Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey.

BACKGROUND: Evidence on workplace bullying and harassment (WBH) in the UK has not used probability-sample surveys with robust mental health assessments. This study aimed to profile the prevalence and nature of WBH in England, identify inequalities in exposure, and quantify adjusted associations with mental health. METHODS: Data were from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional probability-sample survey of the household population in England. Criteria for inclusion in the secondary analysis were being aged 16-70 years and in paid work in the past month (n = 3838). Common mental disorders (CMDs) were assessed using the Clinical Interview Schedule-Revised and mental wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale. Analyses were weighted. We examined associations between past-year WBH and current CMD using multivariable regression modelling, adjusting for sociodemographic factors. Interaction terms tested for gender differences in associations. The study received ethical approval (ETH21220-299). RESULTS: One in ten employees (10.6%, n = 444/3838) reported past-year experience of WBH, with rates higher in women (12.2%, n = 284/2189), those of mixed, multiple, and other ethnicity (21.0%, n = 15/92), and people in debt (15.2%, n = 50/281) or living in cold homes (14.6%, n = 42/234). Most commonly identified perpetrators of WBH were line managers (53.6%, n = 244/444) or colleagues (42.8%, n = 194/444). Excessive criticism (49.3%, n = 212/444), verbal abuse (42.6%, n = 187/444), and humiliation (31.4%, n = 142/444) were the most common types. WBH was associated with all indicators of poor mental health, including CMD (adjusted odds ratio [aOR] 2.65, 95% CI 2.02-3.49), and 11 of 14 mental wellbeing indicators, including lower levels of confidence (aOR 0.57, 0.46-0.72) and closeness to others (aOR 0.57, 0.46-0.72). Patterns of association between WBH and mental health were similar in men and women. CONCLUSIONS: These findings reinforce a need for more cohesive UK legislation against WBH; guidance on recognition of bullying behaviours for employees, managers, and human resources, focusing on prevention and early intervention, and increased awareness of the impact of WBH on mental health among health service practitioners. Limitations include reliance on cross-sectional data collected before pandemic-related and other changes in workplace practices. Longitudinal data are needed to improve evidence on causality and the longevity of mental health impacts.

Migration and infant immunization timeliness in New Zealand: Evidence from the Growing Up in New Zealand study.

BACKGROUND: Migration has been recognized as an important determinant of child health outcomes including childhood vaccination status. This paper aims to examine the association between parental migration status and a less studied aspect of child immunization outcomes, namely timeliness, within the context of New Zealand (NZ), a country characterized by a substantial proportion of its resident population born overseas. Additionally, the study explored the impact of residential duration on children's immunization timeliness. METHODS: The data was taken from a large, representative population-based cohort study in NZ (Growing Up in NZ study). A total of 6156 children and their parents, comprising 2241 foreign-born and 3915 NZ-born mothers and a sub-group of their partners were included in the analysis. The survey data was linked with the National Immunization Register dataset. Timely immunization was defined as receiving two vaccines at each scheduled vaccination point (at six-week, three-month, and five-month, totaling six doses of vaccines) within 30 days of their due date. We examined the associations between parental migration status, maternal residential duration, and child immunization timeliness while controlling for socio-economic variations. The results were presented as adjusted odds ratios (AORs) with 95 % confidence intervals (CIs). RESULTS: The findings revealed that after adjustment for socioeconomic differences, children of foreign-born mothers exhibited higher odds of receiving all six studied vaccine doses on time compared to children of native-born mothers (AOR 1.51, 95 %CI:1.27-1.78). Similarly, having a foreign-born father was also significantly associated with timely completion of all six vaccine doses. Children of recent immigrants who had resided in the country for less than five years demonstrated higher odds of timely vaccination of all six vaccine doses compared to children of settled immigrants who had lived in the country for five or more years (AOR 1.65, 95 %CI: 1.25-2.19). CONCLUSION: This study revealed a significant pattern in NZ where immigrants exhibited higher rates of timely immunization for their children compared to native-born parents. However, the findings also underscore the importance of providing support to settled immigrants, as their children experienced declines in timely vaccination rates compared to children of recent immigrants and even those born to NZ-born parents.

Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey.

BACKGROUND: Evidence on workplace bullying and harassment (WBH) in the UK has not used probability-sample surveys with robust mental health assessments. This study aimed to profile the prevalence and nature of WBH in England, identify inequalities in WBH exposure, and quantify adjusted associations with mental health. METHODS: Data were from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional probability-sample survey of the household population in England, interviewed with verbal informed consent. Criteria for inclusion in the secondary analysis were being aged 16-70 years and in paid work in the past month (n=3838). Common mental disorders were assessed using the Clinical Interview Schedule-Revised and mental wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale. Analyses were weighted. We examined associations between past-year WBH and current common mental disorders using multivariable regression modelling, adjusting for demographic and socioeconomic factors. Interaction terms tested for gender differences in associations. The study received ethics approval (ETH21220-299). FINDINGS: One in ten employees (10·6% (weighted), n=444/3838) reported past-year experience of WBH, with rates higher in women (12·2%, n=284/2189); those of mixed, multiple, and other ethnicity (21·0%, n=15/92); and people in debt (15·2%, n=50/281) or living in cold homes (14·6%, n=42/234). Most commonly identified perpetrators of WBH were line managers (53·6%, n=244/444) or colleagues (42·8%, n=194/444). Excessive criticism (49·3%, n=212/444), verbal abuse (42·6%, n=187/444), and humiliation (31·4%, n=142/444) were the most common types. WBH was associated with all adverse mental health indicators, including common mental disorders (adjusted odds ratio [aOR] 2·65, 95% CI 2·02-3·49), and 11 of 14 mental wellbeing indicators, including lower levels of confidence (aOR 0·57, 0·46-0·72) and of closeness to others (aOR 0·57, 0·46-0·72). Patterns of association between WBH and mental health were similar in men and women. INTERPRETATION: These findings reinforce a need for more cohesive UK legislation at the national level; guidance on recognition of bullying behaviours for employees, managers, and human resources at the organisational level, focusing on prevention and early intervention, and increased awareness of the impact of WBH on mental health among health-service practitioners. Study limitations include reliance on cross-sectional data collected before pandemic-related and other major changes in workplace practices. Longitudinal data are needed to improve evidence on causality and the longevity of mental health impacts. FUNDING: UK Prevention Research Partnership.

Association Between Women's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand.

Importance: Intimate partner violence (IPV) is increasingly recognized as a contributing factor for long-term health problems; however, few studies have assessed these health outcomes using consistent and comprehensive IPV measures or representative population-based samples. Objective: To examine associations between women's lifetime IPV exposure and self-reported health outcomes. Design, Setting, and Participants: The cross-sectional, retrospective 2019 New Zealand Family Violence Study, adapted from the World Health Organization's Multi-Country Study on Violence Against Women, assessed data from 1431 ever-partnered women (63.7% of eligible women contacted) in New Zealand. The survey was conducted from March 2017 to March 2019, across 3 regions, which accounted for approximately 40% of the New Zealand population. Data analysis was performed from March to June 2022. Exposures: Exposures were lifetime IPV by types (physical [severe/any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types. Main Outcomes and Measures: Outcome measures were poor general health, recent pain or discomfort, recent pain medication use, frequent pain medication use, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Weighted proportions were used to describe the prevalence of IPV by sociodemographic characteristics; bivariate and multivariable logistic regressions were used for the odds of experiencing health outcomes by IPV exposure. Results: The sample comprised 1431 ever-partnered women (mean [SD] age, 52.2 [17.1] years). The sample was closely comparable with New Zealand's ethnic and area deprivation composition, although younger women were slightly underrepresented. More than half of the women (54.7%) reported any lifetime IPV exposure, of whom 58.8% experienced 2 or more IPV types. Compared with all other sociodemographic subgroups, women who reported food insecurity had the highest IPV prevalence for any IPV (69.9%) and all specific types. Exposure to any IPV and specific IPV types was significantly associated with increased likelihood of reporting adverse health outcomes. Compared with those unexposed to IPV, women who experienced any IPV were more likely to report poor general health (adjusted odds ratio [AOR], 2.02; 95% CI, 1.46-2.78), recent pain or discomfort (AOR, 1.81; 95% CI, 1.34-2.46), recent health care consultation (AOR, 1.29; 95% CI, 1.01-1.65), any diagnosed physical health condition (AOR, 1.49; 95% CI, 1.13-1.96), and any mental health condition (AOR, 2.78; 95% CI, 2.05-3.77). Findings suggested a cumulative or dose-response association because women who experienced multiple IPV types were more likely to report poorer health outcomes. Conclusions and Relevance: In this cross-sectional study of women in New Zealand, IPV exposure was prevalent and associated with an increased likelihood of experiencing adverse health. Health care systems need to be mobilized to address IPV as a priority health issue.

Association Between Men's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand.

Importance: Health implications of intimate partner violence (IPV) against men is relatively underexplored, although substantial evidence has identified associations between IPV and long-term physical health problems for women. Given the gendered differences in IPV exposure patterns, exploration of men's IPV exposure and health outcomes using population-based samples is needed. Objective: To assess the association between men's lifetime IPV exposure and self-reported health outcomes. Design, Setting, and Participants: This cross-sectional study analyzed data from the 2019 New Zealand Family Violence Study, which was conducted across 3 regions of New Zealand. The representative sample included ever-partnered men aged 16 years or older. Data analysis was performed between May and September 2022. Exposures: Lifetime IPV against men by types (physical [severe or any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types experienced. Main Outcomes and Measures: The 7 health outcomes were poor general health, recent pain or discomfort, recent use of pain medication, frequent use of pain medication, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Results: The sample comprised 1355 ever-partnered men (mean [SD] age, 51.3 [16.9] years), who predominantly identified as heterosexual (96.9%; 95% CI, 95.7%-97.8%). Half of the sample (49.9%) reported experiencing any lifetime IPV, of whom 62.1% reported at least 2 types. Of all sociodemographic subgroups, unemployed men had the greatest prevalence of reporting exposure to any IPV (69.2%) and all IPV types. After adjustment for sociodemographic factors, men's exposure to any lifetime IPV was associated with an increased likelihood of reporting 4 of the 7 assessed health outcomes: poor general health (adjusted odds ratio [AOR], 1.78; 95% CI, 1.34-2.38), recent pain or discomfort (AOR, 1.65; 95% CI, 1.21-2.25), recent use of pain medication (AOR, 1.27; 95% CI, 1.00-1.62), and any diagnosed mental health condition (AOR, 1.66; 95% CI, 1.11-2.49). Specific IPV types were inconsistently associated with poor health outcomes. Any physical IPV exposure was associated with poor general health (AOR, 1.80; 95% CI, 1.33-2.43), recent pain or discomfort (AOR, 2.23; 95% CI, 1.64-3.04), and frequent use of pain medication (AOR, 1.69; 95% CI, 1.08-2.63), which appeared to be associated with exposure to severe physical IPV. Exposure to sexual IPV, controlling behaviors, and economic abuse was not associated with any assessed outcomes after sociodemographic adjustment. Experience of a higher number of IPV types did not show a clear stepwise association with number of health outcomes. Conclusions and Relevance: Results of this study indicate that exposure to IPV can adversely affect men's health but is not consistently a factor in men's poor health at the population level. These findings do not warrant routine inquiry for IPV against men in clinical settings, although appropriate care is needed if IPV against men is identified.

Which Aspects of Social Support Enhance Positive Mental Health in the Context of Intimate Partner Violence?

While there is evidence that social support can mitigate mental illness symptoms associated with intimate partner violence (IPV), there is a need to explore if social support can promote positive mental health. In this New Zealand (NZ) population-based study of women who had experienced physical and/or sexual violence (n = 453), structural equation modeling (SEM) showed that most facets of social support (friends, family, and neighbors) had a significant correlation with each dimension of positive mental health, as measured by Keyes' Mental Health Continuum Short Form (MHC-SF). Safety from IPV (no recent IPV experience) is a prerequisite before social support can assist women to attain positive mental health. Further work is required to ensure friends, family, and communities have the knowledge and resources to provide effective social support.

Gender Patterns in the Use of Physical Violence Against a Violent Partner: Results of a Cross-Sectional Population-Based Study in New Zealand.

We examine gendered patterns in the use of violence in response to the partner's violence ("fighting back"). Within each gender, we examined if socio-demographic differences in prevalence were present, and if contextual factors influenced the use of violence against a violent partner. Data from a large, population-based sample of New Zealand adults was used to identify ever-partnered respondents who had experienced physical IPV (n = 407 women, and n = 391 men). Weighted percentages and 95% confidence intervals (95%CIs) were calculated for the use of violence against a violent partner, stratified by gender. Multivariable logistic regression was used to assess the association between each contextual risk factors and the use of violence against a violent partner. For both men and women, at the multivariable level, use of violence against a violent partner was associated with contextual factors related to the abuse. However, for almost all of these variables a higher proportion of women than men experienced the risk factor; for example, a higher proportion of women than men reported having experienced severe IPV (57.6% women; 43.7% men), injuries resulting from IPV (44.5% women, 15.0% men), and fear of a partner (22.7% women, 4.9% men). Women were also more likely to report experiencing other types of IPV (particularly sexual IPV) and were more likely to report that their children were present at the time of violence. These factors contributed to the higher proportion of women who reported fighting back at least once (53.4% of women and 22.3% of men). Health, social, and legal services need to conduct appropriate and thorough assessment of nature and context (current and historical) of the violence that individuals have been exposed to as part of service provision. Assessments need to be carried out with a gender-lens in order to provide comprehensive and appropriate responses.

Prevalence of interpersonal violence against women and men in New Zealand: results of a cross-sectional study.

OBJECTIVE: To determine prevalence rates of non-partner and partner violence (IPV) in men and women from a population-based study. METHODS: We recruited 2,887 randomly selected respondents (1,464 women and 1,423 men) from three regions of New Zealand between 2017 and 2019. Face-to-face interviews using a questionnaire adapted from the WHO multi-country study on violence against women was used for data collection. RESULTS: Physical violence by non-partners was most commonly experienced by men (39.9% lifetime exposure) compared with 11.9% of women. More women (8.2%) experienced lifetime non-partner sexual violence compared with men (2.2%). About 29% of men and women reported at least one act of physical-IPV in their lifetime, and about 12.4% of women and 2.1% of men reported at least one act of lifetime sexual IPV. More women than men reported serious injuries, fear, and physical and mental health impacts following IPV experience. CONCLUSIONS: These findings indicate high prevalence of interpersonal violence exposure in the population, with marked gender differences in the types and impacts of violence reported. IMPLICATIONS FOR PUBLIC HEALTH: Study results call for the urgent implementation of violence prevention programs, and funding for both services to rehabilitate people who have perpetrated violence and services to support recovery of those affected.

Social-Level Factors Related to Positive Mental Health Outcomes Following Intimate Partner Violence: Results from a Population-Based Aotearoa New Zealand Sample.

Intimate partner violence (IPV) continues to be an issue for women globally. There remains a gap in research about what contributes to better mental health following IPV. The sociodemographic characteristics and other factors associated with positive mental health were explored among a sample of 454 women aged 16 years and over who reported previous exposure to physical and/or sexual IPV. Sixty-six percent of women reported positive mental health. The cessation of violence, support at disclosure, and ongoing informal support were factors significantly associated with positive mental health. Greater community outreach to improve responses to disclosure and practical support is needed.

Relational Mobility and Other Contributors to Decline in Intimate Partner Violence.

This study explored whether changes in risk and protective factors of intimate partner violence (IPV) can account for the noted reduction in 12-month IPV prevalence in New Zealand between 2003 and 2019. Changes in relational mobility over time were also explored. Data from two population-based surveys of 18-64 year-old ever-partnered women in New Zealand that were conducted according to identical procedures in 2003 (n=2764) and 2019 (n=944) were used. Changes in a variety of potential risk and protective factors over time and their possible contribution to IPV reduction were assessed. The findings indicated that there was no change in the prevalence of the strongest risk and protective factors of IPV victimisation and perpetration over time (e.g. partner concurrent relationship, previous exposure to violence for both respondent and partner, and partner's problematic alcohol/drug use). However, a combination of factors including decline in women's problematic alcohol or drug use, decline in the number of children within families, and increases in the proportion of women and partners with a qualification higher than secondary education are likely to be associated with the reduction in IPV prevalence. A greater degree of relational mobility, demonstrated through a greater proportion of women who left their abusive partner permanently and increased numbers of relationships that women had, was also observed between two study years. Overall, these results indicate that changes in 12-month IPV prevalence over time are likely to be linked with changes that increase women's autonomy and ability to move out of violent relationships. To achieve sustained reductions in IPV, more comprehensive and planned efforts are needed to address other underlying and exacerbating causes, including problematic alcohol/drug use and previous exposure to violence during childhood and adulthood.

Factors influencing help-seeking by those who have experienced intimate partner violence: Results from a New Zealand population-based study.

BACKGROUND: There is limited information about what influences help-seeking following experience of intimate partner violence (IPV). This study investigated determinants of formal and informal help-seeking by those who had experienced lifetime physical, sexual or psychological IPV. METHODS: A cross-sectional population-based New Zealand study conducted from 2017 to 2019 recruited 2,887 participants (1,464 women and 1,423 men) aged 16 years and older. Face-to-face interviews were conducted. Of these, 1,373 participants experienced physical, sexual or psychological IPV. Two series of logistic regressions were conducted: 1) comparing those who sought help with those who did not, and 2) comparing those who had not sought help with those who sought informal help only, or with those who also sought formal help. RESULTS: Of the 1,373 participants who reported experience of physical, sexual or psychological IPV 835 participants (71.3% of women and 49.0% of men) sought some form of help. In both genders self-reported physical and mental health or work-related IPV impacts were significantly associated with help-seeking. Experiencing only one form of IPV was associated with lower odds of seeking formal help by women (Adjusted odds ratio = 0.38; 95%CI = 0.15, 0.92 for physical/sexual only and AOR = 0.37, 95%CI = 0.22, 0.64 for psychological only) compared to those experiencing concurrent types of IPV. CONCLUSION AND IMPLICATIONS: Although there were gender differences in help-seeking, for both women and men the experience of greater impacts associated with IPV exposure increased the likelihood of help-seeking. Agencies providing services for people who are experiencing IPV need to be equipped to identify and respond to multiple forms of IPV, and prepared to address the suite of impacts experienced.

Exploring the health burden of cumulative and specific adverse childhood experiences in New Zealand: Results from a population-based study.

BACKGROUND: Adverse childhood experiences (ACEs) can influence later health, but there are gaps in understanding how ACEs may interact with Positive Childhood Experiences (PCEs). Additionally, there are gaps in understanding how ACEs impact on positive markers of health. OBJECTIVES: To explore associations of ACEs with both negative and positive markers of physical and mental health in adulthood and to examine whether positive childhood experiences (PCEs) can mitigate the negative effects of ACEs on health. PARTICIPANTS AND SETTING: 2887 participants (1464 female, 1423 male) from the 2019 New Zealand Family Violence Survey, a population-based study conducted in New Zealand between March 2017-March 2019. METHODS: Multivariable logistic regressions were conducted to ascertain how both ACE score and ACE subtypes influenced the odds of experiencing adverse and positive mental and physical health after adjusting for socio-demographic predictors. A combined ACE-PCE variable was created and included in the multivariable logistic regression models to examine whether PCEs can mitigate the negative effects of ACEs. RESULTS: Findings indicated that respondents with higher ACE scores had an increased likelihood of reporting each adverse outcome. Higher ACE scores had the strongest association with poor mental health followed by disability and chronic physical health conditions. Respondents with higher ACE scores had a decreased likelihood of reporting each positive health outcome. Exposure to ACEs was detrimental to health even in the presence of PCEs, with minimal effects observed from PCEs given the limited variance observed from its assessment. CONCLUSION: This study documents the deleterious impacts of ACEs on a wide range of health outcomes and demonstrates that these effects are persistent. Findings should provide the impetus for widespread prevention and intervention initiatives that seek to address ACEs. Further exploration of PCEs with a more complete assessment is needed to determine if they can mitigate the detrimental consequences of ACEs.

Lifetime Prevalence of Intimate Partner Violence and Disability: Results From a Population-Based Study in New Zealand.

INTRODUCTION: There is no population-based study on prevalence rates for all forms of intimate partner violence experienced by people with different types of disabilities in New Zealand. This study compares the reported lifetime prevalence of intimate partner violence (physical, sexual, psychological, controlling behaviors, and economic abuse) for people with different types of disabilities with that reported by those without disabilities and tests whether there is a gender difference. METHODS: From March 2017 to March 2019, a total of 2,888 women and men aged ≥16 years participated in a cross-sectional study in New Zealand using a cluster random sampling method. Face-to-face interviews were used for data collection. The WHO Multi-country Study questionnaire was employed as the data collection tool. Logistic regression was conducted, and AORs were reported. RESULTS: Those with any disability reported significantly higher rates of most forms of intimate partner violence than those without disabilities, among both genders, including physical intimate partner violence (AOR=1.80, 95% CI=1.32, 2.47 for women, AOR=2.44, 95% CI=1.72, 3.45 for men) and psychological and economic abuse. Women with disabilities were more likely to report experiences of sexual intimate partner violence than men (range =13.5-17.1% vs 4.0%-21.2% in men). Men with intellectual disability were more likely to report physical intimate partner violence than women with intellectual disability (60.5% in men and 36.0% in women). CONCLUSIONS: People with disabilities report experiencing a significantly high lifetime prevalence of intimate partner violence compared with people without disabilities. The results warrant policy and practice changes to identify early signs of abuse and intervene accordingly and warrant an investment in targeted violence prevention programs.

Prevalence of Nonpartner Physical and Sexual Violence Against People With Disabilities.

INTRODUCTION: This study aims to determine the prevalence rates of nonpartner physical and sexual violence in men and women with different disabilities compared with those in people without disabilities. METHODS: Face-to-face interviews were conducted in 3 regions of New Zealand (2017-2019), and 2,887 randomly selected respondents participated (1,464 women, 1,423 men). Respondents provided information on the disability types (physical, intellectual, psychological, none) experienced and on the experience of physical and sexual violence since age 15 years. Analysis was conducted in 2020-2021. RESULTS: More people with disabilities reported nonpartner physical and sexual violence experience than those without disabilities. For women, 15.4% of those with disabilities experienced lifetime nonpartner physical violence, and 11.1% experienced lifetime nonpartner sexual violence. For men with disabilities, 56.2% experienced lifetime nonpartner physical violence, and 5.6% experienced lifetime nonpartner sexual violence. Women and men with psychological disabilities reported the highest prevalence rates of nonpartner physical and sexual violence. The main perpetrators of nonpartner physical violence for women with disabilities were parents and relatives (59.7%), whereas for men with disabilities, strangers (59.3%) were the main perpetrators. Among people with disabilities who reported nonpartner sexual violence, 43.5% of women and 60.0% of men never sought help. CONCLUSIONS: This is one of the few studies globally reporting on the prevalence of nonpartner violence in both men and women with different disability types. It contributes information on the gender and relationships of those who perpetrated the violence. Findings highlight the need for violence prevention and intervention programs that are inclusive of and responsive to those with different disability types.

Adverse childhood experiences in New Zealand and subsequent victimization in adulthood: Findings from a population-based study.

BACKGROUND: Adverse childhood experiences (ACEs) are widespread and are associated with adverse outcomes in later life, yet few studies have explored their prevalence and consequences in New Zealand. OBJECTIVES: To provide prevalence estimates of ACEs in New Zealand using a large sample of adults, and to explore the associations between ACEs and experience of violence by intimate partners and non-partners in adulthood. PARTICIPANTS AND SETTING: 2,887 participants (1464 female, 1423 male) from the 2019 New Zealand Family Violence Survey, a population based study conducted in New Zealand between March 2017-March 2019. METHODS: Descriptive statistics for prevalence of each of the eight ACE types, and cumulative ACE scores were estimated across sociodemographic groups. Multivariate logistic regression models were developed to assess association between ACEs and five IPV and two non-partner violence variables. RESULTS: ACEs were prevalent and co-occurring, with 55 % (95 % CI 53.2 %-56.8 %) of respondents reporting having experienced at least one ACE and 11.6 % (95 % CI 10.4 %-12.8 %) reporting at least four ACEs before the age of 18. Those who were younger, had lower socioeconomic status, and who identified as Maori reported higher prevalence of ACEs. Exposure to any ACE was significantly associated with later exposure to IPV and non-partner violence. CONCLUSIONS: The findings provide the first comprehensive assessment of the prevalence of ACEs in the New Zealand population. They suggest that prevention of childhood trauma, maltreatment, and family dysfunction remain important and interconnected public health goals that need to be addressed to support the wellbeing of children and adults.

Change in prevalence rates of physical and sexual intimate partner violence against women: data from two cross-sectional studies in New Zealand, 2003 and 2019.

OBJECTIVES: To explore changes in reported prevalence of physical and sexual intimate partner violence (IPV) between 2003 and 2019. The impact of sociodemographic differences between the two samples and between group differences were also examined. Changes in attitudes supportive of violence and in help-seeking behaviour following disclosure were also explored. DESIGN: Two cross-sectional studies. SETTING AND PARTICIPANTS: Cross-sectional studies on family violence conducted in New Zealand in 2003 and 2019. Ever-partnered female respondents aged 18-64 years old were included (2003 n=2674, 2019 n=944). MAIN OUTCOME MEASURES: Prevalence rates of lifetime and past 12-month physical and sexual IPV, attitudes towards gender roles and acceptability of a man hitting his wife, help sought and received following disclosure were compared between the study years. RESULTS: Lifetime prevalence of physical IPV was unchanged between 2003 and 2019 (AOR=0.89; 95% CI 0.73 to 1.08). There was a significant decrease in the proportion of women who reported experiencing 12-month physical IPV (AOR=0.53; 95% CI 0.29 to 0.97). Small reductions in rates for lifetime sexual IPV were also observed (AOR=0.74; 95% CI 0.59 to 0.95). In 2019, fewer women agreed with one or more statements supportive of traditional gender roles (48.1% (95% CI 45.7% to 50.5%) in 2003; 38.4% (95% CI 33.8% to 43.2%) in 2019). A significant decrease was noted in the proportion of women who sought help from informal sources (from 71.3% (95% CI 68.1% to 74.2%) in 2003 to 64.6% (95% CI 58.7% to 70.1%) in 2019). No significant changes in seeking help from formal sources, or perceived helpfulness from any source were noted. CONCLUSION: While the reductions in 12-month physical and lifetime sexual IPV are positive, prevention efforts need to be established, maintained and strengthened to address the substantial lifetime prevalence of IPV. Efforts to strengthen responses from formal and informal sources continue to be needed.

Change in prevalence of psychological and economic abuse, and controlling behaviours against women by an intimate partner in two cross-sectional studies in New Zealand, 2003 and 2019.

OBJECTIVES: Changes in reported lifetime prevalence of psychological abuse, controlling behaviours and economic abuse between 2003 and 2019, and past 12-month prevalence of psychological abuse by an intimate partner were examined. DESIGN: Cross-sectional analysis. SETTING AND PARTICIPANTS: Data came from two surveys of family violence in New Zealand, conducted in 2003 and 2019. Respondents were ever partnered women aged 18-64 years old (2003 n=2673; 2019 n=935). MAIN OUTCOME MEASURES: Prevalence rates for psychological abuse, controlling behaviours and economic abuse were compared between the two study years using logistic regression. Sociodemographic and economic correlates of each abuse subtype were investigated. Interactions were examined between sociodemographic factors and the study year for reported prevalence rates. RESULTS: There was a reduction in reported past 12-month experience of two or more acts of psychological intimate partner violence (IPV) from 8.4% (95% CI 7.3 to 9.6) in 2003 to 4.7% (95% CI 3.2 to 6.2) in 2019. The reported lifetime prevalence of two or more acts of controlling behaviours increased from 8.2% in 2003 (95% CI 7.0 to 9.5) to 13.4% in 2019 (95% CI 11.0 to 15.7). Lifetime prevalence of economic IPV also increased from 4.5% in 2003 (95% CI 3.5 to 5.5) to 8.9% in 2019 (95% CI 6.7 to 11.1). Those who were divorced/separated or cohabiting, and those living in the most deprived areas were more likely to report past year psychological IPV, lifetime controlling behaviours and economic abuse. A higher proportion of women who were married or cohabiting reported controlling behaviours in 2019 compared with 2003. CONCLUSION: While the reduction in reported past year psychological IPV is encouraging, the increase in the lifetime prevalence of controlling behaviours and economic abuse from 2003 to 2019 is worth critical evaluation. Results highlight potential gaps in current IPV prevention programmes, the need to identify and address underlying drivers of abusive behaviour and the importance of measuring multiple forms of IPV independently.

Modifiable Early Childhood Risk Factors for Obesity at Age Four Years.

Background: Childhood obesity is associated with an increased risk of adult obesity and related chronic disease. Our aim was to identify modifiable exposures that are independently associated with obesity in the preschool age group. Methods: A prospective cohort study of 5734 children in New Zealand with anthropometric measurements was completed at age 4.5 years. The modifiable exposures of interest, measured at age 9 months and 2 years, were: food security during infancy; and, at age 2 years, screen time; sleep duration; and takeaway food and soft drink intake. The risk of obesity independently associated with each exposure was determined using Binomial and Poisson regression and described using adjusted risk ratios (RRs) and 95% confidence intervals (CIs), after controlling for confounding variables including gender, ethnicity, birth weight, and mother's age. The probability of obesity given cumulative exposures to the four risk factors and the population attributable fraction (PAF) were estimated. Results: Lower food security during infancy (1 hour/day; RR = 1.22; 95% CI : 1.01-1.48), shorter sleep duration (≤11.5 hours/day; RR = 1.30; 95% CI : 1.05-1.61), and weekly to daily consumption of takeaway/soft drink (RR = 1.25, 95% CI : 1.00-1.57) were independently associated with an increased risk of obesity at age 4.5 years. The cumulative PAF for childhood obesity was 42.9%, under an ideal scenario where all risk factors were eliminated. Conclusion: Exposure to modifiable factors by age 2 years is associated with obesity at age 4.5 years. Interventions to prevent childhood obesity need to be effective during infancy.

A century of sexual abuse victimisation: A birth cohort analysis.

This study examined changes in the reported prevalence of adult and child sexual abuse over the last century and explored how changes in social and political circumstances may have affected rates. Data from two population-based face-to-face surveys conducted in New Zealand (samples of 2855 women in 2003 and 1464 women in 2019) were used to produce birth cohort prevalence estimates of three forms of sexual abuse including by an intimate partner (lifetime and 12-month), by non-partners, and child sexual abuse. A timeline of major population influences that might be associated with violence occurrence was developed. There were no changes in reported lifetime intimate partner sexual abuse prevalence estimates found over the past century. The most recent birth cohort reported the lowest rates of 12-month prevalence estimates for intimate partner sexual abuse, lifetime rates of non-partner sexual abuse, and also suggest lower reported rates of child sexual abuse. Macro-social events including feminist movements, changes in legislation, and an increase in public awareness might have contributed to women's awareness about the non-acceptability of violent behaviour, and their ability to leave relationships after violence has occurred. This may have contributed to the small recent decreases in reported 12-month rate of sexual IPV and CSA, as women's ability to leave relationships may be protective for their children. The recent decrease in reported non-partner sexual violence may also be attributed to women's greater awareness of, and agency to avoid sexual abuse. The lack of change for the lifetime prevalence of sexual IPV over the past century highlights the need for ongoing prevention efforts. While recent reductions in reported rates of child and adult sexual abuse are encouraging, even reduced rates are high and warrant sustained implementation of prevention policies and programs.

Intergenerational Impact of Violence Exposure: Emotional-Behavioural and School Difficulties in Children Aged 5-17.

Background and Objectives: The intergenerational impacts of parental exposure to violence during childhood and adulthood have largely been investigated separately. This limits our understanding of how cumulative violence exposure over a lifespan elevates the risk of subsequent generation's maladjustment. To address this, we examined if parental exposure to violence during childhood and during adulthood was associated with increased emotional-behavioural and school difficulties among the children of these parents. Further, we examined if parental exposure to cumulative violence increased the odds of their children experiencing difficulties. Participants and Setting: 705 participants (354 mothers and 351 fathers) from the 2019 New Zealand Family Violence Survey, a population-based study conducted in New Zealand between March 2017 and March 2019. Methods: Multivariable logistic regressions were conducted to ascertain the impact of parental exposure to violence on children's outcomes after adjustment for sociodemographic characteristics. The impact of parental cumulative violence exposure on children's outcomes was also explored. Results: Findings indicated that children of parents who had histories of exposure to violence during childhood were at increased risk for experiencing emotional-behavioural or school difficulties. However, where parents reported a history of childhood abuse but not adult experience of violence, their children had similar odds of experiencing difficulties as the children of parents who had not been exposed to any violence in their lifetime. Children of parents who had been exposed to violence only during adulthood were at higher risk of experiencing emotional-behavioural difficulties compared with children of parents with no violence exposure. Children of parents with histories of exposure to violence during both childhood and adulthood had the highest prevalence of experiencing emotional/behavioural and school difficulties. Conclusion: These findings highlight the intergenerational impacts of violence exposure and the complex intersections between parents' and children's life experiences. Our findings suggest the need for violence prevention initiatives to foster the development of safe, stable and nurturing relationships and to expand services for parents already exposed to violence to build resilience and to break the inter-generational cycle of disadvantage.