Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality.

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. METHOD 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.