title: Exposure to intimate partner violence reduces the protective effect that women's high education has on children's corporal punishment: a population-based study.
abstract: BACKGROUND
  Previous studies have shown that women's education is protective against corporal punishment (CP) of children. However, the effect that women's exposure to intimate partner violence (IPV) has on the association between women's education and children's CP has not been studied.
  
  
  OBJECTIVE
  To understand how the interaction between women's exposure to IPV and their education level influences the occurrence of children's CP at the household level.
  
  
  METHODS
  We selected 10,156 women who had at least one child less than 16 years old from cross-sectional data from the 2006-2007 Nicaraguan Demographic and Health Survey. Children's CP was defined as the punishment of children by slapping them, hitting them with a fist, or hitting them with a rope, belt, stick, or other object. IPV was measured by using a conflict tactic scale. The WHO Self-Reporting Questionnaire 20 (SRQ-20) was used to assess the women's mental health. We computed adjusted risk ratios (ARR) and 95% confidence intervals (CI) using Poisson regression with a robust variance estimator.
  
  
  RESULTS
  Women's exposure to IPV was associated with a 10-17% increase in the risk of children's CP. IPV and children's CP were associated with impaired women's mental health. Women's lifetime exposure to emotional IPV and controlling behavior by a partner significantly decreased the protective effect from women's high education level on children's CP. When women were exposed to emotional IPV, the protective effect from having a college education decreased from ARR=0.61 (95% CI 0.47-0.80) to ARR=0.98 (95% CI 0.80-1.19). A similar pattern was found among women exposed to controlling behavior by a partner, the protective effect decreased from ARR=0.71 (95% CI 0.53-0.90) to ARR=0.86 (95% CI 0.70-1.06).
  
  
  CONCLUSIONS
  This study shows how significant gains in one positive social determinant of children's well-being can be undermined when it interacts with men's violence toward women. Policies that aim to end children's CP must include actions to end women's exposure to IPV.
authors.affiliation: Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden; mariano.salazar@epiph.umu.se.
authors.forename: Mariano
authors.initials: M
authors.lastname: Salazar
authors.affiliation: Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors.forename: Kjerstin
authors.initials: K
authors.lastname: Dahlblom
authors.affiliation: Center for Demography and Health Research, Nicaraguan National Autonomous University, León, Nicaragua.
authors.forename: Lucia
authors.initials: L
authors.lastname: Solórzano
authors.affiliation: Center for Demography and Health Research, Nicaraguan National Autonomous University, León, Nicaragua.
authors.forename: Andrés
authors.initials: A
authors.lastname: Herrera
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009527:Nicaragua; D015995:Prevalence; D011678:Punishment; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D016387:Women's Health
keywords: IPV; children's corporal punishment; education; interaction; women