Physical Spousal Violence Against Women in India Some Risk Factors

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Physical Spousal Violence Against Women In India: Some Risk

Factors
Article in Journal of Biosocial Science · October 2007

DOI: 10.1017/S0021932007001836 · Source: PubMed
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J.biosoc.Sci, (2007) 39, 657–670, 2007 Cambridge University Press
doi:10.1017/S0021932007001836 First published online 9 Mar 2007
PHYSICAL SPOUSAL VIOLENCE

AGAINST WOMEN IN INDIA: SOME RISK
FACTORS
L. JEYASEELAN*, SHUBA KUMAR†, NITHYA NEELAKANTAN*,

ABRAHAM PEEDICAYIL‡, RAJAMOHANAM PILLAI§ 
NATA DUVVURY¶
*Department of Biostatistics, Christian Medical College, Vellore, India, †India

Clinical Epidemiology Network, Chennai, India, ‡Department of Obstetrics and
Gynaecology, Christian Medical College, Vellore, §Medical College, Trivandrum and
¶Gender, Violence and Rights, International Center for Research on Women,
Washington, DC, USA
Summary. Domestic spousal violence against women in developing countries

like India, is now beginning to be recognized as a widespread health problem
impeding development. This study aimed to explore the risk and protective
factors for lifetime spousal physical violence. A cross-sectional household
survey was carried out in rural, urban and urban-slum areas across seven sites
in India, among women aged 15–49 years, living with a child less than 18
years of age. The sample was selected using the probability proportionate to
size method. Trained field workers administered a structured questionnaire
to elicit information on spousal physical violence. The main hypothesized
variables were social support, witnessed father beating mother and experience
of harsh physical violence during childhood, alcohol abuse by spouse and
socioeconomic variables. The outcome variables included three physical
violence behaviours of hit, kick and beat. Odds ratios were calculated for risk
and protective factors of violence using logistic regression. Of 9938 women
surveyed, 26% reported experiencing spousal physical violence during the
lifetime of their marriage. Adjusted odds ratios calculated using multiple
logistic regression analysis suggest that women whose husbands regularly
consumed alcohol (OR 5·6; 95% CI 4·7–6·6); who experienced dowry
harassment (OR 3·2; 95% CI 2·7–3·8); had reported experiencing harsh
physical punishment during childhood (OR 1·6; 95% CI 1·4–1·8) and had
witnessed their fathers beat their mothers (OR 1·9; 95% CI 1·6–2·1), were at
increased risk of spousal physical violence (beat, hit and kick). Higher
socioeconomic status and good social support acted as protective buffers
against spousal physical violence. The findings provide compelling evidence of
the potential risk factors for spousal physical violence, which in turn could
help in planning interventions.
657
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658 L. Jeyaseelan et al.
Introduction
Violence against women has been recognized by the United Nations as a fundamental
violation of women’s human rights. Historically, however, little attention has been
given to domestic violence as a broad social issue, or as one relevant to public health.
The sensitivities and stigma associated with domestic violence, the conceptualization
of it primarily as a judicial and legal issue, and inadequate data on the dimensions
of abuse, have hampered understanding and the development of appropriate
interventions in developing countries (Heise et al., 1994). However, consistent efforts
by women’s organizations, international experts and others have at least helped to
highlight this phenomenon as an abuse of human rights, and therefore, a public
health concern (Mayhew & Watts, 2002).
The lifetime risk of severe injury as a result of domestic violence has been
estimated to be 9% for women, with a lifetime risk of up to 22% for any type of injury
from domestic violence (Wilt & Olson, 1996). Indian data on domestic violence are
limited. Results of a survey conducted on women from districts in Tamil Nadu in the
south, and Uttar Pradesh in the north, revealed a prevalence of 37% and 45%
respectively (Jejeebhoy, 1998). Attempts have also been made to identify the risk
factors for physical violence (Heise & Moreno, 2002), which include several, ranging
from individual, relationship to community and societal factors. Given the dearth of
literature in India, a population-based multi-centric collaborative project called the
Study of Abuse in the Family Environment in India (IndiaSAFE), was carried out by
a multi-disciplinary faculty of the Indian Clinical Epidemiology Network (India-
CLEN) based at seven medical schools in New Delhi, Lucknow, Bhopal, Nagpur,
Chennai, Trivandrum and Vellore during the period April 1998 to September 1999.
The objectives of the study were to determine the magnitude of family violence
(physical and psychological) against women in India and assess the community,
family and individual factors associated with family violence. In addition, the study
also assessed the common disciplinary practices followed by parents in disciplining
their child.
The objective of this paper was to evaluate various socio-demographic and
behavioural characteristics, as possible risk and protective factors for lifetime spousal
physical violence against women in India.
Methods
Each study site obtained institutional ethical clearance before conducting the study;
oral informed consent was obtained from each of the women before inclusion in the
study.
The study sites cover a wide geographical area in India and can be considered to
be representative of the population of India. Using a population-based cross-sectional
study design, data were collected from rural, urban-slum and urban non-slum strata
located in the sites mentioned above. Domestic violence was defined as any reported
violence, either physical or psychological, perpetrated by a husband against his wife.
Physical violence was measured in terms of three behaviours: hit (punch with a closed
fist), kick (hit with foot) and beat (repeated blows). Psychological spousal violence
Physical spousal violence against women in India 659
included the assessment of seven psychological behaviours, namely, insult, demean,
threaten self, threaten someone else, an action that induces fear, abandonment and
(husband) infidelity. This study focuses on the risk factors for physical violence only.
Sample size and sampling

Previous studies had estimated the prevalence of domestic violence against women
at 20–50% (Schuler et al., 1996; Jejeebhoy, 1998). Assuming a prevalence of 40%, at
a precision of 2% with a 95% confidence interval and a 15% drop-out rate, the sample
size in each stratum was estimated at a minimum of 3200 women respondents. At
each of the seven sites in the study, only two of three different strata (rural, urban-
slum, urban non-slum) were selected.
Each study site purposively selected potential blocks, localities and slums based on
easy accessibility. Using the probability proportionate to size method, nearly
8–10 villages/streets from rural and urban areas were selected. For the rural areas, a
junction or some central point was identified. A map was drawn of the area indicating
the streets along all four directions, i.e. north, south, east and west. One spoke (street)
was selected from each direction and all households along that spoke were screened.
If the number of eligible households fell short of the requisite sample size, then the
field team proceeded on to the next spoke and continued with the process of selection.
In the urban non-slum, all households located on a single street were screened. If
there happened to be a building with more than three floors, then one floor alone was
randomly selected and all flats on that floor were screened. When selecting households
from urban slums, the field team randomly selected a path and enumerated all
households located along that path. If they failed to get the requisite sample size fixed
for that particular area, they turned right and kept moving along different such paths
until the required sample size was achieved.
Eligibility criteria
Women aged between 15 and 49 years, with at least one resident child below 18
years of age, were eligible. As the main study also assessed child abuse, the presence
of a resident child was an essential inclusion criterion for participation in the study.
Consequently, childless women were ineligible for inclusion in the study. Those
women who were widowed or separated at the time of the interview were asked to
respond to questions concerning lifetime spousal violence and to their experience over
the last year. All interviews were conducted in privacy.
Questionnaire
Spousal violence against women. A structured questionnaire was developed to
assess spousal physical violence. A large proportion of women living in rural areas
and in the urban-slums in India are non-literate, and consequently it was decided to
administer the questionnaire to the women respondents by trained raters.
The violence behaviours were assessed over the woman’s lifetime of marriage.
Broadly, the instrument elicited information on household characteristics, social
status of woman’s parental family vis-à-vis that of her husband’s family, lifetime
experiences of family violence and childhood history of family violence. To ensure
comparability between the different study regions, the questionnaire was translated
into the local language of the sites (i.e. Hindi, Marathi, Tamil and Malayalam) and
then back-translated into English. All the back-translations were thoroughly checked
to ensure that the meaning of the original English language version was retained. An
intensive joint training session for the research staff from all study sites was
conducted. Only women were recruited and they were provided with formal training
in administering the questionnaire to the women respondents. An inter-rater reliability
exercise revealed an ICC (Intraclass Correlation Coefficient) of 0·75. A data entry
system was developed using Visual Basic as front end and Visual Foxpro as back end.
The data from each site were entered first by the respective sites. The Biostatistics
Research and Training Centre at the Christian Medical College, Vellore, carried out
the second entry and were also responsible for data management.
Social support. Three domains of social support were assessed, namely, natal,
neighbours, co-workers and others. The type of social support was exclusively emo-
tional, thus, physical or material support were not assessed. For hypothesis testing, a
composite score from these three scores was used (equal weighting). For each domain
two scores were possible: 0 if the woman reported no support and 1 if she reported
any support. Thus no social support was given a score of 0, low social support was
given a score of 1 or 2 and high social support was given a score of 3 or 4.
Definitions. ‘Violence’ was defined as the perpetration of any one of three

physically violent behaviours of hit, kick or beat, ‘multiple violence’ as perpetration
of two or more, and ‘all violence’ as the perpetration of all three types of physical
violence behaviours by the husband during the woman’s lifetime of marriage. Only
the severe forms of physical violence, namely hit, kick and beat, were considered for
‘violence’, ‘multiple violence’ and ‘all violence’.
In assessing socioeconomic status, proxy indicators such as household appliances,
including vehicles and toilet facilities, were used. Possession of a greater number of
household appliances such as a refrigerator, gas or electric stove, television, air
conditioner, vehicle, etc., were considered an indication of better socioeconomic
status. Similarly, a toilet facility inside the house as compared with those outside the
home, was an indication of better socioeconomic status.
Risk and protective factors. In addition to socioeconomic factors, the woman’s

access to and availability of social support, her childhood experiences of family
violence (i.e. witnessed father beating mother and/or experienced harsh physical
disciplinary practices) and husband’s alcohol use, constituted the risk and protective
factors for spousal physical violence that were studied.
Statistical methods
As the outcome was ‘violence’, which was categorical (yes or no), the following
analyses were carried out. Age, area of residence and social support were considered
as confounders and were adjusted for during the multivariate analysis. Bivariate
analyses, ANOVA and chi-squared tests were performed. The variables that were
significant at the 25% level in the bivariate analyses were considered for the multiple
logistic regression analysis. Enter method was used in the logistic regression analysis.
Likelihood ratio statistics were used to assess the model significance and the Hosmer
and Lemeshow statistic was used to assess the goodness-of-fit. Deviance chi-squared
statistic was used to test the model assumptions (Hosmer & Lemeshow, 1989).
Results
A total of 11,845 women (rural 3969, urban-slum 3756, urban non-slum 4120) were
contacted, of which 9938 agreed to participate (rural 3611, urban-slum 3155, urban
non-slum 3172). Overall participation rates were 91% for rural, 84% for urban-slum
and 77% for urban non-slum. Participation rates in the urban non-slum were thus the
lowest, indicating that women in urban areas were less willing to participate in such
sensitive surveys than their rural and urban-slum counterparts. Of the 9938 women,
2593 (26%) reported experiencing any physical violence during their lifetime of
marriage.
Socio-demographic characteristics
The average age (SD) of the women respondents was 31·2 (6·7) years. Higher rates
of non-literacy were found among rural (40%) and urban-slum (32%) women, while
higher education levels were found among urban non-slum (31%) women. One-third
of rural women were employed, predominantly in agriculture, in contrast to only 22%
of urban-slum and non-slum women. Most of the women were married (96%), the
remaining being widowed, separated or divorced. Seventeen per cent of urban
non-slum women reported having toilet facilities outside their home, in contrast to
43% from the urban-slum and 32% from the rural areas. Similarly, 49% of urban
non-slum women reported owning a vehicle in contrast to 17% and 15% from the
urban-slum and rural areas, respectively, indicating that women from the rural and
urban-slum areas lived in greater poverty.
Lifetime prevalence of violent physical behaviours

The lifetime experience of violent physical behaviour by the husband was reported
by a quarter of the women. For all three behaviours (Fig. 1) of beating, hitting and
kicking, the reported prevalence differed significantly by stratum (p<0·001). Women
living in rural areas reported the highest rates of beating (26%), those in urban-slums
reported the highest levels of hitting (26%) and kicking (23%), while women living in
urban non-slum areas reported the lowest rates of all three behaviours (beat 12%, hit
11%, and kick 10%).
The experience of violence (rural and urban-slum 31% each, urban non-slum 16%),
multiple violence (rural and urban-slum 23% each, urban non-slum 11%) and all
violence (rural 15%, urban-slum 16%, urban non-slum 7%) was, again, highest among
Fig. 1. Prevalence of spousal physical abuse by location of residence.
the poorer strata of the study sample, namely rural and urban-slum, and least in the
urban non-slum.
Socio-demographic risk factors for violence

An analysis of the association between the socio-demographic variables of
household crowding, appliances, age and education of the woman and her husband,
and social support, with the reporting of any one of the three violent physical
behaviours of beat, hit and kick, shows that reporting of physical violence was less
in women coming from a higher socioeconomic stratum. Thus, women who had
experienced violence had a significantly higher mean (SD) crowding index 3·0 (1·8),
as compared with women who did not report violence 2·5 (1·7). Similarly, women
who had experienced violence had significantly lower mean appliance scores, years of
education and social support. Further, the husbands of such women had significantly
fewer years of education compared with the husbands of those women who did not
report experiencing violence.
Other spousal and family risk factors for physical violence
Women whose husbands regularly consumed alcohol (crude OR 7·3, 95% CI
6·4–8·3), and who reported experiencing high levels of dowry harassment (crude OR
9·4, 95% CI 7·5–11·8) were at greater risk of experiencing physical violence. Similarly,
those who reported experiencing harsh physical punishment during their childhood
(crude OR 1·7, 95% CI 1·5–1·8) or who had witnessed their father beat their mother
(crude OR 2·4, 95% CI 2·2–2·6) were also at greater risk. It is important to note the
effect that the employment status of the woman had on the experience of violence. In
instances where the woman’s job and income status was at a higher level compared
with that of her husband, her risk of experiencing physical violence increased
four-fold (crude OR 4·2, 95% CI 2·9–6·0). Absence of toilet facilities (crude OR 3·9,
95% CI 3·4–4·5) was also found to be strongly associated with the risk of spousal
physical violence. A distinct reduction in violence was evident in households that had
access to a toilet facility within the home.
Regression analysis
A logistic regression analysis (Table 1) of the risk factors for violence, revealed
that strong social support (adjusted OR 0·8; 95% CI 0·81–0·9) emerged as a protective
factor against violence for women. Household factors such as possession of more
household appliances (adjusted OR 0·91, 95% CI 0·9–0·95) also served as a protective
factor against physical violence. Women who had no toilet facility within the home
(adjusted OR 1·8, 95% CI 1·4–2·2), or who only had access to an outside toilet facility
(adjusted OR 2·0, 95% CI 1·6–2·4), had a two-fold risk of experiencing physical
violence as compared with those who had toilets within their home. Women who had
higher levels of education (adjusted OR 0·98, 95% CI 0·9–0·99) experienced less
violence. Differences in employment, wherein the woman was employed while the
husband was not, and women’s experiences of dowry harassment (adjusted OR 3·3,
95% CI 3·2–4·5), increased her risk of experiencing physical violence (adjusted OR
2·1, 95% CI 1·3–3·4). With respect to husband factors, women whose husbands had
a higher level of education (adjusted OR 0·9, 95% CI 0·96–0·99) were protected
against violence. However, those whose husbands regularly consumed alcohol
(adjusted OR 5·5, 95% CI 4·7–6·5) had a nearly six-fold risk of experiencing physical
violence. The hypothesized factors, of women reporting experiencing harsh physical
punishment during childhood (adjusted OR 1·3, 95% CI 1·2–1·5) and witnessing their
fathers beat their mothers (adjusted OR 1·9, 95% CI 1·6–2·2), also increased the risk
of physical violence for women.
Interaction between socioeconomic and socio-cultural factors on experience of physical

violence
In this study, nearly 30% of the husbands had studied beyond the 10th standard,
and about 38% were reported to have consumed alcohol (either frequently or
infrequently). The results further show that 9% of the husbands who had consumed
alcohol had studied beyond the 10th standard as compared with 30% of the husbands
who had consumed alcohol but had less than 10 years of education. Thus, those
Table 1. Multiple logistic regression for physical violence (adjusted OR estimates)
Physical violence
Factors Adjusted OR 95%CI
Area
Urban non-slum 1·00
Urban-slum 1·12 0·92–1·37
Rural 1·16 0·96–1·40
Strong social support 0·87 0·81–0·93***
Poverty/wealth
No. persons sharing room 1·04 1·00–1·07
No. appliances in household 0·91 0·90–0·95***
Toilet facility
No toilet 1·80 1·44–2·24***
Outside toilet only 2·00 1·63–2·46***
Inside toilet shared 1·80 1·40–2·32***
R1 inside household 1·00
Woman factors
Woman’s age (years) 1·01 0·99–1·03
Woman’s education 0·98 0·96–0·99**
Employment difference
Wife not working, spouse working 1·00
Wife working, spouse not working 2·15 1·34–3·44**
Both working 1·17 1·02–1·35*
Dowry harassment 3·36 3·27–4·56***
Husband factors
Husband’s age (years) 1·00 0·98–1·02
Husband’s education 0·97 0·96–0·99**
Alcohol use (husband)
Teetotaller (Ref.) 1·00
Not to excess 1·70 1·36–2·12***
Occasional 1·61 1·36–1·92***
Regular 5·59 4·77–6·54***
Hypothesized factors
Harsh physical punishment in women’s childhood 1·38 1·21–1·57***
Witnessed father beating mother 1·92 1·68–2·20***
*p<0·05, **p<0·01, ***p<0·001. Hosmer–Lemeshow p value=0·761.
husbands who consumed alcohol were three times more likely to be less educated
(%10th standard). Looking at those husbands who had not consumed alcohol, about
19% had studied beyond the 10th standard while 42% had fewer than 10 years of
education. For women, the risk of violence was eleven times (9·0–13·3) more from
husbands who consumed alcohol and at the same time were less educated (%10th
standard) as compared with husbands who did not consume alcohol but who were
better educated (p<0·0001). The risk of violence for women was only 2·7 (2·1–3·5)
Table 2. Mean (SD) appliance scores by women’s experience of physical violence and
husband’s education for strata, social support and alcohol use
Husband had %10 years education Husband had >10 years education
(n=6918) (n=2656)
Experienced Did not experience Experienced Did not experience
physical violence physical violence physical violence physical violence
(n=2130) (n=4788) (n=279) (n=2377)
Mean SD Mean SD Mean SD Mean SD
Area
Non-slum 2·9 1·9 3·8 2·2*** 5·9 2·8 7·1 2·2***
Slum 2·8 1·7 3·3 1·8*** 3·8 1·9 4·4 1·9*
Rural 1·9 1·4 2·5 1·7*** 3·4 2·1 4·3 2·4**
Social support
None 2·3 1·7 3·0 2·0*** 4·4 2·3 5·2 2·4
Some 2·4 1·7 3·1 1·9*** 4·6 2·6 6·3 2·5***
High 2·6 1·8 3·2 2·0*** 3·5 1·7 5·9 2·3***
Alcohol
Yes 2·4 1·7 3·1 2·1*** 4·5 2·7 6·8 2·5***
No 2·5 1·7 3·0 1·9*** 4·5 2·4 6·0 2·5***
***p<0·001; **p<0·01; *p<0·05.
times (p<0·0001) in the group of husbands who consumed alcohol and were better
educated (>10th standard). Another interesting finding was that women had a 3·1
(2·5–3·8) times higher risk of violence from husbands (p<0001) who, though they did
not consume alcohol, had poor education levels (%10th standard).
In India, assessment of income has always been unreliable as people do not
generally provide correct estimates. Consequently, the type of household appliances
people had in their homes was taken as a proxy indicator of their income status. The
mean (SD) appliance score for women who did not experience violence and whose
husbands had studied beyond 10 years was 6·2 (2·5) as compared with 4·5 (2·6) in
women who had experienced violence, a difference that was statistically significantly
(p<0·0001) (Table 2). Similarly, for husbands who had less than 10 years of
education, the mean (SD) appliance score was 3·4 (2·0) for those women who did not
experience violence as compared with 2·4 (1·7) for those who did experience violence,
a difference that was statistically significant (p<0·0001). This implies that irrespective
of educational status, violence was more prevalent among women belonging to low
income families, a trend that was consistent across all strata.
About 121 (1·2%) women in the study who were employed had husbands who
were not working. The risk for violence was nearly two times greater for these women
compared with those whose husbands were employed but the woman was not. While
the degree of risk was similar in both rural and urban-slum areas, it was nearly four
times higher in the urban non-slum stratum.
Discussion
Although spousal physical violence is a near universal phenomenon that threatens the
health, well-being, rights and dignity of women, it is only recently that it has emerged
as a global issue. In India, despite the tremendous impact it has on the woman, her
family and society, it continues to be a ‘crime of silence’ (Pillai, 2001), largely because
of the importance attached to the sanctity of the family. This study reported a lifetime
prevalence of spousal physical violence of 26% (not including ‘slap’), a rate that in all
likelihood is an underestimate. The sense of shame and embarrassment, coupled with
the need to keep it hidden so as to protect family honour, keeps many women silent.
Interestingly, in this study, 58% of women reported that such types of domestic
violence are part and parcel of married life, and 16% feared that reporting the
violence would hurt family prestige or would result in loss of respect for the family.
Years of exposure to domestic violence, combined with the cultural demands on
women to be subservient and accepting of their husbands, could be other reasons why
women remain silent.
Risk factors: demographic characteristics

Studies from a range of settings show that while violence against partners cuts
across all socioeconomic groups, women living in poverty are disproportionately
affected (Ellsberg et al., 1999). Yet another study (Hilberman, 1980), reported that
although spousal abuse was not limited to a particular social class, the highest
reported incidence was among the poor. This study showed that increased household
crowding, fewer household appliances, absence of a toilet facility within the home –
all proxy indicators of poorer socioeconomic status – were found to be strongly
associated with the risk of spousal physical violence. Heise (1998) postulated that
poverty probably acts as a marker for a variety of social conditions that combine to
increase the risk faced by women. This does not imply that spousal physical violence
does not exist among upper socioeconomic groups, but in relative terms, may be less,
considering that the stresses associated with poverty are unlikely to be present in this
group. What also needs to be highlighted is the lower response rate in the urban
non-slum (77%) compared with the rural settings (91%).
Education as a protective factor against spousal physical violence emerged to be
significant, only when the duration of education in both partners was over 7–8 years.
Studies have reported that lower levels of education may be an indicator of poor
communication skills, which have been associated with domestic violence (Dutton &
Strachan, 1987). Jejeebhoy (1998) found that the influence of education was far
stronger in the southern state of Tamil Nadu, which has a more egalitarian society,
compared with that in the northern state of Uttar Pradesh. As a result, the effect of
education, both primary and secondary, enabled women to protect themselves from
violence and intimidation. In Uttar Pradesh, however, attainment of secondary
education was needed to afford some protection to the women. In other words,
education in itself is a slow-acting protective factor in a cultural context of rigid
gender norms. Better educational levels of both partners, thus, plays a critical role in
reducing the risk of violence and therefore has important policy implications for the
country.
Risk factors: spousal and family characteristics
Regular alcohol consumption by the husband, dowry harassment by in-laws, and
a gap in employment status between wife and husband were other factors that
emerged as risk factors for spousal physical violence, all of which have been well
documented (Black et al., 1999). Alcohol has consistently emerged as a risk marker
for partner violence that is especially consistent across different settings (McCauley
et al., 1995). According to Kyriacou et al. (1999), the precise mechanism by which
alcohol acts to increase the risk of injury from domestic violence is not very clear,
although there may be physiologic, psychological and environmental factors that may
be playing a critical role here. Some researchers believe that alcohol operates as a
situational factor, increasing the likelihood of violence by reducing inhibitions,
clouding judgment and impairing an individual’s ability to interpret cues (Flanzer,
1993).
Another important finding is that women’s risk of violence was very high from
husbands who consumed alcohol and at the same time were less educated (%10th
standard), as compared with husbands who consumed alcohol but were better
educated. While individually, both alcohol use and low education levels in men were
risk factors for violence against a woman, the interaction between these variables
heightened her risk 11-fold.
Harassment by in-laws on issues related to dowry, a social problem that is unique
to the Indian setting, emerged as a strong risk factor for spousal physical violence.
The practice of dowry has been in existence for many years and the subject of much
debate as well as legislative action (Agnes, 1992). Many Indian women face severe
harassment, not just from their spouses but also from their in-laws, due to unfulfilled
dowry demands (Subadra, 1999). Dowry is not a one-off payment made at the time
of marriage, but a life-long torture that haunts the woman throughout her marital
life, quite often culminating in suicide or in her murder by husband/in-laws. Other
studies from India (Ranjana, 1989; Bloch & Rao, 1995) have also emphasized the
close links between dowry and spousal violence, highlighting the critical role it plays
in the power relationships between spouses and their families. Unfortunately, while
there have been laws enacted banning this practice, these have, at best, remained
paper tigers.
A gap in the employment status between wife and husband is also a significant
risk factor for spousal physical violence. This is a finding that has been reported in
the US context (Ylo & Straus, 1990). While this finding may seem counterintuitive,
it reveals that violence is linked to the changing power dynamics in the spousal
relationship. Women who are employed, thus violating the norm of the husband being
the only provider, experience more violence than unemployed women who may only
fulfil the traditional role of homemaker. When the norm is further violated, with
women having a higher employment status than their husbands, they experience even
more violence.
Risk factors: individual characteristics

Experiencing harsh physical punishment during childhood, and witnessing father
beat mother, also emerged as risk factors for violence. According to Lachance (1999),
one-half of all Canadian women have experienced at least one incident of physical or
sexual violence since the age of 16. Violence in the family of origin, whether in terms
of experiencing stern disciplinary methods or in terms of witnessing physical
aggression by father to mother, quite often serves as a role model. Thus women tend
to accept such behaviour as the norm. The results from the current study clearly echo
these findings. The strong statistical association that emerged between the two
variables of witnessing father beat mother and exposure to harsh disciplinary practices
during childhood with spousal physical violence, provide compelling evidence of the
long-term deleterious effects of such behaviour.
Finally, the beneficial effects of social support have been well acknowledged. In
the current study women who reported having good social support reported
experiencing less spousal physical violence. Coker et al. (2003) found that higher levels
of emotional support may modify the effect of intimate partner violence on health,
and suggest that interventions to increase emotional and social support to women
victims of violence may reduce the negative, mental and physical health consequences.
Jacobson (1986) spoke of three types of support that mitigate the effects of crisis,
namely, emotional support, cognitive support and material support, and went on to
highlight the importance of emotional support as being critical and helpful,
particularly to patients in the early stages of their diagnosis. Almedom (2004), in her
study on factors that mitigate war-induced anxiety and mental distress, found that
emotional support kept communities together. Thus people who have similar
experiences and suffered together tend to form strong support groups. This, in turn,
has implications for intervention, in terms of building support groups for women
victims of violence, much like the ‘alcoholic anonymous’ groups. Such a body would
not only provide emotional solace and support, but in time, could also act as a
powerful lobby for women victims of domestic violence.
Study limitations
This study has some limitations. Firstly all assessments are based on self-reports
by women, which are likely to be underestimates of the true extent of the problem.
Secondly, the cross-sectional design has precluded the ability of the study to establish
causal effect and, thirdly, by excluding childless and older women it is quite likely that
an important risk factor for violence, namely infertility, may have been missed.
Despite this, it is important to highlight that this large population-based study has
provided valuable data on domestic violence across the country. The findings indicate
several strong risk factors for violence, the magnitude of which provides substantive
evidence of the need to: (i) classify domestic violence as a major public health problem
and (ii) develop culturally acceptable and sustainable intervention strategies specifi-
cally targeting these risk factors so that women no longer need suffer in silence.
Acknowledgments
This research was made possible by a grant from the International Council for
Research in Women (ICRW) as part of its research programme on domestic violence
in India, supported by funding from USAID/India. The authors of this paper
represent the IndiaSAFE Steering Committee. They are grateful to the Steering
Committee for the encouragement provided in the writing of this paper.
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Physical Spousal Violence Against Women In India: Some Risk

Article in Journal of Biosocial Science · October 2007

Lakshmanan Jeyaseelan Shuba Kumar

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PHYSICAL SPOUSAL VIOLENCE

L. JEYASEELAN*, SHUBA KUMAR†, NITHYA NEELAKANTAN*,

*Department of Biostatistics, Christian Medical College, Vellore, India, †India

Summary. Domestic spousal violence against women in developing countries

Sample size and sampling

Deﬁnitions. ‘Violence’ was defined as the perpetration of any one of three

Risk and protective factors. In addition to socioeconomic factors, the woman’s

Lifetime prevalence of violent physical behaviours

Fig. 1. Prevalence of spousal physical abuse by location of residence.

Socio-demographic risk factors for violence

Interaction between socioeconomic and socio-cultural factors on experience of physical

*p<0·05, **p<0·01, ***p<0·001. Hosmer–Lemeshow p value=0·761.

***p<0·001; **p<0·01; *p<0·05.

Risk factors: demographic characteristics

Risk factors: individual characteristics

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L. JEYASEELAN, SHUBA KUMAR†, NITHYA NEELAKANTAN,

p<0·05, p<0·01, p<0·001. Hosmer–Lemeshow p value=0·761.

p<0·001; p<0·01; p<0·05.