Intersections of intimate partner violence and food insecurity in Gauteng

Please read analysis with reference to the fully designed Vignette here.

Globally, the 2018 estimated lifetime prevalence of intimate partner violence (IPV) among women aged 15 years and older is 30% (World Health Organisation, 2021). IPV against women has been identified as a significant global public health concern and a serious human rights violation (Devries et al., 2013). Although prevention efforts are being made to eliminate violence against women, recent evidence shows that IPV continues to be one of the most common forms of violence worldwide, including in South Africa (Oram et al., 2022; Sardinha et al., 2022). In South Africa, one in five (21%) women have experienced physical violence by a partner at some point in their lives (Statistics South Africa, 2016). IPV remains a gendered problem with the burden of this violence overwhelmingly borne by women.

Academic studies have confirmed a correlation between poverty and IPV and have also indicated that both poverty and IPV significantly impact women’s physical and psychosocial well-being (Gillum et al., 2019; Goodman et al., 2009). Recently, scholars have explored food insecurity to understand causal pathways that lead to the greater likelihood of IPV (Gibbs et al., 2017; Hatcher et al., 2019; Hatcher et al., 2022). Food insecurity is a proxy for poverty, but it also has a specific causal pathway leading to a greater risk of IPV. Because of widely-shared societal norms and historical gender roles that position men as the expected ‘providers’ or ‘breadwinners’ in a household, an inability to put food on the table can lead to feelings of frustration, anxiety, stress, disempowerment and misplaced anger among men. This in turn may lead to an increased risk of IPV for female partners. Gibbs (2017) confirms that food insecurity is a significant contributing factor to women experiencing IPV, with men who perpetrate IPV often doing so as a result of economic stressors related to providing for their families.

Figure 1 below is a conceptual framework that represents this clear causal pathway linking food insecurity to IPV. It further shows that there is then also a reverse flow / feedback-loop logic connecting IPV to greater household food insecurity.

Figure 1: Framework linking household food insecurity and intimate partner violence

This Vignette uses data from the GCRO’s Quality of Life (QoL) survey 6 (2020/21) to explore the causal relationships between food insecurity and IPV among a population-based sample of women in Gauteng.

Overall in Gauteng, 5.1% of women reported experiences of IPV in the past year before they were interviewed for the QoL 2020/21 fieldwork. However, the prevalence of IPV varies by the extent of food security and food insecurity. Women from food secure households do experience IPV, but as shown in Figure 2 women from food-insecure households are almost twice as likely (at 7.1%) to report experiencing IPV in the past year than those from food-secure households (at 4.4%), thus confirming the associations between household food insecurity and IPV.

Figure 2: Percentage of women who experienced IPV in the past year by whether household is food secure or insecure (GCRO, 2021)

The analysis represented in Figure 2 goes deeper to show that socially more vulnerable women and those from economically challenged households are more at risk of IPV than those who are more advantaged, but furthermore that within the more vulnerable categories, the presence of food insecurity is a significant exacerbating factor for IPV risk.

• Women who reported a monthly household income of less than R3200 are highly and substantially more likely to report IPV in the past year, compared to those with monthly household income of R3201 and more. However, within households earning less than R3200, 8.4% of women experience IPV where the household is food insecure compared to 6.1% where the household is food secure.
• Women with low and medium socio-economic status are also substantially more likely to report IPV in the past year, compared to those with high socio-economic status. However, within the low and medium socio-economic status categories, households that are also food insecure see women almost twice as likely to experience IPV.
• Women at high risk of depression were also more likely to report IPV, compared to those with low risk of depression. Where high risk of depression women live in food insecure households, 8% say they have experienced IPV compared to 5.2% in food secure households.
• Similarly, 9.5% of unemployed women from food insecure households experienced IPV in the past year, compared to 5.9% of those employed.
• The same patterns apply with respect to whether respondents reported debt or not, and whether they have low or high levels of education.

As shown in our causal pathways diagram, IPV can in turn worsen household food insecurity, leaving women disempowered and with poor mental health outcomes which then leads to less economic productivity. Overall, 28.5% of households experience food insecurity in Gauteng; however, this also varies by whether or not women in the household have experienced IPV. Figure 3 shows that of women who reported experiencing IPV in the past year before the QoL interview, a substantially higher than average 39,6% live in households defined as food insecure. Again in turn this also makes it difficult for women from food-insecure households to break free from the cycle of abuse.

Figure 3: Percentage of women living in food-insecure households, by IPV exposure versus non-exposure (GCRO, 2021)

This work adds to literature that explores the association between household food insecurity and IPV among a population-based and representative sample of women in Gauteng, South Africa. In a South African society with high levels of gender-based violence and community trauma, preventing IPV before it starts through creating employment opportunities and elevating economic growth is paramount. In addition, interventions to lessen IPV need to work to reduce household food insecurity in conjunction with gender transformative interventions that aim to change the narrative around unequal gender norms and power structures in society. This includes addressing the societal expectations that men are the primary "providers" or "breadwinners" in households. Thus, addressing both household food insecurity and IPV in South Africa requires a multi-faceted approach that addresses the systemic issues at play and the self-reinforcing cyclical nature of the problem.

Notes on method

1. IPV was recoded from incidents of hitting, kicking, threats or use of a weapon to intimidate and/or forced sex by the current or former intimate partner in the 12 past months.
2. The food insecurity index was constructed using four questions from the QoL survey. The index comprised: inadequate monthly expenditure on food relative to household size; an adult having skipped meals due to lack of money to buy food; not having enough money to feed children; and no place to purchase food within walking distance.
3. Socio-economic status was assessed using a weighted measure of the Quality of Life Index, which covers medical insurance, highest level of education completed, working internet access in the home, employment status, and household income that ranged from 1–10 on a continuous scale. This was categorised into three categories (low [<3.34], medium [3.34-6.77], high [>6.77]).
4. Risk of depression was assessed using the 2-item shortened version of the Patient Health Questionnaire-2 (PHQ-2), which has been validated in South Africa (Bhana et al., 2015). This brief screening tool asks about the frequency of two symptoms over the past two weeks (1) feeling down, depressed, and hopeless and 2) losing pleasure or interest in doing things) with responses ranging on a Likert scale of 0 (not at all), 1 (a few days), 2 (more than half the days) and 3 (nearly every day). With combined scores for the two questions ranging from 0-6, the PHQ-2 score of two or more (high risk of depression) has been shown to have good sensitivity, suggesting probable depression.
5. Education was assessed by the highest level of education completed by the respondent. This was divided into two categories: 1) low education (no education, only primary, and secondary incomplete), 2) high education (matric and tertiary)
6. Employment status was dichotomised by whether the respondent is employed or unemployed, which was based on three questions from the QoL survey on: 1) employment in the past seven days, 2) employed but have not started working, and 3) unemployment and looking for work.
7. Monthly household income was accessed by the reported all money coming into the household, from all sources and this was captured as categorical. For analysis, this was divided into two categories: 1) monthly household income of less than R3200, 2) monthly household income of R3201 and more.
8. Debt was assessed by whether the respondent owes money to anyone (Yes/No).

References

Devries, K.M., Mak, J.Y., Garcia-Moreno, C., Petzold, M., Child, J.C., Falder, G., Lim, S., Bacchus, L.J., Engell, R.E., Rosenfeld, L. and Pallitto, C. (2013). The global prevalence of intimate partner violence against women. Science, 340(6140), pp.1527-1528. https://doi.org/10.1126/science.1240937

GCRO (Gauteng City-Region Observatory). (2021). Quality of Life Survey 2020-2021, Round 6 Restricted-Access Data. Johannesburg and Cape Town: GCRO & https://doi.org/10.25828/3v4h-7n43

Gibbs, A., Duvvury, N. and Scriver, S. (2017). What Works Evidence Review: The relationship between poverty and intimate partner violence. https://ww2preventvawg.org/evidence-hub/what-works-evidence-review-relationship-between-poverty-and-intimate-partner-violence

Gillum, T. L. (2019). The intersection of intimate partner violence and poverty in Black communities. Aggression and Violent Behavior, 46, pp.37-44. https://doi.org/10.1016/j.avb.2019.01.008

Goodman, L.A., Smyth, K.F., Borges, A.M. and Singer, R. (2009). When crises collide: How intimate partner violence and poverty intersect to shape women’s mental health and coping?. Trauma, Violence, & Abuse, 10(4), pp.306-329. https://doi.org/10.1177/1524838009339754

Hatcher, A.M., Stöckl, H., McBride, R.S., Khumalo, M. and Christofides, N. (2019). Pathways from food insecurity to intimate partner violence perpetration among peri-urban men in South Africa. American Journal of Preventive Medicine, 56(5), pp.765-772. https://doi.org/10.1016/j.amepre.2018.12.013

Hatcher, A.M., Mkhize, S.P., Parker, A. and de Kadt, J. (2022). Depressive symptoms and violence exposure in a population-based sample of adult women in South Africa. PLOS Global Public Health, 2(11), p.e0001079. https://doi.org/10.1371/journal.pgph.0001079

Oram, S., Fisher, H.L., Minnis, H., Seedat, S., Walby, S., Hegarty, K., Rouf, K., Angénieux, C., Callard, F., Chandra, P.S. and Fazel, S. (2022). The Lancet Psychiatry Commission on intimate partner violence and mental health: advancing mental health services, research, and policy. The Lancet Psychiatry, 9(6), pp.487-524. https://doi.org/10.1371/journal.pone.0264845

Sardinha, L., Maheu-Giroux, M., Stöckl, H., Meyer, S.R. and García-Moreno, C. (2022). Global, regional, and national prevalence estimates of physical or sexual, or both, intimate partner violence against women in 2018. The Lancet, 399(10327), pp.803-813. https://doi.org/10.1016/S0140-6736(21)02664-7

Statistics South Africa. (2016). Crimes against women in South Africa, an analysis of the phenomenon of GBV and femicide. Pretoria: Statistics South Africa.

World Health Organization. (2021). Violence Against Women Prevalence Estimates, 2018. Geneva: World Health Organization. https://www.who.int/publications/i/item/9789240022256

Link to projects: Quality of Life Survey 6 (2020/21)

Edits and inputs: Graeme Gotz and Richard Ballard

Design: Leith Davis

Recommended citation: Petersen, C. and Mkhize, S.P. (2023). Intersections of food insecurity and intimate partner violence in Gauteng. Johannesburg: Gauteng City-Region Observatory.