Loss of Health

7/29/2019 Loss of Health

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LOSS OF HEALTH DUE to

VIOLENCE: Time for VALY?Thoughts on Measuring Violence

Against Women in India

Arindam BasuUniversity of Canterbury


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This is Where I Work


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This is Where I live


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This is What I am Going to Talk About Today


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Is Violence Against Women in India Increasing?


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Violence Against Women

0

50000

100000

150000

200000

250000

300000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total Number of Crime Against Women


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Cruelty Against Women (%)

0

5

10

15

20

25

30

35

40

45

50

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Really Cruel Crime Against Women (%)


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Dowry Related Violence as %

5.6

5.8

6

6.2

6.4

6.6

6.8

7

7.2

7.4

7.6

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Dowry Related Violence (%)


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Violence Against Women (VAW) in

India (2001-2012)

9

9.5

10

10.5

11

11.5

12

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Percentage of Rape of All Crimes


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Assaults (% of)

0

5

10

15

20

25

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Percentage of Assaults Against Women of All Crimes Committed


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So, Whats The Story?


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How Does This Affect Womens Health and Well Being?


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Exposure Versus Outcomes

Depression

Suicidal Ideations, Self Harm

Substance Abuse

HIV, STDs, Cancer

DEATH!!!

Violence Against Women in All Forms


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Exposure Versus Outcomes

Depression


Substance Abuse

HIV, STDs, Cancer

DEATH!!!



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Need a Summary Measurement


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At Birth, her Life Expectancy was 75 years


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Violence Against her, she dies, DEAD @ 25 years,

50 years lost!


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She Survives, but with 50% Quality of Life


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With 50% quality of life, she has lost 25 years out of

possible 50 years she could have lived, lost 25 years


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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?


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DALY = YLL + YLD


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DALY = YLL + YLD

Years of Life Lost


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DALY = YLL + YLD

Years Lost Due to Disability


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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 StudyFunded by the World Bank


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Top 10 DALYs, 1999


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Link Back Disease Burden to Violence

Depression


Substance Abuse

HIV, STDs, Cancer

DEATH!!!



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Three Sources to Pull Data From

Probability of Exposure

to ViolenceLinkage Between

Exposure and Disease

Burden of Disease

Attributable to Violence


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Source of Data


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Risk of Exposure to Violence for Women


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Exposure-Disease Linkages


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Results


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Percentage of Disease Burden

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

50.00

Femicide HIV Syphilis Chlamydia Abortion Low

Birthweight

Alcohol Abuse Depression Suicide Injuries

67% of the Burden of

Disease are from Depression

and Suicide


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The Case for Violence Adjusted Life

Year Estimation: Is Violence an

Outcome? Is Violence only anExposure?


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Concepts of VALY

VALY = Violence Adjusted Life Years

Violence Against Women is Common in India

Disease Burden Affected by Living in an Environment ofViolence (for Women)

Intimate Partner Violence Non-intimate Partner Violence

Domestic/Outside of Domestic Violence

Others?

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

Need for Adjustment for GBD and Local Burden ofDisease Estimation

Loss of Health

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