“Communities are only as strong as the health of their women.”

–  Michelle Obama, Former First Lady of the United States

INTRODUCTION

Be it in the workplace, at school, or at home, thousands of individuals worldwide are subjected to some form of gender-based violence every day. 

Gender-based violence (GBV) is an umbrella term that describes any harmful act directed at an individual or group of individuals based on their gender identity, gender expression, or perceived gender (Statistics Canada, 2019). This may include intimate partner violence (domestic violence), sexual violence, and violence against women and girls, among many others. The term is often used to highlight the gender-based structural and power imbalances that exist within society and the ways in which they place women and other gender minorities at increased risk of experiencing violence (UN Women, n.d.). 

GBV is a deeply-rooted issue with several significant implications for public health and safety. Governments and policymakers do, however, have access to a wide range of tools and policy solutions to address and prevent it.

In this blog post, we’ll be discussing:

• Gender-based violence in Canada and around the world

• Public health implications
• Ending gender-based violence: programs and policy solutions

Gender-based violence in Canada and around the world

GBV is, unfortunately, pervasive in every corner of the world. Almost 1 in 3 women globally have been subjected to physical and/or sexual intimate partner violence, non-partner sexual violence, or both at least once in their lifetime (UN Women, 2022). This burden is disproportionately shouldered by low- and lower-middle-income countries, where at least 37 percent of women have experienced GBV (Un Women, 2022). 

In Canada, more than 4 in 10 women have experienced some form of intimate partner violence in their lifetime (Statistics Canada, 2021). In 2020 alone, 160 women and girls were killed by violence – a marked increase from the 118 killed in 2019 (Canadian Femicide Observatory for Justice and Accountability, 2020). Many experts believe this increase may be linked to the COVID-19 pandemic, which forced many people to quarantine with their abusers for long periods of time. 

While anyone can fall victim to gender-based violence, women, girls, and gender-diverse individuals are disproportionately targeted compared to men (Canadian Women’s Foundation, 2021). Other groups at increased risk include:

• Indigenous peoples: Indigenous women and girls are 12 times more likely to be murdered or missing than any other woman in Canada and 16 times more likely than white women (National Inquiry into Missing and Murdered Indigenous Women and Girls, 2019).
• People of color: racialized women are less likely than non-racialized women to be taken seriously within the criminal law system when reporting GBV (Ruparelia, 2012).
• People with disabilities: women living with a disability are three times more likely to experience violent victimization than those living without a disability (Cotter, 2021). 
• LGBTQ+: individuals who identify as lesbian or bisexual are three to four times more likely than heterosexual women to report experiencing spousal violence (Simpson, 2018). Three in five transgender women have experienced intimate partner violence since the age of 16 (Trans PULSE Canada Survey, 2019). 
• Adolescents and youth: women and girls aged 15 to 19 and aged 20 to 24 are five times more likely than women 25 and older to be physically or sexually assaulted by a non-intimate partner (Savage, 2021). 

Public health implications

While GBV poses an obvious threat to the safety and security of those affected, it also bears significant long-term public health consequences.

Many victims of GBV experience a wide range of physical and mental health problems following their assault. Common physical health problems associated with intimate partner violence and other forms of GBV include chronic pain, gastrointestinal disorders, sleep disorders, and other general reductions in physical functioning (Wathen, 2012). In terms of reproductive health, GBV increases the risk of contracting sexually transmitted infections like HIV, experiencing a range of gynaecological disorders, and unwanted pregnancy (Wathen, 2012). 

GBV is also associated with higher rates of various mental health problems including anxiety, depression, and post-traumatic stress disorder (Watham, 2012). Individuals living with these problems are more likely to engage in risky or dangerous behaviors like increased alcohol use, smoking, and self-harm (Watham, 2012). 

Those in close proximity to victims of GBV can also be indirectly affected. Children who witness GBV, for instance, are at increased risk of developing psychological, social, emotional, and behavioral problems (Wathen, 2012). They are also more likely to have violent dating and intimate relationships as adults and/or mistreat their own children as a result of this trauma (Wathen, 2012). 

Ending gender-based violence: programs and policy solutions

It’s clear that more comprehensive policy and programming solutions are needed to address GBV globally. But what exactly should those solutions look like?

There are three basic levels of prevention when it comes to addressing GBV. The first, or primary, level is concerned with reducing the risk factors associated with violence and promoting protective factors to prevent GBV from happening in the first place. The secondary level focuses on treating the immediate injuries and harms caused by GBV. The tertiary level focuses on reducing the long-term consequences associated with GBV such as reproductive health problems and post-traumatic stress. 

From a public health perspective, strategies that operate at the primary level of prevention to stop GBV before it ever happens are the most favorable. Effective actions that may be taken at this level include, but are not limited to:

• Comprehensive sexual health education: many experts have stressed the importance of mandatory sexual health education in schools that covers healthy relationships, consent, self-responsibility, boundaries, and domestic violence awareness.
• Standard practices for preventing and addressing GBV in organizations: this may include mandatory employee workshops, zero-tolerance sexual violence/harassment policies, and clear procedural steps for addressing GBV in the workplace, at school, etc. 
• Increased access to affordable housing: may provide temporary or long-term shelter for those at risk of experiencing GBV
• Implementing calls for justice: governments should acknowledge groups at disproportionate risk of experiencing GBV (e.g. Indigenous women and girls, racialized individuals, etc.) and develop specific policy actions (Courage to Act, 2021). 

As with most social issues, there’s no singular catch-all strategy that can be universally applied to end GBV. Policies and programs should therefore be context-specific and formulated to address the specific needs of a particular country, province, or community. This includes consideration of a wide range of factors such as age/race demographics of the target community, socio-economic situation, local cultures and beliefs, etc.

TL;DR:

• GBV is deeply rooted in gender-based structural and power imbalances that put women, girls, and gender-diverse individuals in vulnerable positions. These imbalances exist in many countries, including Canada.
• In addition to the safety and security implications, GBV has many long-term public health consequences. These include increased physical health problems like chronic pain and sexually transmitted infections as well as mental health problems like depression and post-traumatic stress disorder.
• Policy actions to end GBV can be taken at the primary, secondary, and tertiary levels of prevention. Primary interventions that aim to prevent GBV before it happens include comprehensive sexual health education, standard practices for preventing GBV in organizations, increased access to affordable housing, and implementing calls for justice.  

Written by: Claire Borganonkar, BPAPM (c)