title: Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality.
abstract: 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.
  
  
  METHODS
  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.
authors: 1 National School of Public Health, Institute of Health "Carlos III", Madrid, Spain 2 CIBER of Epidemiology and Public Health (CIBERESP), Spain bsanz@isciii.es.
authors: Belén
authors: B
authors: Sanz-Barbero
authors: 2 CIBER of Epidemiology and Public Health (CIBERESP), Spain 3 Public Health Research Group, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Alicante University, Alicante, Spain.
authors: Carmen
authors: C
authors: Vives-Cases
authors: 1 National School of Public Health, Institute of Health "Carlos III", Madrid, Spain 2 CIBER of Epidemiology and Public Health (CIBERESP), Spain.
authors: Laura
authors: L
authors: Otero-García
authors: 4 Bloomberg Faculty of Nursing, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada 5 BK21+ Pg in Embodiment: Mind Body Interaction, Korea University.
authors: Carles
authors: C
authors: Muntaner
authors: 3 Public Health Research Group, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Alicante University, Alicante, Spain 6 Department of Statistics, Mathematics and Computing, Miguel Hernández University, Elche, Spain.
authors: Jordi
authors: J
authors: Torrubiano-Domínguez
authors: 4 Bloomberg Faculty of Nursing, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada 7 Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada.
authors: Patricia
authors: P
authors: O'Campo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D000066511:Intimate Partner Violence / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014478:Unemployment / Q000706:statistics & numerical data*; D016387:Women's Health; D055815:Young Adult