abstract: 'Background On average, intimate partner violence affects nearly one in

  three women worldwide within their lifetime. But the distribution of

  partner violence is highly uneven, with a prevalence of less than 4\% in

  the past 12 months in many high-income countries compared with at least

  40\% in some low-income settings. Little is known about the factors that

  drive the geographical distribution of partner violence or how

  macro-level factors might combine with individual-level factors to

  affect individual women''s risk of intimate partner violence. We aimed to

  assess the role that women''s status and other gender-related factors

  might have in defining levels of partner violence among settings.

  Methods We compiled data for the 12 month prevalence of partner violence

  from 66 surveys (88 survey years) from 44 countries, representing 481

  205 women between Jan 1, 2000, and Apr 17, 2013. Only surveys with

  comparable questions and state-of-the-art methods to ensure safety and

  encourage violence disclosure were used. With linear and quantile

  regression, we examined associations between macro-level measures of

  socioeconomic development, women''s status, gender inequality, and

  gender-related norms and the prevalence of current partner violence at a

  population level. Multilevel modelling and tests for interaction were

  used to explore whether and how macro-level factors affect

  individual-level risk. The outcome for this analysis was the population

  prevalence of current partner violence, defined as the percentage of

  ever-partnered women (excluding widows without a current partner), aged

  from 15 years to 49 years who were victims of at least one act of

  physical or sexual violence within the past 12 months.

  Findings Gender-related factors at the national and subnational level

  help to predict the population prevalence of physical and sexual partner

  violence within the past 12 months. Especially predictive of the

  geographical distribution of partner violence are norms related to male

  authority over female behaviour (0.102, p<0.0001), norms justifying wife

  beating (0.263, p<0.0001), and the extent to which law and practice

  disadvantage women compared with men in access to land, property, and

  other productive resources (0.271, p<0.0001). The strong negative

  association between current partner violence and gross domestic product

  (GDP) per person (-0.055, p=0.0009) becomes non-significant in the

  presence of norm-related measures (-0.015, p=0.472), suggesting that GDP

  per person is a marker for social transformations that accompany

  economic growth and is unlikely to be causally related to levels of

  partner violence. We document several cross-level effects, including

  that a girl''s education is more strongly associated with reduced risk of

  partner violence in countries where wife abuse is normative than where

  it is not. Likewise, partner violence is less prevalent in countries

  with a high proportion of women in the formal work force, but working

  for cash increases a woman''s risk in countries where few women work.

  Interpretation Our findings suggest that policy makers could reduce

  violence by eliminating gender bias in ownership rights and addressing

  norms that justify wife beating and male control of female behaviour.

  Prevention planners should place greater emphasis on policy reforms at

  the macro-level and take cross-level effects into account when designing

  interventions. Copyright (C) Heise et al. Open access article published

  under the terms of CC BY'
affiliation: 'Heise, LL (Corresponding Author), London Sch Hyg \& Trop Med, Dept Global
  Hlth \& Dev, London WC1H 9SH, England.

  Heise, Lori L., London Sch Hyg \& Trop Med, Dept Global Hlth \& Dev, London WC1H
  9SH, England.

  Kotsadam, Andreas, Univ Oslo, Dept Econ, Oslo, Norway.'
author: Heise, Lori L. and Kotsadam, Andreas
author-email: lori.heise@lshtm.ac.uk
author_list:
- family: Heise
  given: Lori L.
- family: Kotsadam
  given: Andreas
da: '2023-09-28'
doi: 10.1016/S2214-109X(15)00013-3
esi-highly-cited-paper: Y
esi-hot-paper: N
files: []
issn: 2214-109X
journal: LANCET GLOBAL HEALTH
keywords-plus: 'GENDER INEQUALITY; DOMESTIC VIOLENCE; DETERMINANTS; AGGRESSION;

  EQUALITY; INDIA'
language: English
month: JUN
number: '6'
number-of-cited-references: '36'
pages: E332-E340
papis_id: 994d241ec86838722fd90bb93878a3bf
ref: Heise2015crossnationalmultile
researcherid-numbers: Heise, LORI/AAI-6251-2020
times-cited: '307'
title: 'Cross-national and multilevel correlates of partner violence: an analysis
  of data from population-based surveys'
type: Article
unique-id: WOS:000354827300014
usage-count-last-180-days: '0'
usage-count-since-2013: '82'
volume: '3'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2015'