The effect of intimate partner violence and socioeconomic status on the physical and mental health in middle-aged Hong Kong residents

Abstract

Intimate partner violence (IPV) has recently been recognized as a global public health issue that can cause various kinds of long-lasting physical, sexual, and psychological health problems for survivors. Limited studies are available concerning the relationship between objective and subjective socioeconomic status (SES) and IPV. Furthermore, little is known about the relationship between subjective SES and health outcomes that result from IPV. These questions are particularly relevant for IPV in Hong Kong, where severe wealth disparity and lower subjective SES may potentially contribute to higher indices of IPV and resulting more health problems. Previous studies on IPV in Hong Kong have focused on young adults and the elderly, while few studies have focused on middle-aged adults. The study presented here aimed to (1) summarize the current literature on the IPV, SES, and health status; (2) identify the objective and subjective SES as risk factors of IPV; and (3) examine the mediating effect of IPV between SES and health status in the middle-aged Chinese population. This study was a secondary analysis. Cross-sectional, territory-wide survey data from 400 households were collected to quantify participants’ IPV experience, somatic symptoms, anxiety and depression, objective and subjective SES, and other demographic information. Independent t-test, Chi-square test, and linear regressions were used to measure the different SES indicators and IPV. Structural equation modelling (SEM) was performed to further explore the mediating effect of IPV in the association between SES and health status. Education, marital status, adverse childhood experiences, and subjective SES were the main indicators that showed significant association with IPV. Moreover, IPV was positively associated with participants’ health status. Employment status, household income, and subjective SES were significantly associated with participants’ somatic symptoms. Employment and subjective SES were significantly associated with anxiety, while household income was the only variable significantly associated with depression. Three paths were tested for the indirect mediating effects of objective SES on health status. SEM found that the path of objective SES to health with subjective SES as mediator was significant and it accounted for 0.329 negative estimates. Another path of objective SES to health though subjective SES and IPV was also significant, accounting for 0.092 negative estimates. The path from objective SES to health through IPV was not significant. The total indirect role of subjective SES and IPV between objective SES and health status was significant in the model. This study presented the first data measuring subjective SES as a factor for IPV and is also the first research that explored the association between objective SES and health status with the mediating effect of subjective SES and IPV in middle-aged Hong Kong residents. Findings from this study filled in the gap of the association among three variables in the Chinese population. Future studies using a longitudinal design should examine the association and mediating effects retrieved from this study and further establish causality. Finally, a priority for future studies is the confirmation and expansion of subjective SES and its function in clinical measures. (492 words)