Cumulative Lifetime Violence Severity: Does It Make a Difference to the Health of Canadian Men
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Abstract
Background and Objective: Interpersonal violence is a major public health problem that is among the top 25 causes of years of life lost worldwide. But how cumulative lifetime violence affects the health of men has received little attention. Our objective was to explore differences in men’s health and health behaviors according to cumulativelifetime violence severity as target and/or perpetrator in a community sample of Canadian men.
Materials and Methods: Data are from a convenience community sample of 590 men, ages 19 to 65, who completed an online survey for the Men’s Violence, Gender and Health Study(MVGHS). The survey included questions about social location, health behaviours, and health status. Validated measures of depression, anxiety, chronic pain, posttraumatic stress disorder and alcohol use also were included. Perceived cumulative lifetime violence severity (LVS) was measured with 64 study-specific items. Based on the median LVS score, the sample was divided into two groups, lower and higher LVS, and compared for significant differences on social location, health behavior, and health variables. Using logistic regression, odds ratios for higher LVS and three selected health outcomes (depression, chronic pain, daily cannabis use) were calculated and adjusted for potential confounders.
Results: On most measures, men with higher LVS had significantly poorer health than those with lower LVS. Alcohol use was not significantly different between groups but was higher than expected for all men. Those with higher LVS had significant odds ratios for depression (OR= 3.71;CI= 2.59, 5.31), daily cannabis use (OR= 3.20;CI= 2.07, 4.92) and chronic pain (OR= 3.19;CI= 1.98, 5.14). In odds ratio models adjusted for confounders, higher LVS remained significant only for daily cannabis use (aOR= 2.07; CI = 1.23, 3.43) and other significant aORsincluded current smoking, unemployment and difficulty living on current income. In the depression and chronic pain models, common indicators of dysregulation of the body’s natural stress response by violence severity, posttraumatic stress disorder and anxiety respectively, were significant predictors. Number of chronic health problems and being overwhelmed by daily stress frequently were also significant in the depression model. For chronic pain, number of chronic health problems and injury with permanent disability were both significant predictors.
CONCLUSIONS: These findings provide some of the first comparative evidence from a community sample that men with higher cumulativelifetime violence severityare more likely to have poorer health than men with lower LVS. The adjusted models suggest more complex relationships among higher LVS and health outcomes that indicate the need for further exploration of how biophysical consequences of violence, social location and/or comorbidities may moderate or mediate how cumulative violence severity affects men’s health.
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