Abstract
Background: Although male partners' socioeconomic status (SES) and substance use is associated with worse health of female partners, the mechanism behind this link is still unknown. Objectives: To investigate whether intimate partner violence (IPV) is a mechanism by which male partners' SES and substance use influence female partners' self-rated health (SRH) as victims and survivors of IPV. Materials and Methods: Fragile Families and Child Wellbeing Study (FFCWS) is an ongoing population-based cohort. Male and female partners' SES, anxiety, depression, and substance use, and their relationship status were measured at baseline. IPV victimization was also asked among female partners' at baseline. Female partners' subjective health was measured 3 times (baseline-1998, 3 years later-2001, and 5 years later-2003). Using AMOS, we fitted two structural equation models (SEM) for data analysis. In Model 1 we tested direct paths from male partners' SES and mental health to female partners' SRH, in the absence of IPV. In the Model 2 we conceptualized female partners' IPV victimization between male partners' SES and mental health and female partners' SRH. In both models we controlled for the effect of female partners' SES and mental health. Results: In Model 1, male partners' poor SES and substance use were associated with worse trajectory of SRH of female partner. In Model 2, male to female IPV was the mechanism by which male partners' SES and substance use were associated with female partners' SRH. Conclusions: IPV is one of the mechanisms by which male partners' SES and substance use can influence female partners' health. That is, IPV may operate as a vehicle by which male partners' social and psychological risk factors impact female partners' health. Thus, this study demonstrates how male partners' socio-ecological risk factors such as low SES and substance use impact female partners' health. Therefore, there is a need for broader socio-ecological approach to IPV prevention and intervention that recognizes the relationship between male partners' risk factors and their female partners' health outcomes. Such approach can inform prevention and treatment of IPV and enhance partner wellbeing.