A multilevel analysis of individual, household, and neighborhood correlates of intimate partner violence among low-income pregnant women in Jefferson county, Alabama.
OBJECTIVE
We examined individual, household, and neighborhood correlates of intimate partner violence (IPV) before and during pregnancy.


METHODS
We used multilevel modeling to investigate IPV among 2887 pregnant women in 112 census tracts who sought prenatal care in 8 public clinics in Jefferson County, Alabama, from 1997 through 2001. Data were collected from the Perinatal Emphasis Research Center project, the 2000 Census, and the local Sheriff and Police Departments Uniform Crime Reports for 1997 through 2001.


RESULTS
Participants were predominantly young, African American, on Medicaid, and residents of low-income neighborhoods. The prevalence of past-year male partner-perpetrated physical or sexual violence was 7.4%. Neighborhood residential stability, women performing most of the housework (lack of involvement among partners), being unmarried (being in an uncommitted relationship), and alcohol use were positively associated with elevated IPV risk. Significant protective factors for IPV included older age at first vaginal intercourse and a greater sense of mastery (e.g., the perception of oneself as an effective person).


CONCLUSIONS
Both neighborhood contextual and individual and household compositional effects are associated with IPV among low-income pregnant women. The results imply that combined interventions to improve neighborhood conditions and strengthen families may effectively reduce IPV.
Li
Qing
Q
Department of Maternal and Child Health, University of Alabama, Birmingham, Birmingham, AL 35294, USA. youliqing@hotmail.com
Kirby
Russell S
RS
Sigler
Robert T
RT
Hwang
Sean-Shong
SS
Lagory
Mark E
ME
Goldenberg
Robert L
RL
D000328:Adult; D001741:Black or African American / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data; D000407:Alabama / Q000453:epidemiology; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D018585:Battered Women / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D016015:Logistic Models; D017533:Marital Status; D008423:Maternal Age; D008484:Medicaid / Q000706:statistics & numerical data; D008960:Models, Psychological; D055361:Multilevel Analysis; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D020377:Self Efficacy; D013179:Spouse Abuse / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States
Am J Public Health. 2005 Mar;95(3):471-7
15727979
Pharm Res. 1999 May;16(5):709-17
10350015
JAMA. 1992 Jun 17;267(23):3176-8
1593739
Int J Health Geogr. 2006 Mar 17;5:11
16545132
Violence Against Women. 1998 Jun;4(3):262-90
12296014
Acta Obstet Gynecol Scand. 2004 May;83(5):455-60
15059158
Trauma Violence Abuse. 2004 Jan;5(1):47-64
15006296
Demography. 1996 Nov;33(4):395-412; discussion 413-6
8939412
Obstet Gynecol. 2002 Jul;100(1):27-36
12100800
AJS. 2003 Mar;108(5):976-1017
14560732
Am J Public Health. 1995 Aug;85(8 Pt 1):1092-7
7625502
Violence Vict. 1986 Summer;1(2):101-24
3154143
Ann Epidemiol. 2000 Jul;10(5):297-308
10942878
Science. 1997 Aug 15;277(5328):918-24
9252316
Am J Orthopsychiatry. 2001 Jul;71(3):290-7
11495331
Matern Child Health J. 2000 Jun;4(2):85-92
10994576
Ann Intern Med. 2002 Apr 16;136(8):637-40
11955043
Am J Public Health. 2005 Feb;95(2):224-32
15671454
Health Place. 2006 Dec;12(4):547-56
16188483
Public Health Rep. 2003 Jan-Feb;118(1):44-58
12604764
Acta Obstet Gynecol Scand Suppl. 1997;165:19-29
9219452
JAMA. 1996 Jun 26;275(24):1915-20
8648873
Matern Child Health J. 2000 Jun;4(2):79-84
10994575
J Interpers Violence. 2004 Mar;19(3):322-40
15005995
Am J Public Health. 2006 Jan;96(1):132-8
16317213