Blair Kevin J, Tupper Haley, Rook Jordan M, de Virgilio Michael, Torres Thiago S, Chittibabu Akshayaa K, Tranfield M Wynn, Myers Bethany, Hubbard Alan, Chichom-Mefire Alain, Ajiko Mary-Margaret, Juillard Catherine, Dicker Rochelle, Dissak-Delon Fanny Nadia
Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
, 10833 Le Conte Ave, 72-227 CHS, Los Angeles, CA, 90095, USA.
BMC Public Health. 2025 Mar 19;25(1):1065. doi: 10.1186/s12889-025-21321-6.
Interpersonal violence-related physical injury (IPVRPI) is a leading cause of death in low- and middle-income countries (LMICs), yet reliable data relating socioeconomic status (SES) and IPVRPI in these settings are lacking. We analyzed existing literature on associations between SES and IPVRPI in LMICs to understand how SES is measured in these contexts and synthesize data relating markers of SES to IPVRPI at the individual-level in order to inform future hospital-based IPVRPI prevention efforts.
We searched Ovid MEDLINE, EMBASE, and Global Health databases in January 2022 for analytical studies from LMICs that explored individual-level associations between IPVRPI and markers of SES. Studies about intimate partner violence, suicide, or children < 12 years old were excluded, as were population-level studies. Markers of SES considered were educational attainment, employment, and household wealth. Collated data relating these SES indicators with IPVRPI were presented in forest plots.
A total of 34 studies from 20 LMICs were included. Brazil, Mexico, and South Africa were the most represented countries. Studies were mostly cross-sectional (n = 23), and data were typically from patient hospital records (n = 17) or population surveys (n = 12). Included studies explored associations between IPVRPI and education (n = 26), employment (n = 26), and household wealth (n = 19). Categorizations, particularly for employment and wealth, were highly variable between studies. Among the studies that performed multivariable analyses, IPVRPI was found to be significantly associated with lower educational attainment (n = 6), unemployment (n = 4), and lower household wealth (n = 6).
Numerous studies have explored individual-level associations between IPVRPI and markers of SES among LMIC populations. Across a variety of LMIC contexts, we found that IPVRPI tended to be associated with markers of lower SES. Further conclusions were limited by the heterogeneity of SES measure categorizations, varied IPVRPI case definitions, and lack of adjusted analyses. Future research should ensure SES measures utilized in LMICs are comprehensive and comparable, focus more specifically on IPVRPI from community violence, and consider hospital-based interventions to reduce risk of IPVRPI in LMIC settings.
人际暴力相关身体伤害（IPVRPI）是低收入和中等收入国家（LMICs）的主要死因，但在这些环境中，缺乏有关社会经济地位（SES）与IPVRPI的可靠数据。我们分析了关于LMICs中SES与IPVRPI之间关联的现有文献，以了解在这些背景下如何衡量SES，并综合个体层面上SES指标与IPVRPI相关的数据，为未来基于医院的IPVRPI预防工作提供信息。
我们于2022年1月在Ovid MEDLINE、EMBASE和全球健康数据库中搜索了来自LMICs的分析性研究，这些研究探讨了IPVRPI与SES指标之间的个体层面关联。排除了关于亲密伴侣暴力、自杀或12岁以下儿童的研究，以及人群层面的研究。所考虑的SES指标包括教育程度、就业情况和家庭财富。将这些SES指标与IPVRPI相关的数据整理后呈现在森林图中。
共纳入了来自20个LMICs的34项研究。巴西、墨西哥和南非是代表性最强的国家。研究大多为横断面研究（n = 23），数据通常来自患者医院记录（n = 17）或人口调查（n = 12）。纳入的研究探讨了IPVRPI与教育（n = 26）、就业（n = 26）和家庭财富（n = 19）之间的关联。不同研究之间的分类，特别是就业和财富的分类，差异很大。在进行多变量分析的研究中，发现IPVRPI与较低的教育程度（n = 6）、失业（n = 4）和较低的家庭财富（n = 6）显著相关。
许多研究探讨了LMIC人群中IPVRPI与SES指标之间的个体层面关联。在各种LMIC背景下，我们发现IPVRPI往往与较低的SES指标相关。由于SES测量分类的异质性、IPVRPI病例定义的差异以及缺乏调整分析，进一步的结论受到限制。未来的研究应确保在LMICs中使用的SES测量方法全面且具有可比性，更具体地关注社区暴力导致的IPVRPI，并考虑基于医院的干预措施以降低LMIC环境中IPVRPI的风险。
