The Link Between Family Violence and Child Health: Lessons for Maternal and Child Health Promotion New York University, Global Public Health Besa H Bauta, Keng-Yen Huang, Sabrina Cheng, Melissa Mak INTRODUCTION Multiple studies suggest that Family violence has a negative effect on children’s biological, cognitive, and social emotional development. However, very little is known about the effect of family violence on child development at the country level. The predictors for family violence and the consequences on population child health are not clear. Family violence impacts the achievement of the Millennium Development Goals (MDGs): 3 – Gender equality, 4 – Reducing of child mortality, and 5 – Improving maternal health. The effects are aggregated overtime and impede the implementation of MDGs at the national level. 1 METHODS Data Source Public use data file from the Multiple Indicator Cluster Survey (MICS) project (UNICEF, 2006). We utilized data collected between: 2000-2007). MICS program is developed by UNICEF to assist countries in filling data gaps for monitoring the situation of children and women through statistically sound indicators. More than 100 countries participated in the MICS project. Depend on the areas of data, 40-139 countries had data on study variables. 92 countries with domestic violence data, 46 countries with violent discipline data, and 37 countries had data on both. Analyses for Aim 2 & 3 are based on 37 countries. Country characteristics See Table 1. Measures Family Violence: measured by harsh/violent discipline and domestic violence Predictors of family Violence: GDP, adult literacy, income, mortality rate under 5, % low birth weight, women's attitudes toward domestic violence, and female genital mutilation prevalence Child Health Outcome: disability rate, child labor rate, and prevalence for suspected pneumonia. RESULTS Percent of Children Experienced Family Violence (Figure 1) Experienced Violent Method of Discipline: 79% of children (across 46 countries) experience violent methods of discipline. Experienced Domestic Violence: 46% of children (across 92 countries) experience some sort of family violence Family violence level is varied by countries and regions (ranging from 71% - 89% for the violent discipline, ranging from 35-56% for the domestic). High domestic violence is also related to high violence child discipline use (r=.56) Factors Relate to Country Level’s Family Violence (r ) (Table 2) High adult literacy rate and high female genital mutilation prevalence were related to low violent discipline. Women’s attitude toward domestic violence was also related to domestic violence rate (high % of women believe that the violence is justifiable was related to high percent of family violence in a country) GDP and income level were not related to family violence. Family Violence and Child Outcomes (r ) Family violence measures were also not associated with child disability. Both family violence measures were associated with child labor outcome—high rate of violent discipline and domestic violence were associated with high child labor rate [r=.48, and .56, respectively]. Violent discipline was also related to poor child health (with higher percent of children with suspected pneumonia, r=.28) AIMS & HYPOTHESES Describe family violence patterns across countries Identify predictors for family violence at the country-level. Hypothesis: low income countries and countries with low adult literacy rate will have higher rate of family violence. 3. Examine how level of family violence in different countries related to overall population child health. Hypothesis: higher rate of family violence will be associated with high mortality, child disability, and child labor rates. CONCLUSIONS & IMPLICATIONS Family violence is related to child health and violation of children’s right (high labor rates) Promote education and improve women’s attitude/beliefs toward domestic violence may reduce family violence. Need to measure more health and developmental indicators in order to understand how family violence related to child population health. 1 http://www.unmillenniumproject.org