Today is the final day of 16 Days of Activism against Gender-Based Violence. This international campaign runs annually from 25th November, the International Day for the Elimination of Violence against Women, until 10 December, Human Rights Day.
Gender-based violence is a cause and a consequence of gender inequality and includes sexual violence, domestic abuse, female genital mutilation, and so-called honour-based killings.
The impacts of gender-based violence include physical, psychological, economic and social harms. Victims of violence or those living in fear of violence are more likely to adopt health harming behaviours, suffer from anxiety, depression or PTSD or experience social isolation.
Estimates of the economic and social costs of domestic abuse in England and Wales in 2017, place the annual cost at £66 billion. The overall costs of all forms of violence against women, domestic abuse and sexual violence are considerably higher. The cost of domestic violence, in both human and economic terms, is so significant that even marginally effective interventions are cost effective.
The most recent Crime Survey for England and Wales which included domestic abuse statistics was in 2020. This showed that an estimated 2.4 million adults aged 16 to 74 years experienced domestic abuse in the year ending March 2020 (1.6 million women and 786,000 men). This represents an overall prevalence rate of approximately 5 in 100 adults.
The Office for National Statistics have released the latest analysis of domestic abuse data for England and Wales. In 2020-2021 police recorded 846,000 domestic abuse related crimes in England and Wales. This makes up over 18% of all crimes recorded (previously 15%, 2019/20). In 73% of all domestic abuse related crimes the victims were female.
A public health approach to gender-based violence is aimed at entire populations and as such, its success depends on action from more than one organisation or group. The World Health Organization’s Violence Prevention Alliance describes four steps of the public health approach to violence prevention as:
Surveillance/epidemiology (what is the problem?)
Identify risk and protective factors (what are the causes?)
Develop and evaluate interventions (what works and for whom?)
Implementation and scaling up effective policy and programmes
Many of the factors that affect individuals’ risk of violence arise through their circumstances and experiences in early life. A life course approach to understanding and tackling gender-based violence is therefore advocated.
Violence is an outcome of interactions between a range of risk factors at the individual, relationship, community and the societal level.
Individual factors include personal history and biological factors such as being a victim of child maltreatment or abuse, psychological disorders, alcohol and/or substance abuse and a history of behaving aggressively influence how individuals behave and can increase their likelihood of becoming a victim or a perpetrator of violence.
Relationships such as family, friends, intimate partners and peers may influence the risks of becoming a victim or perpetrator of violence. For example, having violent friends or family may influence whether a young person engages in or becomes a victim of violence.
Community contexts in which social relationships occur, such as schools, neighbourhoods and workplaces, also influence violence. Risk factors here may include the level of unemployment and population density.
Societal factors influence whether violence is encouraged or inhibited. Economic and social policies can maintain socioeconomic inequalities between men and women. Social and cultural norms can be a risk factor such as those around male dominance over women and cultural norms that endorse violence as an acceptable way to resolve conflicts.
A strategic public health response to gender-based violence must address the risk factors at each level with equal importance incorporating work to address cultural and societal norms. Existing mechanisms can be strengthened in their potential to prevent violence.
To successfully prevent violence against women in the future it is essential to tackle the root causes of violence, which includes challenging societal and cultural norms that can lead to violence. There is a need to place greater emphasis on the wider determinants of health and address wider system issues such as parenting, poverty, unemployment, education, housing and homelessness.
The World Health Organisation and United Nations RESPECT Framework for preventing and responding to VAWG describes seven inter-related intervention strategies that aim to address these wider determinants across the life course.
Public Health Wales recently published a report showing that there is a growing evidence base to guide public health action against gender-based violence. We can and should be maximising these approaches.