LOSS OF HEALTH DUE to VIOLENCE: Time for VALY?

Thoughts on Measuring Violence Against Women in IndiaArindam Basu

University of Canterbury

This is Where I Work

This is Where I live

This is What I am Going to Talk About Today …

How Much Illness Can be Attributed to Violence Against Women In India?

Where’s What’s VALY?

Is Violence Against Women in India Increasing?

Violence Against Women

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

50000

100000

150000

200000

250000

300000

Total Number of Crime Against Women

Cruelty Against Women (%)

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

5

10

15

20

25

30

35

40

45

50

Really Cruel Crime Against Women (%)

Dowry Related Violence as %

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20125.6

5.8

6

6.2

6.4

6.6

6.8

7

7.2

7.4

7.6

Dowry Related Violence (%)

Violence Against Women (VAW) in India (2001-2012)

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20129

9.5

10

10.5

11

11.5

12

Percentage of Rape of All Crimes

Assaults (% of)

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

5

10

15

20

25

Percentage of Assaults Against Women of All Crimes Committed

So, What’s The Story?

How Does This Affect Women’s Health and Well Being?

Exposure Versus Outcomes

Depression

Suicidal Ideations, Self Harm

Substance Abuse

HIV, STDs, Cancer …

DEATH!!!

Violence Against Women in All Forms

Exposure Versus Outcomes

Depression

Suicidal Ideations, Self Harm

Substance Abuse

HIV, STDs, Cancer …

DEATH!!!

Violence Against Women in All Forms …

Need a Summary Measurement …

At Birth, her Life Expectancy was 75 years

Violence Against her, she dies, DEAD @ 25 years, 50 years lost!

She Survives, but with 50% Quality of Life

With 50% quality of life, she has lost 25 years out of possible 50 years she could have lived, lost 25 years

So Between the Two Nirbhayas (Jane Does), 75 years of Life Lost!

Math Quiz:

With Hundreds of Nirbhayas Being Violated Every Year in India, How Many Lives Are Lost? Who Loses? What is the Loss? Why Do We Need to Know This?

DALY = YLL + YLD

DALY = YLL + YLD

Disability Adjusted Life Years

DALY = YLL + YLD

Years of Life Lost

DALY = YLL + YLD

Years Lost Due to Disability

This Simple formula was worked out by Alan Lopez and Chris Murray at Harvard and UQ in

1990 for the Global Burden of Disease, a Study Funded by the World Bank

Top 10 DALYs, 1999

Link Back Disease Burden to Violence

Depression

Suicidal Ideations, Self Harm

Substance Abuse

HIV, STDs, Cancer …

DEATH!!!

Violence Against Women in All Forms …

Three Sources to Pull Data From

Probability of Exposure to Violence Linkage Between

Exposure and Disease

Burden of Disease

Attributable to Violence

Source of Data

Risk of Exposure to Violence for Women

Exposure-Disease Linkages

Results

Percentage of Disease Burden

Femicid

eHIV

Syphilis

Chlamyd

ia

Abortion

Low Birt

hweight

Alcohol A

buse

Depres

sion

Suicid

e

Injuries

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

50.00

67% of the Burden of Disease are from Depression and Suicide

The Case for Violence Adjusted Life Year Estimation: Is Violence an Outcome? Is Violence only an Exposure?

Concepts of VALY• VALY = Violence Adjusted Life Years• Violence Against Women is Common in India• Disease Burden Affected by Living in an Environment of

Violence (for Women)– Intimate Partner Violence– Non-intimate Partner Violence– Domestic/Outside of Domestic Violence– Others?

• VALY = Years of Life Lost Due to Violence (YLLV) + Years of Life Lost due to Disability owing to Violence

• Need for Adjustment for GBD and Local Burden of Disease Estimation