Presentation on VALY at the NZIRI Conference in Wellngton (Draft)
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Transcript of Presentation on VALY at the NZIRI Conference in Wellngton (Draft)
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LOSS OF HEALTH DUE to VIOLENCE: Time for VALY?
Thoughts on Measuring Violence Against Women in IndiaArindam Basu
University 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 …
How Much Illness Can be Attributed to Violence Against Women In India?
Where’s What’s VALY?
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Is Violence Against Women in India Increasing?
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Violence Against Women
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120
50000
100000
150000
200000
250000
300000
Total Number of Crime Against Women
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Cruelty Against Women (%)
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120
5
10
15
20
25
30
35
40
45
50
Really Cruel Crime Against Women (%)
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Dowry Related Violence as %
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20125.6
5.8
6
6.2
6.4
6.6
6.8
7
7.2
7.4
7.6
Dowry Related Violence (%)
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Violence Against Women (VAW) in India (2001-2012)
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20129
9.5
10
10.5
11
11.5
12
Percentage of Rape of All Crimes
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Assaults (% of)
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120
5
10
15
20
25
Percentage of Assaults Against Women of All Crimes Committed
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So, What’s The Story?
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How Does This Affect Women’s 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
Suicidal Ideations, Self Harm
Substance Abuse
HIV, STDs, Cancer …
DEATH!!!
Violence Against Women in All Forms …
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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
Disability Adjusted Life Years
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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 Study Funded by the World Bank
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Top 10 DALYs, 1999
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Link Back Disease Burden to Violence
Depression
Suicidal Ideations, Self Harm
Substance Abuse
HIV, STDs, Cancer …
DEATH!!!
Violence Against Women in All Forms …
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Three Sources to Pull Data From
Probability of Exposure to Violence Linkage 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
Femicid
eHIV
Syphilis
Chlamyd
ia
Abortion
Low Birt
hweight
Alcohol A
buse
Depres
sion
Suicid
e
Injuries
0.00
5.00
10.00
15.00
20.00
25.00
30.00
35.00
40.00
45.00
50.00
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 an Exposure?
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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 of
Violence (for Women)– Intimate Partner Violence– Non-intimate Partner Violence– Domestic/Outside of Domestic Violence– Others?
• VALY = Years of Life Lost Due to Violence (YLLV) + Years of Life Lost due to Disability owing to Violence
• Need for Adjustment for GBD and Local Burden of Disease Estimation