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Interpersonal Violence in Three Caribbean Countries: Barbados, Jamaica, and Trinidad and Tobago

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Interpersonal Violence in Three Caribbean Countries: Barbados, Jamaica, and Trinidad and Tobago Investigación original / Original research Interpersonal violence in three Caribbean countries: Barbados, Jamaica, and Trinidad and Tobago Elsie Le Franc,1 Maureen Samms-Vaughan,2 Ian Hambleton,3 Kristin Fox,4 and Dennis Brown 5 Suggested citation Le Franc E, Samms-Vaughan M, Hambleton I, Fox K, Brown D. Interpersonal violence in three Carib- bean countries: Barbados, Jamaica, and Trinidad and Tobago. Rev Panam Salud Publica. 2008;24(6): 409–21. ABSTRACT Objectives. This article reports the prevalence of two types of interpersonal violence (IPV) (sexual and physical) and one type of aggression (psychological) in three low-to-middle-income Caribbean countries. It examines IPV among adolescents and young adults as both victims and perpetrators. Method. This population-based study compares the experiences of 15–30 year olds in coun- tries at different levels of socioeconomic development. The Revised Conflict Tactics Scales (CTS2) and other behavioral instruments were used to assess the level and characteristics of IPV. Results. Out of 3 401 respondents, 70.9% reported victimization by some form of violence, which was most commonly perpetrated by a relationship partner (62.8%). Sexual violence vic- timization was reported more commonly by women, and was highest in Jamaica. Significant between-country differences in overall levels of reported physical violence, and psychological aggression, were evident when stratifying by perpetrator type. Conclusions. The very high levels of reported IPV indicate very high levels of tolerance among victims, and suggest a culture of violence and of adversarial intimate relationships may be well entrenched. The findings support the view that co-occurrence of general interpersonal violence and partner violence may be limited, and that one may not necessarily be a predictor of the other. They also reveal that, among partners, not only are there no gender differentials in victimization by physical violence, but more women than men are self-reporting as perpe- trators of this type of IPV. Key words Sexual violence, domestic violence, aggression, adolescent, adult, Barbados, Ja- maica, Trinidad and Tobago. Obstetrics, Gynaecology & Child Health, The Uni- Based on recent studies of violence 1 Professor Emeritus, Sir Arthur Lewis Institute of versity of the West Indies, Kingston, Jamaica. and injury reporting high and rising Social and Economic Studies (SALISES), The Uni- 3 Senior Lecturer in Biostatistics, Chronic Disease versity of the West Indies, Kingston, Jamaica. Send Research Centre, Tropical Medical Research Insti- rates of morbidity and mortality as correspondence and reprint requests to: Elsie Le tute, The University of the West Indies, Bridge- well as high associated economic Franc, Professor Emeritus, SALISES, The Univer- town, Barbados. sity of the West Indies, Mona, Kingston 7, Jamaica, 4 Senior Research Fellow, SALISES, The Univers- costs, violence and injury must now be West Indies; telephone: (876) 927-1234; fax: (876) ity of the West Indies, Kingston, Jamaica. seen as a major public health problem 927-2409; e-mail: [email protected] 5 Senior Lecturer, Department of Sociology and So- 2 Professor of Child Health, Development and Be- cial Work, The University of the West Indies, St. (1–3), especially in the Caribbean (4–6). haviour, Section of Child Health, Department of Augustine, Trinidad and Tobago. In addition, there is growing evidence Rev Panam Salud Publica/Pan Am J Public Health 24(6), 2008 409 Original research Le Franc et al. • Interpersonal violence in three Caribbean countries that the consequences of violence go young adults (23). In Jamaica, qualita- ribbean include research on the prob- far beyond immediate morbidity and tive data suggest that the adolescent lem of IPV and aggression in schools mortality, comprising longer-term and partnering process is closely linked to and its effect on educational perfor- negative effects on mental and repro- IPV and aggression (24). mance and nutrition (34, 38–40); the ductive health as well as general so- Over time, there have been many at- impact of exposure to violence-related cioeconomic development (1, 7–9). tempts to explain antisocial behaviors, psychological distress (37); and the role Understanding the full burden of such as crimes against individuals. of protective factors against violence, violent behavior in a specific country Yet, understanding of the magnitude such as family connectedness (38). requires consideration of not only mor- and causes of this type of violence is This article provides an initial report tality statistics but also morbidity sta- still inadequate. With respect to the of a population-based survey of IPV tistics, which are often much higher. specific problem of domestic violence and aggression among adolescents In the United States, for example, the (including partner violence), there is and young adults (15–30 years of age) estimated ratio of mortality to morbid- still no clear consensus or overarching in three Caribbean countries (Barba- ity ranges from 1:19 to 1:200 (8, 10–12). theoretical model to explain the causes dos, Jamaica, and Trinidad and To- Although reliable morbidity data are of this phenomenon across time bago). It includes the reported preva- not available for the Caribbean region, and/or space. There is, however, con- lence of two types of IPV (sexual and one study estimates a mortality-to- tinuing debate about what should be physical) and one type of aggression morbidity ratio range of 1:8 to 1:26 (4). incorporated in the definition of vari- (psychological) experienced by vic- In Jamaica, most admissions to casu- ous types of violence, and their respec- tims, as well as perpetrators. This is alty departments and accident and tive causes. Given the wide variations the first quantitative, comparative, Ca- emergency units are related to injury of violence in terms of its expressions, ribbean study utilizing the Revised caused by violence, with one-half of rationalizations, and locations, these Conflict Tactics Scales (CTS2) and admissions resulting from intentional causes are likely to be complex and other behavioral instruments to assess violence on individuals under 30 years multiple (1, 25–30). the extent and characteristics of IPV of age (13). In Barbados and Trinidad There are also conflicting views re- and aggression in the region, and col- and Tobago, injuries account for 10– garding the role of gender in IPV and lecting information on a range of pos- 25% of hospital admissions (14). In aggression. Certainly, the feminist sible determinants, including educa- St. Vincent and the Grenadines, there movement has been critical in raising tion and occupation; family structure were 17 murders recorded per 100 000, awareness of the serious problem of and migration patterns; household versus 1 257 and 863 per 100 000 for as- female battery and spurring its incor- composition; social support networks; sault and wounding, respectively (15). poration into national health agendas. parenting; and psychosocial variables Increasing awareness of domestic However, there is increasing recogni- such as perceptions of self-esteem, ex- violence has led to a recent increase in tion of the reality of male victimization clusion, and personal power. The related literature, which reports inci- and the fact that the “gender gap” (a study aims to determine the magni- dence rates ranging from 16 to 69% (1, disproportionate number of female tude of physical and sexual IPV, and 16–17). In the Caribbean, there is lim- victims versus male victims) may not psychological aggression,6 as well as ited quantitative data on the subject exist or is narrowing (25, 30–33). It is the possible role of gender in victim- but considerable qualitative evidence therefore important that analyses of ization or perpetration by/of these that the problem is serious, growing, IPV and aggression be gender-differ- types of violence. It also investigates and widespread (4, 18–21). A clearer entiated to determine possible differ- differences between violence among understanding of the characteristics, ences in incidence rates. partners and violence among acquain- prevalence, and causes of interper- Although current evidence indicates tances and strangers. sonal violence (IPV) and aggression low- and middle-income countries has therefore become critical. have a disproportionately high rate Violence, violent injury, and other of IPV and aggression (1), research on MATERIALS AND METHODS health-risky behaviors often begin at a the determinants of this type of vio- very early age. As in most countries in lence in these countries remains lim- Study design the Americas (5, 10, 22), violence and ited (34–38). Most existing explanatory injury is now the leading cause of models and frameworks were devel- All individuals aged 15–30 years death among adolescents and young oped in high-income North Atlantic were eligible for participation in this adults in the English-speaking Carib- countries. Therefore, their usefulness study. Actual study participants were bean, with injury as the leading cause in low- to middle-income countries of death among 5–14 year-old males, needs to be explored, particularly in and homicide and suicide the most im- the Caribbean, where the economic sit- 6 Although some data are provided on psychologi- portant causes of death among the uation, as well as sociocultural mores cal aggression to illustrate the likely magnitude of the problem compared to experiences with actual 15–24 year age group (4). Partner vio- and
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