Factors associated with severity of intimate partner abuse in Mexico: results of the first National Survey of Violence Against Women.

Avila-Burgos, Leticia ; Valdez-Santiago, Rosario ; Hijar, Martha 等

Various studies conducted in Mexico in different populations estimate that 15% to 71% of women have been physically or sexually assaulted by an intimate partner during their lifetime. (1) Current intimate partner abuse (IPA) among women attending Mexican public clinics or hospitals is estimated to range from 6% to 32%. (2-5) Variability in the prevalence of IPA in Mexico appears to depend on the measuring scale used, as well as the definition of IPA and the cultural context.

A small number of studies (none of them done in Mexico) have estimated that the greater the severity of IPA, the greater the risk of severe injuries, emotional distress, mental disorders or permanent disabilities. (6,7)

IPA is defined in this study as a "repetitive pattern of abuse inflicted by the woman's male partner. Abuse is characterized by a series of coercive behaviours that include physical, emotional, economic or sexual violence." (8)

The main objective of the study was to identify factors associated with the severity of IPA among women who had sustained an intimate relationship during the previous 12 months, had for any reason attended a public health care facility and who had participated in the National Survey of Violence Against Women (ENVIM) 2003. (8)

METHODS

The ENVIM-2003 surveyed a representative national and state sample of users of public health care services in Mexico during November 2002 to November 2003. Institutions from Social Security and the Ministry of Health were included, (8) since they provide medical coverage to 70% of the Mexican population. (9) Additionally, these institutions had a sample frame of their medical units and made major provisions to facilitate our access.

Selection of subjects

A stratified probabilistic sampling was carried out in two stages. In the first stage, clinics and hospitals located throughout the country were selected with a proportional probability to the number of units per type of institution. In the second stage, all women over age 14, recipients of preventive or curative services at those medical units, were selected by systematic sampling. The cutoff age of 14 years was selected because, in Mexico, women are susceptible to intimate relationships at an early age. The sample size was calculated to obtain a minimum prevalence of 19% in each of the 32 States; more details are described in a previous publication. (2) The survey included 26,042 women. (2)

The information was collected by trained female interviewers, and interviews were held in private rooms. The response rate was 98%, similar to rates reported by other studies on violence in Mexico. (10,11) Approval for this project was granted by the National Institute of Public Health's Ethics Committee.

The ENVIM-2003 questionnaire* has 17 sections, including sociodemographic questions on both the interviewee and her partner, frequency of alcohol consumption, perception of gender roles, the family and characterization of partner abuse.

Measures

Severity of Partner Abuse

A 27-item scale was selected from two instruments that have shown sensitivity in measuring partner abuse: the Index of Spouse Abuse (12) and the Severity of Violence Against Women Scale. (13) The items are shown in Appendix 1. For modeling purposes, the number of variables was reduced to a small number of factors; therefore, factor analysis was used. Four factors were obtained, which together explained 62% of the variance. To determine confidence, Cronbach's alpha was calculated to be 0.99. With the linear combination of these factors, a Severe Intimate Partner Abuse Index (SIPAI) was constructed. The cutting points were as follows: scores under the mean indicated no violence; from the mean up to the mean plus one standard deviation non-severe violence; and the mean plus values over one standard deviation indicated cases of severe violence (for a more detailed description of the methodology, see Valdez et al. (14)). The frequency of violent acts during the previous year was recorded on a 4-point scale for each item (0=never, 1=once, 2=occasionally and 3=many times). These instruments have been used previously and validated with the Mexican population. (15)

Individual Variables

For both subject and partner, variables included were: age; years of schooling; monthly income, expressed as a multiple of the minimum wage (during 2003 the minimum wage was the equivalent of C$5.01 daily (16,17)); and number of children in the household under 18 years of age. These variables were measured on a continuous scale. Also included were work activity during the week before the interview and frequency of alcohol consumption. Additionally, subjects' information regarding marital status and history of childhood abuse was collected. All these variables were measured on a categorical scale.

"Partner" was defined as the last spouse or intimate partner with whom the subject had lived during the year preceding the survey. (2) Partner information was reported by the women.

Socio-economic Indicators

Using principal component analysis, the Household Assets Index was generated, which is a proxy variable for economic status in the home. This index is based on house ownership, number of electrical appliances and possession of a car or truck. Crowded living conditions (a mean of 2.5 residents or more per bedroom) was included as a dichotomous variable. The index was categorized by terciles corresponding to social levels or stratum: low, medium and high.

Statistical analysis

This model included 77% (n=14,503) of subjects who had had an intimate partner during the previous year and had provided complete information. The dependent variable was the SIPAI, which had three categories ordered as 0=no violence, 1=non-severe violence and 2=severe violence. The ordinal logistic regression model (Model 1) was used initially but rejected later because it did not comply with the model's central supposition test (test of parallel lines); (16) the multinomial logistic regression model (Model 2) was used instead. Model 2 assumes that the dependent variable has more than two non-ordered categories. Subjects who were exposed to severe partner violence and those who reported non-severe violence were compared with those who did not report violence.

Variables that showed a value of p<0.20 (18) in the bivariate analysis were tested in the multivariate model as confounders and effect modifiers and were kept if p<0.05.18 The model's global adjustment was verified with Pearson's goodness-of-fit test and was considered to have adequate adjustment with a value of p>0.10.18 In both bivariate and multivariate analysis, the confidence intervals were calculated with a robust standard error. (19) Continuous variables were evaluated by observing whether the change in the logit of the dependent variable had the same magnitude when there were increases of one unit in the independent variable (Box-Tidwell test). (18,20) Since this test was rejected, these variables became categories when they were incorporated in the model.

Differences among variable categories were evaluated to determine statistical differences. Thus, when the statistics showed no differences (lincom test p>0.10),18 the categories were collapsed. The statistical packages used were Stata version 8.2 (Stata Corp., College Station, TX) and SPSS version 10 (SPSS, Chicago, IL).

RESULTS

Women's socio-demographic characteristics

This study included 18,902 women. The mean subject age was 35.3 [+ or -] 12 years. About 8.6% had not attended school, 69.1% had had schooling at the elementary and junior high levels. Housewives constituted 51% of the sample; 87.7% of the subjects lived in urban areas, and 74% of all participants had no salary. Almost 96% did not drink alcohol or did so occasionally (Table 1).

Partners' characteristics

Intimate partner's mean age was 38.9 [+ or -] 13 years; 7.6% had not attended school, and 62.8% had completed elementary and junior high school. Most of the partners (59%) were employees or factory workers. Women reported that 18.3% of their partners drank alcohol more than once a week (Table 2).

Women's history of violence during childhood

Almost 22% of subjects indicated that their parents or relatives had humiliated or insulted them, and 43.2% of these also reported physical abuse. Around 25% reported that the blows and humiliations were infrequent, 9.7% said this occurred several times, and 9% reported physical strikes and humiliations happening almost all the time.

Severity of intimate partner abuse

Using the SIPAI, we found that 72.6% reported no abuse, 18.1% had experienced non-severe abuse, and 9.3% had been victims of severe partner abuse during the previous 12 months.

Table 2 presents the unadjusted models. The women's variables associated with partner abuse corresponded mostly to being under 55 years of age, having a lower level of education, a higher frequency of alcohol consumption, working out of the home and having a history of childhood abuse. The partner's characteristics relating to severity of abuse were lower education, lower income and greater frequency of alcohol consumption. Other variables associated were the Index of Household Assets and the (greater) number of children in the household.

Multivariate model of severity of intimate partner abuse

Table 3 presents the final multivariate model which shows that age was only significantly related to violence when violence was severe. The age group 25 to 34 showed the highest risk of severe violence (OR 1.53, 95% CI 1.17-1.99). A woman's lack of education was associated with the possibility of being abused; this risk was 51% for severe (OR 1.51, 95% CI 1.00-2.30) and 35% (OR 1.35, 95% CI 1.161.56) for non-severe violence.

Women working out of the home had a 30% greater possibility of being the victims of severe violence (OR 1.3, 95% CI 0.99-1.72). Two or more children increased the possibility of severe violence by 44% (OR 1.44, 95% CI 1.18-1.77), and for non-severe violence the possibility was 20%. In all cases, the category of comparison was homes with no children.

When women's reported alcohol consumption was in excess of once a month, the possibility of severe violence increased 2.5 times (OR 2.51, 95% CI 1.62-3.90) and of non-severe violence by 60%, compared with those who abstained.

A history of childhood abuse was more strongly associated with severe violence. The possibility of experiencing severe partner abuse more than tripled among women who reported exposure to abuse as occuring several times and almost all the time during their childhood (OR 3.7, 95% CI 3.03-4.52); this association more than doubled (OR2.19, 95% CI 2.07-2.31) when the violence was not severe.

With respect to the partner's variables, the most important predictor of the severity of violence was the frequency of the man's alcohol consumption. Adjusting for the other variables, partners who consumed alcohol almost every day had an over 14 times higher possibility (OR 14.77, 95% CI 13.25-16.46) of being severe aggressors. A clear gradient was observed: as frequency of alcohol consumption decreased, so did the probability of being an aggressor. Other variables associated with severity of IPA were lower education and income. Therefore, less education and lower income had a higher association with non-severe violence, at 54% and 29%, respectively.

DISCUSSION

Among the study's most relevant aspects was the creation of the SIPAI index, which allows analysis of the results on the basis of the severity of IPA. With it, factors associated not only with violence but also with the severity of the violence can be identified. In this context, it is important to reconsider those factors associated with severe partner abuse: women of reproductive age, women with a history of childhood violence, and frequent alcohol consumption by both partners. The variable "man's frequency of alcohol consumption" should be highlighted, since it was the most important factor associated with severe partner violence. The association between violence and alcohol intake has been broadly studied, (21-23) and in spite of existing controversies regarding the way in which frequency and excessive alcohol consumption may trigger violent episodes, it is true that greater alcohol consumption in abusive men increases their risk of becoming more violent.

The association between history of abuse during childhood and abuse from the partner is sufficiently documented. In a broad review of the literature, Black et al. (24) described how a history of violence in the family of origin, in men as well as women, can be conducive to increased violence in couples.

Women with low education and low socio-economic status were at greater risk of suffering violence; these findings agree with other studies reporting that women who live in situations of poverty are the most vulnerable. (25)

Of special interest is the greater risk of exposure to IPV in women working out of the home. Several authors report that the effect of this variable on IPA will depend upon the socio-cultural context. (26,27) Therefore, in the context of a very rigid gender role, perception of a salary by a woman constitutes a risk factor for increased violence. (26) The finding suggests the need for a more detailed study of this relation.

Undoubtedly, one contribution of the SIPAI is the possibility of identifying differentiated risks for severe and non-severe violence among women according to their characteristics, those of their partners and of their environment. Identifying victims of violence in conjunction with the severity of the violence can be useful in designing violence prevention programs and health care models. (28,29)

Finally, this study has some important limitations that should be taken into account when interpreting the data: on 23% of subjects (n=4,445) there were incomplete data and the women were not included in the analysis; they were significantly older, had lower education, higher alcohol consumption, worked out of the home, and were exposed to a high degree of childhood abuse. We can infer that these subjects were at higher risk of IPA, which suggests that our reported findings are somewhat conservative.

In this study, only recipients of public health services were included, for which we may expect biases. Women in extreme poverty face more barriers to access health services in general, (30) and those with higher income are less interested in using public medical services; (30) for these reasons, these groups are under-represented.

The study was cross-sectional, which presents a problem of temporal ambiguity; for this reason, only statistical associations may be established and not causality.

It is important to further explore factors linked to the severity of partner abuse, not only in Mexico but elsewhere. Enhanced knowledge about this topic would help identify individuals whose physical and emotional integrity are at greater risk of suffering irreversible injury and would allow the government to focus resources and actions on this vulnerable sector of the population.

Appendix 1. Factorial Matrix of the Violence Index with
Varimax Rotation

                                           Factor I        Factor II
                                        Psychological       Physical
                                           Violence         Violence

 1. Has he insulted you?                    0.791            0.247
 2. Has he belittled or berated you?        0.787            0.200
 3. Does he berate or humiliate you
    in front of other people?               0.782            0.195
 4. Has he said things to you as if
    you are unattractive or ugly?           0.692            0.165
 5. Has he become jealous or
    suspicious of your friendships?         0.682            0.150
 6. Has he hit or kicked the wall or
    any other piece of furniture? *         0.583            0.461
 7. Has he threatened to hit you? *         0.568            0.543
 8. Has he destroyed any of your
    belongings? *                           0.532            0.506
 9. Has he made you feel afraid of
    him? *                                  0.520            0.490
10. Has he hit you with his hand
    or fist?                                0.310            0.731
11. Has he shaken or pushed you?            0.371            0.721
12. Has he twisted your arm?                0.212            0.693
13. Has he kicked you?                      0.181            0.690
14. Has he pushed you on purpose?           0.363            0.669
15. Has he hit you with any kind of
    stick or belt or any domestic
    object? *                               0.096            0.515
16. Has he threatened to kill you,
    himself or the children? *              0.394            0.432
17. Has he shot you with a gun or
    rifle?                                  0.053            0.007
18. Has he attacked you with a
    razor, knife or machete?                0.034            0.209
19. Has he burned you with a
    cigarette or any other
    substance?                              0.007            0.096
20. Has he threatened you with any
    kind of gun or rifle?                   0.303            0.161
21. Has he threatened you with any
    kind of razor, knife or machete?        0.276            0.359
22. Has he tried to choke or
    suffocate you?                          0.068            0.340
23. Has he demanded that you have
    sexual relations with him?              0.288            0.283
24. Has he used physical force to
    have sexual relations with you?         0.202            0.333
25. Has he threatened to go out with
    other women if you do not
    consent to having sexual
    relations with him?                     0.356            0.248
26. Has he controlled you by not
    giving you money or by taking
    it away from you? *                     0.356            0.248
27. Has he taken away or made use
    of your belongings against your
    will? *                                 0.372            0.214

    % of variance explained                19.46%           17.73%

                                          Factor III       Factor IV
                                            Severe          Sexual/
                                           Physical         economic
                                           Violence         Violence

 1. Has he insulted you?                    0.061            0.218
 2. Has he belittled or berated you?        0.090            0.226
 3. Does he berate or humiliate you
    in front of other people?               0.105            0.223
 4. Has he said things to you as if
    you are unattractive or ugly?           0.150            0.224
 5. Has he become jealous or
    suspicious of your friendships?         0.060            0.205
 6. Has he hit or kicked the wall or
    any other piece of furniture? *         0.132            0.111
 7. Has he threatened to hit you? *         0.140            0.230
 8. Has he destroyed any of your
    belongings? *                           0.198            0.122
 9. Has he made you feel afraid of
    him? *                                  0.147            0.267
10. Has he hit you with his hand
    or fist?                                0.153            0.327
11. Has he shaken or pushed you?            0.110            0.297
12. Has he twisted your arm?                0.232            0.235
13. Has he kicked you?                      0.285            0.305
14. Has he pushed you on purpose?           0.145            0.248
15. Has he hit you with any kind of
    stick or belt or any domestic
    object? *                               0.438            0.289
16. Has he threatened to kill you,
    himself or the children? *              0.336            0.186
17. Has he shot you with a gun or
    rifle?                                  0.810            0.140
18. Has he attacked you with a
    razor, knife or machete?                0.738            0.176
19. Has he burned you with a
    cigarette or any other
    substance?                              0.727            0.217
20. Has he threatened you with any
    kind of gun or rifle?                   0.632           -0.110
21. Has he threatened you with any
    kind of razor, knife or machete?        0.598           -0.004
22. Has he tried to choke or
    suffocate you?                          0.535            0.351
23. Has he demanded that you have
    sexual relations with him?              0.112            0.723
24. Has he used physical force to
    have sexual relations with you?         0.183            0.688
25. Has he threatened to go out with
    other women if you do not
    consent to having sexual
    relations with him?                     0.101            0.665
26. Has he controlled you by not
    giving you money or by taking
    it away from you? *                     0.101            0.581
27. Has he taken away or made use
    of your belongings against your
    will? *                                 0.142            0.550

    % of variance explained                13.22%           11.95%

 * These items were not included in the Index.

Acknowledgments: Our gratitude goes to all the women interviewed for their participation in this study. As well, we acknowledge the financial support provided by the National Center of Gender Equity and Reproductive Health, which made it possible to carry out ENVIM 2003.

Received: April 3, 2009

Accepted: August 15, 2009

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* Copies of the questionnaire can be obtained by contacting Rosario Valdez: rvaldez@insp.mx.

Leticia Avila-Burgos, PhD, [1] Rosario Valdez-Santiago, MSc, [1] Martha Hijar, PhD, [1] Aurora del Rio-Zolezzi, MSc, [2] Rosalba Rojas-Martinez, PhD, [1] Carlo E. Medina-Solis, MSc [3]

Author Affiliations

[1.] National Institute of Public Health, Cuernavaca, Morelos, Mexico

[2.] National Centre for Gender Equity and Reproductive Health, Ministry of Health, Mexico, DF, Mexico

[3.] Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico

Correspondence and reprint requests: Rosario Valdez-Santiago or Leticia Avila, Centre for Health Systems Research, National Institute of Public Health, Av. Universidad 655, Col. Santa Maria Ahuacatitlan, C.P. 62508, Cuernavaca, Morelos, Mexico, E-mail: rvaldez@insp.mx or lavila@insp.mx.

Table 1. Demographic Characteristics of 18,902 Female
Participants and Their Partners, Mexico

Variable                                     Frequency      %

Age (years)
  15-24                                          3789     20.0
  25-34                                          6375     33.7
  35-44                                          4642     24.6
  45-54                                          2590     13.7
  [greater than or equal to] 55                  1506      8.0
Education
  No education                                   1624      8.6
  Elementary and junior high school            13,055     69.1
  High school and more                           4223     22.3
Work activity *
  Student                                          92      0.5
  Unpaid worker                                   233      1.2
  Housewife                                      9715     51.4
  Unemployed                                     3568     19.0
  Fieldworker                                     112      0.6
  Self-employed                                  1490      7.9
  Employee                                       3639     19.3
Income (multiple of minimum monthly
    salary) ([dagger])
  No salary                                    13,994     74.0
  Up to two salaries                             2870     15.2
  3-4 salaries                                   1254      6.6
  4-6 salaries                                    449      2.4
  >6 salaries                                     335      1.8
Type of locality
  Rural                                           231     12.3
  Urban                                        16,585     87.7
Frequency of alcohol consumption *
  Does not drink                                 9891     52.3
  Occasionally                                   8233     43.6
  1 or more times per month                       558      3.0
Frequency of childhood abuse *
  Never                                        10,502     55.6
  Occasionally                                   4804     25.4
  Several times to almost always                 3538     18.7

Socio-economic characteristics of partner
Education *
  No education                                   1445      7.6
  Elementary and junior high school            11,858     62.8
  High school and more                           4363     23.1
Work activity *
  Student                                         249      1.3
  Unemployed                                     1181      6.2
  Fieldworker or mason's assistant               3038     16.1
  Self-employed                                  2675     14.2
  Employee ([double dagger])                   11,151     59.0
Income (multiple of minimum monthly
    salary) * ([dagger])
  0 to <2                                        7528     39.8
  2 to <5                                        6812     36.0
  [greater than or equal to] 5                   1210      6.4
Frequency of alcohol consumption *
  Does not drink                                 2869     15.2
  Occasionally                                   9492     50.2
  1-3 times per month                            2459     13.0
  1-3 times per week                             2520     13.3
  Every day or almost every day                   951      5.0

Source: ENVIM, 2003

* There were missing values.

([dagger]) The minimum daily pay a worker must receive by law.16
The minimum salary during 2003 was the equivalent of C$3.83.
Exchange rate: C$1 = 11.38 pesos, 2006.

([double dagger]) Employees included teachers, office employees
and manual labourers.

Table 2. Factors Associated with Partner Violence, Mexico
(unadjusted odds ratios)

Variable                                Severe Violence *          P
                                          N = 1,758

Women's characteristics              OR     CI 95% ([dagger])

Age (years)
  [greater than or equal to] 55             1
  45-54                             1.40    (1.17-1.68)           0.00
  35-44                             1.56    (1.21-2.01)           0.00
  25-34                             1.32    (1.19-1.46)           0.00
  15-24                             1.46    (1.31-1.62)           0.00
Education
  High school and more                      1
  Elementary and junior high
    school                          1.34    (1.11-1.61)           0.00
  No education                      1.81    (1.16- 2.85)          0.00
Woman's frequency of alcohol
    consumption
  Does not consume alcohol                  1
  Occasionally                      1.64    (1.42-1.88)           0.00
  More than once a month            4.07    (3.76-4.40)           0.00
Work activity
  Housewife                                 1
  Works outside the home            1.65    (1.34-2.04)           0.00
History of childhood abuse
  Was not physically abused                 1
  Occasionally                      1.68    (1.57-1.81)           0.00
  Several times and almost
    always                          4.18    (3.50-4.99)           0.00
Income (multiple of minimum
    monthly wage)
    ([double dagger])
  [greater than or equal to] 5              1
  2 to <5                           1.32    (0.90-1.92)           0.15
  1 to <2                           1.99    (1.39-2.83)           0.00
  No salary                         0.88    (0.62-1.25)           0.48

Partner's characteristics

Education
  High school and more                      1
  Elementary and junior high
    school                          1.67    (1.60-1.74)           0.00
  No education                      1.91    (1.55-2.36)           0.00
Work activity
  Employee [section]                        1
  Self-employed                     1.13    (0.99-1.30)           0.07
  Fieldworker or mason's
    assistant                       1.25    (0.97-1.62)           0.08
  Student                           1.87    (1.69-2.06)           0.00
  Unemployed                        1.50    (1.17-1.92)           0.00
Income (multiple of monthly
    salary) ([double dagger])
  [greater than or equal to] 5              1
  2 to <5                           1.41    (1.12-1.77)           0.00
  0 to <2                           1.60    (1.19-2.15)           0.00
Partner's frequency of
    alcohol consumption
  No alcohol consumption                    1
  Occasionally                      1.52    (1.09-2.13)           0.00
  1-3 times per month               3.54    (2.70-4.65)           0.00
  1-3 times per week                6.56    (5.25-8.21)           0.00
  Every day or almost every day    10.50    (9.24-11.93)          0.00

Others

Number of children in the
    household
  0                                         1
  1                                 0.85    (0.80-0.91)           0.07
  [greater than or equal to] 2      1.06    (0.99-1.15)           0.00
Household asset index
  High                                      1
  Medium                            1.39    (1.26-1.54)           0.00
  Low                               1.57    (1.16-2.14)           0.00

Variable                              Non-severe Violence *        P
                                         N = 3,430

Women's characteristics              OR     CI 95% ([dagger])

Age (years)
  [greater than or equal to] 55             1
  45-54                             1.05    (0.78-1.42)           0.72
  35-44                             1.08    (0.92-1.27)           0.35
  25-34                             1.03    (0.75-1.40)           0.85
  15-24                             1.32    (0.95-1.83)           0.09
Education
  High school and more                      1
  Elementary and junior high
    school                          1.16    (1.05-1.26)           0.00
  No education                      1.60    (1.19-2.14)           0.00
Woman's frequency of alcohol
    consumption
  Does not consume alcohol                  1
  Occasionally                      1.51    (1.40-1.63)           0.00
  More than once a month            2.26    (1.91-2.67)           0.00
Work activity
  Housewife                                 1
  Works outside the home            1.24    (1.14-1.35)           0.00
History of childhood abuse
  Was not physically abused                 1
  Occasionally                      1.81    (1.79-1.84)           0.00
  Several times and almost
    always                          2.43    (2.29-2.57)           0.00
Income (multiple of minimum
    monthly wage)
    ([double dagger])
  [greater than or equal to] 5              1
  2 to <5                           1.27    (0.95-1.68)           0.10
  1 to <2                           2.03    (1.51-2.72            0.00
  No salary                         1.37    (1.003-1.87)          0.05

Partner's characteristics

Education
  High school and more                      1
  Elementary and junior high
    school                          1.58    (1.44-1.72)           0.00
  No education                      1.90    (1.61-2.26)           0.00
Work activity
  Employee [section]                        1
  Self-employed                     1.17    (1.10-1.23)           0.00
  Fieldworker or mason's
    assistant                       1.33    (1.78-1.50)           0.00
  Student                           1.54    (0.74-3.18)           0.25
  Unemployed                        1.16    (1.02-1.34)           0.03
Income (multiple of monthly
    salary) ([double dagger])
  [greater than or equal to] 5              1
  2 to <5                           1.18    (0.37-1.67)           0.36
  0 to <2                           1.35    (0.83-2.18)           0.22
Partner's frequency of
    alcohol consumption
  No alcohol consumption                    1
  Occasionally                      1.39    (1.22-1.58)           0.00
  1-3 times per month               2.24    (1.96-2.57)           0.00
  1-3 times per week                2.39    (2.06-2.78)           0.00
  Every day or almost every day     2.58    (1.93-3.46)           0.00

Others

Number of children in the
    household
  0                                         1
  1                                 0.94    (0.85-1.02)           0.17
  [greater than or equal to] 2      0.90    (0.86-0.95)           0.00
Household asset index
  High                                      1
  Medium                            1.34    (1.15-1.56)
  Low                               1.42    (1.19-1.69)           0.00

* Women who were victims of severe or non-severe violence inflicted
by their partners are compared with women who experienced no
violence (N = 13,714).

([dagger]) The analysis was carried out adjusting by stratum.
Confidence intervals to 95% were calculated with robust standard
errors adjusted by "cluster" (institution).

([double dagger]) The minimum daily pay a worker must receive by
law. (16) The minimum wage during 2003 was the equivalent of C$5.01.
Exchange rate: C$1 = 8.69 pesos, 2003.

([section]) Employees included teachers, office employees and manual
labourers.

Table 3. Multivariate Model of Independent Factors Associated with
Partner Abuse, Mexico

Variable                                Severe Violence *          P
                                           N = 1,017

Women's characteristics              OR     CI 95% ([dagger])

Age (years)
  [greater than or equal to] 55             1
  45-54                             1.31    (0.94-1.82)           0.11
  35-44                             1.51    (1.35-1.7)            0.00
  25-34                             1.53    (1.17-1.99)           0.00
  15-24                             1.49    (1.01-2.21)           0.05
Education
  High school and more                      1
  Elementary and junior high
    school                          1.15    (0.80-1.65)           0.45
  No education                      1.51    (1.00-2.30)           0.05
Women's frequency of alcohol
    consumption
  No alcohol consumption                    1
  Occasionally                      1.48    (1.34-1.65)           0.00
  More than once a month            2.51    (1.62-3.90)           0.00
Work activity
  Housewife                                 1
  Works outside the home            1.30    (0.99-1.72)           0.06
History of childhood abuse
  Was not physically abused                 1
  Occasionally                      1.60    (1.56-1.65)           0.00
  Several times and almost
    always                          3.70    (3.03-4.52)           0.00

Partner's characteristics

Education
  High school and more                      1
  Elementary and junior high
    school                          1.37    (0.85-2.18)           0.19
  No education                      1.48    (0.79-2.77)           0.22
Income (multiple of minimum
    monthly wage) ([double
    dagger])
  [greater than or equal to] 5              1
  2 to <5                           1.01    (0.76-1.35)           0.93
  0 to <2                           1.13    (0.91-1.41)           0.27
Partner's frequency of alcohol
    consumption
  No alcohol consumption                    1
  Occasionally                      1.77    (1.62-1.93)           0.00
  1-3 times per month               4.00    (3.74-4.28)           0.00
  1-3 times per week                6.85    (6.29-7.47)           0.00
  Every day or almost every day    14.77    (13.25-16.46)         0.00

Others

Number of children in the
    household
  0                                         1
  1                                 1.14    (1.04-1.24)           0.00
  [greater than or equal to] 2      1.44    (1.18-1.77)           0.00
Household asset index
  High                                      1
  Medium                            1.32    (1.02-1.18)           0.04
  Low                               1.15    (1.14-1.72)           0.00

Variable                              Non-severe Violence *        P
                                           N = 2,242

Women's characteristics              OR     CI 95% ([dagger])

Age (years)
  [greater than or equal to] 55             1
  45-54                             0.93    (0.79-1.12)           0.44
  35-44                             0.96    (0.75-1.24)           0.78
  25-34                             0.96    (0.67-1.37)           0.82
  15-24                             1.01    (0.66-1.55)           0.94
Education
  High school and more                      1
  Elementary and junior high
    school                          0.96    (0.78-1.17)           0.68
  No education                      1.35    (1.16-1.56)           0.00
Women's frequency of alcohol
    consumption
  No alcohol consumption                    1
  Occasionally                      1.43    (1.28-1.59)           0.00
  More than once a month            1.60    (1.51-1.69)           0.00
Work activity
  Housewife                                 1
  Works outside the home            1.10    (1.00-1.21)           0.04
History of childhood abuse
  Was not physically abused                 1
  Occasionally                      1.65    (1.56-1.75)           0.00
  Several times and almost
    always                          2.19    (2.07-2.31)           0.00

Partner's characteristics

Education
  High school and more                      1
  Elementary and junior high
    school                          1.36    (1.25-1.47)           0.00
  No education                      1.54    (1.35-1.76)           0.00
Income (multiple of minimum
    monthly wage) ([double
    dagger])
  [greater than or equal to] 5              1
  2 to <5                           1.18    (0.93-1.49)           0.18
  0 to <2                           1.29    (1.02-1.63)           0.00
Partner's frequency of alcohol
    consumption
  No alcohol consumption                    1
  Occasionally                      1.29    (1.09-1.53)           0.00
  1-3 times per month               1.95    (1.59-2.38)           0.00
  1-3 times per week                2.17    (1.74-2.71)           0.00
  Every day or almost every day     3.04    (2.75-3.36)           0.00

Others

Number of children in the
    household
  0                                         1
  1                                 1.18    (1.10-1.26)           0.00
  [greater than or equal to] 2      1.20    (1.04-1.39)           0.01
Household asset index
  High                                      1
  Medium                            1.18    (0.89-1.57)           0.24
  Low                               1.31    (1.05-1.62)           0.01

Goodness of fit test = 0.75

* Women who were victims of severe or non-severe violence inflicted
by their partners are compared with women who experienced no
violence (N = 13,714).

([dagger]) The analysis was carried out adjusting by stratum.
Confidence intervals to 95% were calculated with robust standard
errors adjusted by "cluster" (institution).

([double dagger]) The minimum daily pay a worker must receive by
law. (16) The minimum wage during 2003 was the equivalent of C$5.01.
Exchange rate: C$1 = 8.69 pesos, 2003.