Intimate Partner Violence against Women during the COVID-19 Lockdown in Spain.

AIMS: To analyze the temporal and geographical distribution of different indicators for the evolution of intimate partner violence against women (IPV) before, during and after the COVID-19 induced lockdown between March and June 2020 in Spain. METHODS: Descriptive ecological study based on numbers of 016-calls, policy reports, women killed, and protection orders (PO) issued due to IPV across Spain as a whole and by province (2015-2020). We calculated quarterly rates for each indicator. A cluster analysis was performed using 016-call rates and protection orders by province in the second quarters of 2019 and 2020. ANOVAs were calculated for clustering by province, unemployment rates by province, and the current IPV prevalence. RESULTS: During the second quarter of 2020, the highest 016-call rate was recorded (12.19 per 10,000 women aged 15 or over). Policy report rates (16.62), POs (2.81), and fatalities (0.19 per 1,000,000 women aged 15 or over) decreased in the second quarter of 2020. In the third quarter, 016-calls decreased, and policy reports and POs increased. Four clusters were identified, and significant differences in unemployment rates between clusters were observed (F = 3.05, p < 0.05). CONCLUSIONS: The COVID-19 lockdown fostered a change in IPV-affected women's help-seeking behavior. Differences between the volume of contacts made via 016-call and the policy reports generated provide evidence for the existence of barriers to IPV-service access during the lockdown and the period of remote working. More efforts are needed to reorganize services to cope with IPV in non-presential situations. The provinces with the highest 016-call and PO rates were also those with the highest rates of unemployment, a worrying result given the current socioeconomic crisis.

[Validation of the Spanish Version of Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS)]. / Validación de la versión española del cuestionario Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS).

BACKGROUND: At the international level PREMIS -"Physician Readiness to Manage Intimate Partner Violence Survey"- is amongst the most comprehensive instruments to evaluate primary health care professionals' readiness. The aim of this study is to assess the reliability, internal consistency and construct validity of the Spanish version of this questionnaire. METHODS: After translation, back translation and assessment of content validity of the questionnaire, 200 questionnaires were distributed to medical doctors and nurses working in 15 primary health care centres located in 4 autonomous regions (Comunidad Valenciana, Castilla León, Murcia, Cantabria), in 2013. Cronbach's alpha, intraclass correlation and rho Spearman coefficients were calculated. RESULTS: the Spanish version of PREMIS encompasses 64 items. Cronbach's alpha coefficient was greater than or close to 0.7 in most of indices. Intraclass correlation coefficient of 0.87 and Spearman coefficient of 0.67 showed a high reliability. All correlations for the scale of Opinions, which is the only one that was considered factorial structure of the questionnaire PREMIS, were higher than 0.30. CONCLUSIONS: the Spanish version of PREMIS obtained good internal validity, high reliability and predictive self-reported capacity of medical practitioners and nurses in Intimate Partner Violence cases in PHC centers.

Validación de la versión española del cuestionario Physician readiness to manage intimate partner violence survey (PREMIS) / Validation of the Spanish version of Physician readiness to manage intimate partner violence survey (PREMIS)

Fundamentos: El Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) es uno de los cuestionarios más completos en el contexto internacional para la valoración de la capacidad de respuesta frente a la violencia del compañero íntimo por los profesionales de Atención Primaria de Salud. El objetivo de este estudio fue determinar la fiabilidad, consistencia interna y validez de constructo de la versión española de este cuestionario. Métodos: Tras la traducción, retrotraducción y valoración de la validez de contenido del cuestionario, se distribuyeron en una muestra de 200 profesionales de medicina y enfermería de 15 centros de atención primaria de 4 Comunidades Autónomas en 2013 (Comunidad Valenciana, Castilla León, Murcia y Cantabria). Se calcularon los coeficientes alfa de Cronbach, los de correlación intraclase y rho de Spearman (test-retest). Resultados: la versión española del PREMIS incluyó 64 ítems. El coeficiente α de Cronbach fue superior a 0,7 o muy cercano a ese valor en la mayoría de los índices. Se obtuvo un coeficiente de correlación intraclase de 0,87 y un coeficiente de Spearman de 0,67 que muestran una fiabilidad alta. Todas las correlaciones observadas para la escala de opiniones, la única tratada como estructura factorial en el cuestionario PREMIS, fueron superiores a 0,30. Conclusiones: el PREMIS en español obtuvo una buena validez interna, alta fiabilidad y capacidad predictiva de las prácticas auto-referidas por médicos(as) y enfermeros(as) frente a casos de violencia del compañero íntimo en centros de atención primaria (AU)

Background: At the international level PREMIS - 'Physician Readiness to Manage Intimate Partner Violence Survey'- is amongst the most comprehensive instruments to evaluate primary health care professionals’ readiness. The aim of this study is to assess the reliability, internal consistency and construct validity of the Spanish version of this questionnaire. Methods: After translation, back translation and assessment of content validity of the questionnaire, 200 questionnaires were distributed to medical doctors and nurses working in 15 primary health care centres located in 4 autonomous regions (Comunidad Valenciana, Castilla León, Murcia, Cantabria), in 2013. Cronbach’s alpha, intraclass correlation and rho Spearman coefficients were calculated. Results: the Spanish version of PREMIS encompasses 64 items. Cronbach’s alpha coefficient was greater than or close to 0.7 in most of indices. Intraclass correlation coefficient of 0.87 and Spearman coefficient of 0.67 showed a high reliability. All correlations for the scale of Opinions, which is the only one that was considered factorial structure of the questionnaire PREMIS, were higher than 0.30. Conclusions: the Spanish version of PREMIS obtained good internal validity, high reliability and predictive self-reported capacity of medical practitioners and nurses in Intimate Partner Violence cases in PHC centers (AU)

Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality.

BACKGROUND: Intimate partner violence (IPV) against women is a complex worldwide public health problem. There is scarce research on the independent effect on IPV exerted by structural factors such as labour and economic policies, economic inequalities and gender inequality. OBJECTIVE: To analyse the association, in Spain, between contextual variables of regional unemployment and income inequality and individual women's likelihood of IPV, independently of the women's characteristics. METHOD: We conducted multilevel logistic regression to analyse cross-sectional data from the 2011 Spanish Macrosurvey of Gender-based Violence which included 7898 adult women. The first level of analyses was the individual women' characteristics and the second level was the region of residence. RESULTS: Of the survey participants, 12.2% reported lifetime IPV. The region of residence accounted for 3.5% of the total variability in IPV prevalence. We determined a direct association between regional male long-term unemployment and IPV likelihood (P = 0.007) and between the Gini Index for the regional income inequality and IPV likelihood (P < 0.001). Women residing in a region with higher gender-based income discrimination are at a lower likelihood of IPV than those residing in a region with low gender-based income discrimination (odds ratio = 0.64, 95% confidence intervals: 0.55-0.75). CONCLUSIONS: Growing regional unemployment rates and income inequalities increase women's likelihood of IPV. In times of economic downturn, like the current one in Spain, this association may translate into an increase in women's vulnerability to IPV.

Social and immigration factors in intimate partner violence among Ecuadorians, Moroccans and Romanians living in Spain.

BACKGROUND: Intimate partner violence (IPV) against women occurs in all countries, all cultures and at every level of society; however, some populations may be at greater risk than others. The aim of this study was to explore IPV prevalence among Ecuadorian, Moroccan and Romanian immigrant women living in Spain and its possible association with their personal, family, social support and immigration status characteristics. METHODS: Cross-sectional study of 1607 adult immigrant women residing in Barcelona, Madrid and Valencia (2011). Prevalence rates and adjusted odds ratios (AORs) were calculated, with current IPV being the outcome. Different women's personal (demographic), family, social support and immigration status characteristics were considered as explicative and control variables. All analyses were separated by women's country of origin. RESULTS: Current IPV prevalence was 15.57% in Ecuadorians, 10.91% in Moroccans and 8.58% in Romanians. Some common IPV factors were found, such as being separated and/or divorced. In Romanians, IPV was also associated with lack of social support [AOR 5.96 (1.39-25.62)] and low religious involvement [AOR 2.17 (1.06-4.43)]. The likelihood of current IPV was lower among women without children or other dependents in this subgroup [AOR 0.29 (0.093-0.92)]. CONCLUSION: The IPV prevalence rates obtained for Moroccan, Romanian and Ecuadorian women residing in Spain were similar. Whereas the likelihood of IPV appeared to be relatively evenly distributed among Moroccan and Ecuadorian women, it was higher among Romanian women in socially vulnerable situations related to family responsibilities and the lack of support networks. The importance of intervention in the process of separation and divorce was common to all women.

Application of the Putting Women First protocol in a study on violence against immigrant women in Spain.

In this paper, we describe our experience of using the Putting Women First protocol in the design and implementation of a cross-sectional study on violence against women (VAW) among 1607 immigrant women from Morocco, Ecuador and Romania living in Spain in 2011. The Putting Women First protocol is an ethical guideline for VAW research, which includes recommendations to ensure the safety of the women involved in studies on this subject. The response rate in this study was 59.3%. The prevalence of VAW cases last year was 11.7%, of which 15.6% corresponded to Ecuadorian women, 10.9% to Moroccan women and 8.6% to Romanian women. We consider that the most important goal for future research is the use of VAW scales validated in different languages, which would help to overcome the language barriers encountered in this study.

Social determinants and health effects of low and high severity intimate partner violence.

PURPOSE: We sought to analyze whether the sociodemographic profile of battered women varies according to the level of severity of intimate partner violence (IPV), and to identify possible associations between IPV and different health problems taking into account the severity of these acts. METHODS: A cross-sectional study of 8,974 women (18-70 years) attending primary healthcare centers in Spain (2006-2007) was performed. A compound index was calculated based on frequency, types (physical, psychological, or both), and duration of IPV. Descriptive and multivariate procedures using logistic regression models were fitted. RESULTS: Women affected by low severity IPV and those affected by high severity IPV were found to have a similar sociodemographic profile. However, divorced women (odds ratio [OR], 8.1; 95% confidence interval [CI], 3.2-20.3), those without tangible support (OR, 6.6; 95% CI, 3.3-13.2), and retired women (OR, 2.7; 95% CI, 1.2-6.0) were more likely to report high severity IPV. Women experiencing high severity IPV were also more likely to suffer from poor health than were those who experienced low severity IPV. CONCLUSIONS: The distribution of low and high severity IPV seems to be influenced by the social characteristics of the women involved and may be an important indicator for estimating health effects. This evidence may contribute to the design of more effective interventions.

Identifying sociodemographic differences in Intimate Partner Violence among immigrant and native women in Spain: a cross-sectional study.

OBJECTIVES: To analyze whether sociodemographics and social support have a different or similar effect on the likelihood of Intimate Partner Violence in immigrants and natives, and to estimate prevalences and associations between different types of IPV depending on women's birthplace. METHODS: Cross-sectional study of 10,048 women (18-70 years) attending primary healthcare in Spain (2006-2007). OUTCOME: Current Intimate Partner Violence (psychological, physical and both). Sociodemographics and social support were considered first as explicative and later as control variables. RESULTS: Similar Intimate Partner Violence sociodemographic and social support factors were observed among immigrants and natives. However, these associations were stronger among immigrants, except in the case of poor social support (adjusted odds ratio natives 4.36 and adjusted odds ratio immigrants 4.09). When these two groups were compared, immigrants showed a higher likelihood of IPV than natives (adjusted odds ratios 1.58). CONCLUSION: Immigrant women are in a disadvantaged Intimate Partner Violence situation. It is necessary that interventions take these inequalities into account.

Violencia de género en mujeres inmigrantes y españolas: magnitud, respuestas ante el problema y políticas existentes / Gender-based violence in immigrant and spanish women: scale of the problem, responses and current policies

Objetivo: Comparar la prevalencia de la violencia de género entre mujeres inmigrantes y españolas. Describir sus respuestas ante esta situación y posibles diferencias entre ellas. Identificar intervenciones ya existentes en España sobre prevención y atención sociosanitaria de violencia de género dirigidas a inmigrantes. Métodos: Estudio transversal mediante encuesta autoadministrada en 10.202 mujeres que acudieron a centros de atención primaria en España (2006-2007). Análisis de contenido del informe de seguimiento de la ley 1/2004 de medidas de protección integral contra la violencia de género remitido por las comunidades autónomas (CC.AA.) (2005) y las leyes y planes autonómicos más recientes. Resultados: La prevalencia de violencia de género en las españolas es del 14,3% y en las inmigrantes del 27,3%. La probabilidad de violencia de género en las inmigrantes es mayor (odds ratioajustada: 2,06; intervalo de confianza del 95%: 1,61–2,64). Las inmigrantes dijeron haber denunciado a su pareja con más frecuencia, así como que no sabían resolver su situación. Algunas CC.AA. ya han emprendido intervenciones para superar las barreras de acceso a los servicios sociosanitarios, pero sólo tres facilitan el número de mujeres inmigrantes beneficiarias de ayudas económicas y laborales hasta 2005. Conclusiones: Existe una desigual distribución en la prevalencia de la violencia de género según el país de origen, afectando en mayor medida a las mujeres inmigrantes. Éstas denuncian con más frecuencia que las españolas, pero tal actuación no supone una garantía de resultados efectivos. Aunque se han identificado otras intervenciones específicas en algunas CC.AA., sería necesario evaluarlas para asegurar que las mujeres inmigrantes se están beneficiando (AU)

Objective: To compare the prevalence of gender-based violence among immigrant and Spanish women. To describe their responses to this problem and the possible differences. To identify specific interventions to deal with gender-based violence in immigrant women in Spain. Methods: We performed a cross-sectional survey through a self-administered questionnaire in 10,202 women attending primary care in Spain (2006-2007). A content analysis was performed of the follow-up report of law 1/2004 of integral protection measures against gender violence sent by each Spanish region (2005) and the most recent regional laws and acts. Results: The prevalence of gender-based violence was 14.3% in Spanish women and 27.9% in immigrant women. The likelihood of gender-based violence was higher in immigrant (odds ratio adjusted: 2.06; 95% confidence interval: 1.61–2.64). Immigrant women more frequently reported that they had denounced their intimate partners and that they did not know how to manage the situation. Some Spanish regions have already started interventions to overcome access barriers to social and health services, but only three have provided data on the number of immigrant women who received economic and occupational help up to 2005. Conclusions: Inequalities were observed in the prevalence of gender-based violence according to country of origin, with immigrant women being more frequently affected. Immigrant women more frequently denounce their intimate partners than Spanish women but this action does not guarantee effective results. Other specific interventions have been identified in some autonomous regions of Spain but these interventions need to be evaluated to ensure that they benefit immigrant women (AU)

[Gender-based violence against immigrant and Spanish women: scale of the problem, responses and current policies]. / Violencia de género en mujeres inmigrantes y españolas: magnitud, respuestas ante el problema y políticas existentes.

OBJECTIVE: To compare the prevalence of gender-based violence among immigrant and Spanish women. To describe their responses to this problem and the possible differences. To identify specific interventions to deal with gender-based violence in immigrant women in Spain. METHODS: We performed a cross-sectional survey through a self-administered questionnaire in 10,202 women attending primary care in Spain (2006-2007). A content analysis was performed of the follow-up report of law 1/2004 of integral protection measures against gender violence sent by each Spanish region (2005) and the most recent regional laws and acts. RESULTS: The prevalence of gender-based violence was 14.3% in Spanish women and 27.9% in immigrant women. The likelihood of gender-based violence was higher in immigrant (odds ratio adjusted: 2.06; 95% confidence interval: 1.61-2.64). Immigrant women more frequently reported that they had denounced their intimate partners and that they did not know how to manage the situation. Some Spanish regions have already started interventions to overcome access barriers to social and health services, but only three have provided data on the number of immigrant women who received economic and occupational help up to 2005. CONCLUSIONS: Inequalities were observed in the prevalence of gender-based violence according to country of origin, with immigrant women being more frequently affected. Immigrant women more frequently denounce their intimate partners than Spanish women but this action does not guarantee effective results. Other specific interventions have been identified in some autonomous regions of Spain but these interventions need to be evaluated to ensure that they benefit immigrant women.

Perfil sociodemográfico de las mujeres afectadas por violencia del compañero íntimo en España / Sociodemographic profile of women affected by intimate partner violence in Spain

ObjetivoDeterminar la prevalencia de la violencia del compañero íntimo declarada y analizar sus principales características sociodemográficas.MétodosEstudio transversal basado en la Encuesta Nacional de Salud de España de 2006 (ENS-06). La muestra son las 13.094 mujeres dispuestas a responder preguntas sobre malos tratos (87,2% del total de las encuestadas). Se realizó un análisis bivariado y multivariado, siendo la variable dependiente la violencia del compañero íntimo declarada y las independientes el nivel de estudios, el empleo, el estado civil, la situación de convivencia con la pareja o análogo, el número de menores en el hogar, el país de origen (españolas frente a extranjeras) y la edad.ResultadosLa violencia del compañero íntimo es reconocida por un 1% (n=128) de la muestra. La violencia declarada se asocia con tener estudios primarios o no tener estudios (odds ratio [OR]: 3,63 [1,90–6,92]), tres o más menores (OR: 3,51 [1,78–6,90]) y estar separada o divorciada (OR: 2,81 [1,89–4,97]), una vez controlado el efecto del resto de las variables. La violencia del compañero íntimo declarada es mayor entre las mujeres nacidas fuera de España (OR: 2,83 [1,87–4,28]).ConclusionesLa violencia del compañero íntimo parece manifestarse de manera desigual entre las mujeres españolas y las extranjeras. El nivel educativo, el número de menores en el hogar y el estado civil son las características que más se asocian a la violencia declarada por las mujeres. Sería pertinente reflexionar sobre la sensibilidad de las medidas existentes contra la violencia del compañero íntimo en relación a las necesidades de las mujeres afectadas(AU)

ObjectiveTo determine the prevalence of reported intimate partner violence (IPV) and to analyze the main sociodemographic characteristics of affected women.MethodsWe performed a cross-sectional study based on the Spanish National Health Survey of 2006. The sample comprised 13,094 women who agreed to answer questions about violence (87.2% of the total interviewees). Bivariate and multivariate analyses were performed. The dependent variable was reported IPV and the independent variables were educational level, employment, marital status, living arrangements with the partner or analogous individual, number of children at home, nationality (Spanish vs. foreign women) and age.ResultsIPV was reported by 1% (n=128) of the sample. Women with primary school education or without studies (odds ratio [OR]: 3.63 [1.90–6.92]), with three or more children (OR: 3.51 [1.78–6.90]), and those who were separated or divorced (OR: 2.81 [1.89–4.97]) were most likely to experience IPV when the effect of the remaining variables was controlled. The likelihood of IPV was also higher in women born outside Spain (OR: 2.83 [1.87–4.28]).ConclusionsIPV seems not to affect Spanish and foreign women equally. The characteristics most closely associated with women affected by IPV were educational level, the number of children at home and marital status. The sensitivity of current measures against IPV should be considered in relation to the needs of affected women(AU)

[Sociodemographic profile of women affected by intimate partner violence in Spain]. / Perfil sociodemográfico de las mujeres afectadas por violencia del compañero íntimo en España.

OBJECTIVE: To determine the prevalence of reported intimate partner violence (IPV) and to analyze the main sociodemographic characteristics of affected women. METHODS: We performed a cross-sectional study based on the Spanish National Health Survey of 2006. The sample comprised 13,094 women who agreed to answer questions about violence (87.2% of the total interviewees). Bivariate and multivariate analyses were performed. The dependent variable was reported IPV and the independent variables were educational level, employment, marital status, living arrangements with the partner or analogous individual, number of children at home, nationality (Spanish vs. foreign women) and age. RESULTS: IPV was reported by 1% (n=128) of the sample. Women with primary school education or without studies (odds ratio [OR]: 3.63 [1.90-6.92]), with three or more children (OR: 3.51 [1.78-6.90]), and those who were separated or divorced (OR: 2.81 [1.89-4.97]) were most likely to experience IPV when the effect of the remaining variables was controlled. The likelihood of IPV was also higher in women born outside Spain (OR: 2.83 [1.87-4.28]). CONCLUSIONS: IPV seems not to affect Spanish and foreign women equally. The characteristics most closely associated with women affected by IPV were educational level, the number of children at home and marital status. The sensitivity of current measures against IPV should be considered in relation to the needs of affected women.

[Gender development inequalities epidemiology in Spain (1990-2000)]. / Epidemiología de las desigualdades del desarrollo de género en España (1990-2000).

BACKGROUND: Gender is an important health determinant for public health policies. This study describes the changes in gender development inequalities in Spain and its autonomous regions from 1990 to 2000. METHODS: An ecological study using the Human Development Index (HDI) and the Gender Development Index (GDI) was done. IDG both men and women was analysed according to indexes of education, income and life expectancy at birth. RESULTS: Although the GDI has had an increase of 5,05% in the 90 s, 51,5% of the population was located above the global GDI of Spain in 1990, moreover this number decreased to 46,3% in 2000. Gender inequalities have been reduced both at national and regional levels. The regions with the lowest increase were Asturias (3.37%), Cantabria (3.68%) and Baleares Islands (3.71%). The regions with the highest increase were Madrid (6,46%) and Extremadura (6,75%). All the autonomous regions showed a number of GDI lower than the value of HDI. Both sexes achieved similar increase in life expectancy (Men: 5% and Women: 4%). An unequal variation was detected according to the autonomous region (Basque Country; Men: 7% and Women: 3%; Madrid; Men:8% and Women:5%). Women have improved their educational level in comparison to men (Men: 3% and Women: 6%). In the 90 s, men obtained more income than women, but women improved their situation three times more than men. CONCLUSIONS: Inequalities in Human Development analysed by gender have been reduced in the 90 s in Spain. However, the improvement of education, income and life expectancy occurred only in some autonomous regions. This situation shows the differences among Spanish autonomous regions.

[Mortality due to intimate partner violence in foreign women living in Spain (1999-2006)]. / Mortalidad por violencia del compañero íntimo en mujeres extranjeras residentes en España (1999-2006).

OBJECTIVES: To describe the distribution of mortality due to intimate partner violence (IPV) in foreign women living in Spain and to explore the potentially greater risk of dying from IPV in this group. METHODS: We performed a retrospective ecological study of deaths from IPV registered by the Women's Institute of Spain (1999-2006). Mortality rates and Poisson models for relative risk and 95% confidence intervals were calculated. RESULTS: The average risk of dying from IPV in foreign women was 5.3 times greater than that in Spanish women. In the years studied, the increased risk in foreign women was 2 to 8 times greater than that in Spanish women. CONCLUSION: Foreign women living in Spain are especially vulnerable to death from IPV. Further research on the causes of this phenomena and strategies involving health services are needed.

Epidemiología de las desigualdades del desarrollo de género en España (1990-2000) / Gender development inequalities epidemiology in Spain (1990-2000)

Fundamento: El género es un determinante de la salud importante para las Políticas de Salud Pública. Este estudio describe los cambios en las desigualdades del desarrollo de género en España y sus Comunidades Autónomas (CCAA) en la década 1990 y 2000. Métodos: Estudio ecológico del Índice de Desarrollo Humano (IDH) y el Índice de Desarrollo de Género (IDG) y sus componentes por sexo (educación, ingresos y esperanza de vida al nacer). Resultados: El IDG de España ha crecido en un 5,05% en los años 90. Pero, mientras que en 1990 el 51,5% de la población estaba ubicada por encima del IDG promedio español en 2000 disminuyó al 46,3%. Asturias: 3,37%, Cantabria: 3,68% e Islas Baleares: 3,71% son las de menor crecimiento; Madrid: 6,46% y Extremadura: 6,75% las de mayor. Todas las CCAA. tienen un valor de IDG menor que de IDH. Ambos sexos tuvieron un crecimiento promedio similar en la esperanza de vida (Hombres: 5% y Mujeres: 4%) manteniéndose las diferencias, aunque se detectan variaciones según CCAA. En educación, las mujeres mejoraron el doble que los hombres (Hombres: 3% y Mujeres: 6%), siendo Cataluña, Aragón, Madrid, Baleares y Galicia las de mayor igualdad. Pese a que las mujeres mejoraron el triple que los hombres en el índice de ingresos (Hombres: 3% y Mujeres: 9%), las diferencias persisten a favor de los hombres. Conclusiones: Las desigualdades en el desarrollo de género disminuyeron en los 90 en España, aunque la mejora de la educación, ingresos y esperanza de vida se produjo sólo en algunas CCAA, persistiendo diferencias interregionales (AU)

Background: Gender is an important health determinant for public health policies. This study describes the changes in gender development inequalities in Spain and its autonomous regions from 1990 to 2000. Methods: An ecological study using the Human Development Index (HDI) and the Gender Development Index (GDI) was done. IDG both men and women was analysed according to indexes of education, income and life expectancy at birth. Results: Although the GDI has had an increase of 5,05% in the 90´s, 51,5% of the population was located above the global GDI of Spain in 1990, moreover this number decreased to 46,3% in 2000. Gender inequalities have been reduced both at national and regional levels. The regions with the lowest increase were Asturias (3.37%), Cantabria (3.68%) and Baleares Islands (3.71%). The regions with the highest increase were Madrid (6,46%) and Extremadura (6,75%). All the autonomous regions showed a number of GDI lower than the value of HDI. Both sexes achieved similar increase in life expectancy (Men: 5% and Women: 4%). An unequal variation was detected according to the autonomous region (Basque Country; Men: 7% and Women: 3%; Madrid; Men:8% and Women:5%). Women have improved their educational level in comparison to men (Men: 3% and Women: 6%). In the 90s, men obtained more income than women, but women improved their situation three times more than men. Conclusions: Inequalities in Human Development analysed by gender have been reduced in the 90s in Spain. However, the improvement of education, income and life expectancy occurred only in some autonomous regions. This situation shows the differences among Spanish autonomous regions (AU)

Mortalidad por violencia del compañero íntimo en mujeres extranjeras residentes en España (1999-2006) / Mortality due to intimate partner violence in foreign women living in Spain [1999-2006]

Objetivos: Describir la evolución de la mortalidad por violencia del compañero íntimo (VCI) en las mujeres extranjeras residentes en España y explorar un posible mayor riesgo de este colectivo de morir por VCI.Métodos: Estudio ecológico retrospectivo basado en las muertes por VCI del Instituto de la Mujer (1999-2006). Cálculo de tasas de mortalidad y modelos de Poisson para el cálculo de riesgos relativos e intervalos de confianza del 95%.Resultados: El riesgo de morir por VCI de una mujer extranjera es 5,3 veces mayor que el de una española, y por años estudiados las extranjeras tienen un riesgo 2-8 veces mayor.Conclusión: Las mujeres extranjeras residentes en Españason especialmente vulnerables ante la muerte por VCI. Se requiere una mayor investigación para profundizar en las causas y estrategias transversales que también impliquen al sector sanitario

Objectives: To describe the distribution of mortality due to intimate partner violence (IPV) in foreign women living in Spain and to explore the potentially greater risk of dying from IPV in this group.Methods: We performed a retrospective ecological study ofdeaths from IPV registered by the Women’s Institute of Spain (1999-2006). Mortality rates and Poisson models for relative risk and 95% confidence intervals were calculated.Results: The average risk of dying from IPV in foreign women was 5.3 times greater than that in Spanish women. In the years studied, the increased risk in foreign women was 2 to 8 times greater than that in Spanish women.Conclusion: Foreign women living in Spain are especially vulnerable to death from IPV. Further research on the causes of this phenomena and strategies involving health services are needed (AU)

[Temporary distribution of reports and murders because of partner violence during the period 1998-2006, Spain]. / Distribución temporal de las denuncias y muertes por violencia de género en España en el período 1998-2006.

BACKGROUND: Intimate Partner Violence (IPV) has received special attention in the spanish political agenda. Despite the importance of developed interventions, empirical evidence about their effectiveness is scarce. The aim of this study is to explore the temporary distribution of Intimate Partner Violence (IPV) reports and murders and to identify possible changes in the risk of dying and reporting by IPV from the Spanish law against gender violence of December of 2004. METHODS: We performed a descriptive study based on statistics of The Woman's Institute and The Divorced and Separated Women Federation. CALCULATIONS: IPV mortality and reports rates by years and periods around the law (1998-2004 vs. 2005-2006); Poisson Regression; and, Epidemic index by months -Ratio between the actual number of IPV murders and reports in a given month and the median number of cases in the same month in the five preceding years- and underlying epidemic index -annual average of the scores of the epidemic index of reports and murders. RESULTS: The epidemic index trends permit us to observe that the problem has decreased since 2005. Nevertheless, the possibility of reporting IPV between 2005 and 2006 is 1.6 times upper that between 1998 and 2004. The risk of dying by this cause does not show statistically significant changes. CONCLUSION: The possibility of reporting IPV has been increased in Spain throughout the time. However, the risk of dying stays. Although still it is soon for the evaluation of the impact of the law in this epidemic, we could say that its effectiveness for the reduction of IPV mortality seems limited.

Distribución temporal de las denuncias y muertes por violencia de género en España en el período 1998-2006 / Temporary distribution of reports and murders because of partner violence during the period 1998-2006, Spain

Fundamento: la violencia del compañero íntimo contra las mujeres (VCI) ha recibido especial dedicación de la agenda política española. A pesar de la importancia de las intervenciones desarrolladas, la evidencia empírica sobre su efectividad es todavía escasa. El objetivo de este estudio es explorar la distribución temporal de las denuncias y muertes por VCI e identificar posibles cambios de tendencia en las muertes y denuncias por VCI a partir de la Ley española contra la violencia de género de diciembre de 2004. Métodos: estudio descriptivo de denuncias y muertes por VCI (1998-2006) basado en las estadísticas del Instituto de la Mujer y la Federación de Mujeres Separadas y Divorciadas. Cálculos: Tasas de mortalidad ajustadas por edad y tasa de denuncias por años y periodos en torno a la ley (1998-2004 vs. 2005-2006); Regresión de Poisson; e, Índices epidémicos mensual -razón entre casos mensuales y mediana de casos de los meses correspondientes al quinquenio anterior al mes para el que se calcula el índice- y subyacente -media anual de las puntuaciones del índice epidémico mensual- de denuncias y muertes. Resultados: Desde 2005, las puntuaciones de los índices epidémicos muestran una tendencia decreciente. Sin embargo, la posibilidad de denunciar VCI entre 2005 y 2006 es 1,6 veces superior que entre 1998 y 2004. El riesgo de morir por esta causa no muestra cambios estadísticamente significativos. Conclusión: con el paso del tiempo se ha incrementado la posibilidad de denunciar VCI en España. Sin embargo, el riesgo de morir se mantiene. Aunque todavía es pronto para la evaluación del impacto de la ley en esta epidemia, puede decirse que su eficacia para la reducción de la mortalidad por VCI parece limitada (AU)

Background: Intimate Partner Violence (IPV) has received special attention in the spanish political agenda. Despite the importance of developed interventions, empirical evidence about their effectiveness is scarce. The aim of this study is to explore the temporary distribution of Intimate Partner Violence (IPV) reports and murders and to identify possible changes in the risk of dying and reporting by IPV from the Spanish law against gender violence of December of 2004. Methods: We performed a descriptive study based on stadistics of The Woman’s Institute and The Divorced and Separated Women Federation. Calculations: IPV mortality and reports rates by years and periods around the law (1998-2004 vs. 2005-2006); Poisson Regression; and, Epidemic index by months -Ratio between the actual number of IPV murders and reports in a given month and the median number of cases in the same month in the five preceding years- and underlying epidemic index -annual average of the scores of the epidemic index of reports and murders. Results: The epidemic index trends permit us to observe that the problem has decreased since 2005. Nevertheless, the posibility of reporting IPV between 2005 and 2006 is 1.6 times upper that between 1998 and 2004. The risk of dying by this cause does not show statistically significant changes. Conclusion: The posibility of reporting IPV has been increased in Spain throughout the time. However, the risk of dying stays. Although still it is soon for the evaluation of the impact of the law in this epidemic, we could say that its effectiveness for the reduction of IPV mortality seems limited (AU)

[The impact of gender inequality on intimate partner violence in Spain]. / El impacto de la desigualdad de género en la violencia del compañero íntimo en España.

OBJECTIVE: To explore the geographical distribution of mortality due to intimate partner violence (IPV) and reports of IPV according to the gender development index (GDI) of Spanish provinces. METHODS: We performed an ecological study, based on GDI by provinces, of deaths from IPV and official complaints of IPV made by women between 1997 and 2004. The sources were the "Report on Human Capital and Human Development in Spain", the "Home Affairs Statistics Yearbook", and the web page of the Federation of Separated and Divorced Women. Provinces were divided into 2 groups according to whether their GDI score was above or below the mean GDI score for Spain (0.895). Mortality rates by age and rates of official complaints of IPV were calculated for the two groups of provinces (high and low GDI). Relative risks and their confidence intervals were calculated to analyze the risk of dying from or reporting IPV in low GDI provinces compared with that in high GDI provinces. RESULTS: The risk of death due to IPV was higher in women living in low GDI provinces than in those living in high GDI provinces (RR = 1.328; 95% CI, 1.253-1.406). Furthermore, the risk of reporting IPV was higher in low GDI provinces than in high GDI provinces (RR = 1.468; 95% CI, 1.462-1.474). CONCLUSION: Despite the trend to develop IPV strategies focused on individual causes, our results suggest that to tackle this problem, strategies for promoting gender equity in Spain are required.

El impacto de la desigualdad de género en la violencia del compañero íntimo en España / The impact of gender inequality on intimate partner iolence in Spain

Objetivo: Explorar la distribución geográfica de la mortalidad y las denuncias por violencia del compañero íntimo (VCI) según el índice de desarrollo de género (IDG) de las provincias españolas. Métodos: Estudio ecológico basado en el IDG por provincias y muertes y denuncias de mujeres por VCI de 1997 a 2004. Fuentes: Informe sobre Capital Humano y Desarrollo Humano en España, Anuario Estadístico del Ministerio del Interior, y página web de la Federación de Mujeres Separadas y Divorciadas. Se agruparon las provincias según su situación por encima o por debajo de la media española de IDG (0,895). Se calcularon las tasas de mortalidad ajustadas por edad y las tasas brutas de denuncias para los 2 grupos de provincias (las de IDG alto y bajo). Se calcularon los riesgos relativos (RR) y los intervalos de confianza (IC) para analizar el riesgo de morir y denunciar VCI en provincias con un IDG bajo en comparación con las de un IDG alto. Resultados: El riesgo de morir por VCI de las mujeres que viven en provincias con un IDG bajo es mayor respecto a las mujeres que viven en provincias con un IDG alto (RR = 1,328; IC del 95%, 1,253-1,406). Asimismo, el riesgo de denunciar VCI en las provincias con un IDG bajo es mayor en comparación con las que presentan un IDG alto (RR = 1,468; IC del 95%, 1,462-1,474). Conclusiones: Aunque hay una cierta tendencia a desarrollar respuestas en torno a la VCI centradas en las causas individuales, los resultados obtenidos sugieren que la reducción del problema requiere estrategias de promoción de la igualdad de género en España

Objective: To explore the geographical distribution of mortality due to intimate partner violence (IPV) and reports of IPV according to the gender development index (GDI) of Spanish provinces. Methods: We performed an ecological study, based on GDI by provinces, of deaths from IPV and official complaints of IPV made by women between 1997 and 2004. The sources were the «Report on Human Capital and Human Development in Spain», the «Home Affairs Statistics Yearbook», and the web page of the Federation of Separated and Divorced Women. Provinces were divided into 2 groups according to whether their GDI score was above or below the mean GDI score for Spain (0.895). Mortality rates by age and rates of official complaints of IPV were calculated for the two groups of provinces (high and low GDI). Relative risks and their confidence intervals were calculated to analyze the risk of dying from or reporting IPV in low GDI provinces compared with that in high GDI provinces. Results: The risk of death due to IPV was higher in women living in low GDI provinces than in those living in high GDI provinces (RR = 1.328; 95% CI, 1.253-1.406). Furthermore, the risk of reporting IPV was higher in low GDI provinces than in high GDI provinces (RR = 1.468; 95% CI, 1.462-1.474). Conclusion: Despite the trend to develop IPV strategies focused on individual causes, our results suggest that to tackle this problem, strategies for promoting gender equity in Spain are required