the problem. With women and children at the
receiving end, a culture of gender bias, where women are considered to be the weaker sex
appears to be the underlying cause. Consequences of the violence on the mental health of the
women and children are serious. Depression, anxiety and PTSD are common. Apart from
physical and mental abuse, economic abuse also compromises the well being of women.
Cognitive development delays, and lack of attachment, and concentration in studies are a
fallout when children in the family are forced to witness the violence in homes. The sense of
shame and hopelessness that they experience compromises their childhood and growing up
years. Their exposure to harm, particularly in case of younger children adds to their set of
problems. Many of them grow up with wrong stereotypes and mental health issues through
their adult lives.

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