Violence against women is one of the most widespread human rights violations worldwide. This statement can hardly be doubted, based on data collected over decades that show that one in three women in the world has suffered abuse throughout her life. The most recent global study details that violence against women in the context of the couple begins at a very early age: one in four women between the ages of 15 and 24 have already suffered violence from her partner. Although the rates vary between regions, these variations are not explained only by the level of resources of each country; Some of the countries with the highest resources also have a high prevalence of violence against women, especially with regard to intimate partner violence. Take as an example the attacks suffered by women in the United Kingdom every time England loses a football match.
We start, then, from a clear reality: violence against women exists on a massive scale. It is not an isolated case, it is not located in a single region. It is not something that only happens on another continent, or in another country, or even in another town. It is very likely that you know a couple where the woman is the victim of physical or sexual abuse by her partner. It can be a friendly couple, relatives, neighbors, or ourselves.
The implications that this reality has on society as a whole are enormous, which has promoted the implementation of an international system of monitoring and recommendations to definitively eliminate violence against women in all areas. In the field of public health, the elimination of violence against women (that is, 50% of the population) is beginning to emerge as one of the most effective prevention strategies.
What do we know about the effects of violence on women’s health? The clearest effect is that it kills. According to United Nations estimates, 47,000 women and girls were killed by their partners or someone in their family in 2020 alone. Furthermore, last year we had the first population data showing that homicide is among the leading causes of death for women pregnant in the United States.
Violence against women exists on a massive scale. It is not an isolated case, it is not located in a single region
The diseases and health problems most closely associated with physical and sexual violence are those that directly impact the body. Blows to the head or strangulation can lead to brain trauma with long-term consequences. Infectious diseases and those that affect the reproductive organ are also a serious health problem among survivors: sexually transmitted diseases, vaginal bleeding, vaginal and urinary tract infections, pelvic pain, painful sexual relations, are some of the most clearly related with sexual violence.
The impact of violence against women on mental health is overwhelming. The study Gender-based violence against women: a survey at the European Union level reported that 32% of female survivors of physical violence presented anxiety and 20% depression, and that these percentages increased in female survivors of sexual violence: 45% and 35% respectively. The US National Intimate Partner Violence Survey published in 2018 found that more than 50% of survivors had post-traumatic stress disorder.
Violence against women increases the risk of suicidal thoughts and behavior among survivors threefold. However, the relationship between violence and mental health requires a more detailed reflection than the one guided by empathy. This is not a relationship that we can explain by common sense alone. In fact, by doing so, we run the risk of trivializing the problem and, consequently, its solutions. The proposal that victims hear most frequently is “leave it”, as if it were a personal problem.
The key point to understand the relationship between violence against women and mental health problems is reflection on the context in which violence occurs in most cases: an intimate relationship. Couple relationships with violent characteristics last an average of 10 years; During this time, violent acts appear insidiously and are repeated in cycles. The violence is multiple (physical and sexual, but also psychological, vicarious, control…) and overlaps, and fear progressively becomes the most prevalent emotion.
Women use different strategies aimed at momentarily relaxing the situation of violence, which in some situations means saving their own lives or that of their children. Little by little, these fear coping strategies are marking emotions and behaviors, and shaping what is done and what is said, not only at home, but also in other social and work settings.
The perception and management of fear mechanisms, as well as the affectation of coping processes and response to stress situations, are a fundamental characteristic of the symptoms that define the most common mental health problems among surviving women: depression , anxiety, post-traumatic stress. These conditions are not static, but have a trajectory over time; They may occur irregularly and overlap throughout life.
From this perspective, frequent mental health problems in female survivors can be seen as part of a dynamic process of experience between the person and an environment characterized by high levels of alertness to unpredictable threats, and very limited control of the situation.
Focusing on the mental health of survivors allows not only to reflect more deeply on an extremely complex reality, but also to identify relationships with other health problems that are not so obvious at first glance. For example, the evidence of the association between violence and stress response mechanisms has led to study its impact in the medium and long term on the appearance of chronic diseases that are related to these same mechanisms. We are beginning to have data showing that violence against women increases their chances of suffering from cardiometabolic diseases (cardiovascular and type II diabetes), respiratory diseases, and cervical cancer.
Reflecting on the effects of violence might seem like a job more typical of sociology and politics than of health professionals. But health professionals are among those most likely to see female survivors of violence in their consultations. Until recently (and it still happens in a vast majority of health centers), the relationship between injuries or even head trauma and intimate partner violence was difficult to identify in the absence of specific mechanisms in emergency services where the victim could be assisted without the presence of your partner in the consultation.
Similar examples can be found in other areas, including mental health, where protocols for the systematic identification of violence are being worked on. Perhaps in the not too distant future we will see initiatives in cardiology, oncology, and other medical specialties.
The elimination of violence against women must be a priority for the prevention of public health. Not only to prevent disease among those who have not yet been exposed, but also for survivors. That exposure to a threatening environment can lead to illness is a sign of plasticity and flexibility in the face of change, and leaves the path open to the possibility of restoring health and quality of life if the environment (couple, family, social ) becomes a promoter of well-being. It is essential, however, that health prevention policies are nourished by complementary perspectives.
In the case of the health consequences of violence against women, the World Health Organization recommends a framework with a human rights-based approach. I imagine a future for public mental health where the perspective of human rights dialogues with psychology, medicine, and innovation to build evidence-based strategies that respond to the real needs of the entire population.
You can follow THE COUNTRY Health and Well-being in Facebook, Twitter and instagram.
Source: EL PAIS