1. Intimate partner violence (IPV) disproportionately impacts women in Puerto Rico, with IPV-related homicide rates increasing in recent years. Younger women aged 25-44 and those with low socioeconomic status have higher risks of IPV-related homicide. 2. Factors that contribute to high IPV rates include biases among police, societal norms, and cultural values like "familismo" that emphasize family unity over individual needs and downplay women's roles. 3. IPV has significant short and long-term health impacts for victims, including physical injuries, mental health disorders, lost wages, and high medical costs. Reducing socioeconomic inequalities and challenging harmful gender norms could help lower IP

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Background and Significance of Intimate Partner Domestic Violence in Puerto Rico
José Armando Colón
School of Public Health and Tropical Medicine, Tulane University
SBPS 6500: Violence as a Public Health Problem
Dr. Melissa Goldin Evans
June 23, 2023
Scope of the Problem: Mortality, Demographics, and Prevalence

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In Puerto Rico, women endure comparable Intimate Partner Violence (IPV) hazards as the general
population. Irrespective, females are more susceptible to IPV than the population due to race or ethnicity,
socioeconomic level, and age (25 and 44). As per census statistics in 2022, Puerto Rico had 3.2 million
inhabitants, of whom 1.72 million represented women, or 52.7% of the total population (Romero, 2022).
Based on recent data, during 2020 and 2021, Puerto Rico comprised IPV-related homicide at 2 per 100,000
women associated with intimate partner violence (Krug et al., 2022). Epidemiological data shows that IPV-
related mortality climbed from 67 in 2021 to 84 in 2022 (Krug et al., 2022). The information from the 2018
National Violent Death Reporting System revealed a homicide rate of 64% perpetrated by spouses or
intimate partners (Petrosky et al., 2022). Moreover, the U.S. Department of Justice found that in 2018,
current or former intimate partners murdered 23 women on the island's 3.2 million people. The latter caused
the rate of IPV-related homicides to increase to 1.7 per 100,000 females from 0.77 per 100,000 in 2017
(LeBrón, M., 2019). Not only that, but the findings inform policymakers and law enforcers who are
responsible for female deaths to generate strategies aiming to apprehend and prosecute responsible
parties.
In virtue of the pervasive prejudice in public law enforcement, women have lost credibility and
confidence during the previous few decades (Friedman et al., 2011). Puerto Rico Police Department
(PRPD) acknowledged in 2018 that local police forces had fallen short of their obligations to safeguard IPV
victims and to reported transgressions as required by law (Department of Justice Releases Investigative
Findings on the Puerto Rico Police Department, 2022). The island persists underserved under initiatives
related to services that have not yet received appropriate funding (Niolon et al., 2017). Since Puerto Rico
requires U.S. government funds to offer immediate relief to IPV victims, it is challenging satisfying the needs
of any women, a strong enough reason to keep the forums open to discuss and reach common grounds
between stakeholders and victims (Stone et al., 2017). As a result, Puerto Rico's domestic violence services
are menaced if the Family Violence and Prevention Services Act (FVPSA) is underfunded (2019). To
comprehend the links and fallouts of the system, a broad discussion of Puerto Rico's political situation may
provide an adequate understanding of the island's political system in conjunction with its implications at the
national level, including members of the targeted population (Niolon et al., 2017).

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The latest data on the island's socioeconomic status (SES) and poverty levels shows that the
median household income represents $21,967 between 2017 and 2021 (Romero, 2023). Women with SES
below the poverty line (40.5%) earned an average of $14,047, representing less than 50% of the national
population average (Romero, 2023). According to the Puerto Rican Police Bureau, 78.6% of women living
below the poverty line were victims of IPV-related homicides in 2017 (Statistics Institute of Puerto Rico,
2019). Due to a rise in unemployment rates from 8.3% in 2016 to 9.2% in 2017 (Romero, 2023), experts
linked those findings to the economic collapse following Hurricane Maria. As a result, compared to women
from the medium to upper classes, low-income island dwellers had a greater risk (36%) (p <0.001) of IPV-
related homicide (Natal, 2022).
Fostering routes for jobless families to mitigate IPV considering the substandard SES, low-income
level, economic instability, and gender-specific inequalities that emerge as substantial risk factors for IPV
(Matjasko et al., 2013). Reducing gender income gaps—which research has proven to increase the
likelihood of IPV directly—enables women to be empowered and enjoy equal pay with men (Capaldi et al.,
2012). By way of an example of the latter approach, implementing policies championing subsidies for
childcare and tax credits for children may be achieved via the enforcement of new legislation (Matjasko et
al., 2013). While these proposals aim to support working mothers, discharge basic human needs, and offset
exorbitant daycare expenses, they also ensure high-quality principles despite being a low-income program
serving underserved families (Matjasko et al., 2013). The potential outcome of these interventions includes
reducing IPV, attenuating income inequality, reducing paucity levels, and alleviating economic dependency
(Niolon et al., 2017).
The population of Puerto Rico in 2021 was 3.2 million, reflecting a decline in the population
(3.9 million) soon after Hurricane Maria in 2017 (U.S. Census Bureau fast facts: the United States, 2021).
Three percent represented children under five, 16.1% were under 18, 23.5% appeared as seniors over 65,
and 52.7% represented women (Romero, 2022). From 2015 to 2019, the IPV-related homicide rate in
Puerto Rico's Violent Death Reporting System (PRVDRS) averaged 83% among females across all ages
(Krug et al., 2022). Although IPV affects women of any age, current or previous intimate partners murdered
over half of the women aged 25 to 44 in IPV-related occurrences in 2021 (Zavala-Zegarra et al., 2022). Per
the PRVDRS, IPV-related murders increased by 53% in 2022 compared to 2021 (Zavala-Zegarra et al.,

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2022). Other research found that IPV-related murders claimed the lives of 22% of women between the ages
of 18 and 30. However, LeBrón (2019) found that younger women between the ages of 25 and 44 are prone
to IPV-related homicides.
Bott et al. (2012) demonstrated the value of individual-level treatments, despite the difficulty in
assessing the program. Interventions that simultaneously investigate numerous components of the social-
ecological model represent more significant conflict during project evaluation (Bott et al., 2012). However,
experts acknowledged this technique as successful for long-term preventive initiatives (Bott et al., 2012).
Researchers agreed that the above evaluation methodology could benefit from reforming policies,
reinforcing female civil rights, launching social media communication campaigns, advocating for women's
sexual and reproductive health awareness in the healthcare sector, and encouraging efficient and effective
communication channels aimed at achieving attitudes leading to the desired social change (United Nations,
2015).
Outcomes: Short and Long-Term
In line with Niolon et al. (2017), intimate partner violence negatively impacts victims' and the broader
public's health. Women often endure physical injuries, overarching distress, fractured bones, and other
difficulties, but the primary consternation lies in the elevated IPV-related homicide rate. The individual
factors contributing to intimate IPV-related homicide are being women of younger age (25–44) and having a
low SES (Niolon et al., 2017). The community components adding to the rise in IPV-related homicide rates
include biases from police officers and societal norms (Garcia-Moreno et al., 2012). Data suggest that
victims of IPV are at a greater risk to augment homicide rates, illnesses related to mental health, and
emotional trauma juxtaposed to women within the population (Niolon et al., 2017). Studies disclose that
victims with low socioeconomic status are at a far greater risk of experiencing IPV-related homicide,
disorders of mental health, and emotional trauma than women in the general population (Niolon et al.,
2017).
Between 2009 and 2012, over 68% of Puerto Rican women aged 25 and 44 developed new onsets
of IPV-linked mental health disorders (Friedman et al., 2011). Recent research shows that 25% developed
depression, 36.8% had bipolar disorder (type I or II), and 50% developed schizophrenia (Friedman et al.,
2011). The short-term effects impact the person and the entire population because of the expenditures

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involved. The Center for Domestic Peace indicated an annual IPV-related cost of around $8.3 billion in the
United States and Puerto Rico, of which $4.1 billion covered medical and mental health treatments
(NCADV: National Coalition Against Domestic Violence, 2020). Considering that between 21 and 60% of
IPV victims leave their employment, nearly $0.9 billion is lost yearly, while genuine victims lose
approximately $8 million in unpaid wages (NCADV: National Coalition Against Domestic Violence, 2020).
Experts contend that outlining IPV costs will help policymakers understand the scope of the issue. It
suggests that legislation that strives to safeguard women deserve constant monitoring to determine whether
modifications and reshapes or enact innovative legislation to keep in line with the ever-evolving social
circumstances affecting women today (Arroyo et al., 2016). As a result, it might be ineffective devising
surrogates interventions by transitory mitigating the incidence of IPV but adequately allocating funds to
solving all varieties of intimate partner violence for long-lasting conclusions.
In keeping with experts, stating the cost-related IPV costs helps create an understanding of the
extent of the problem. It indicates the need to revisit policies intended to protect women, as they may
necessitate changes or the creation of new public policies to determine whether ongoing initiatives are
working or if present regulations correspond to today's changing circumstances for women (Arroyo et al.,
2016). Instead of employing the funds to address the surface of the problem, it may be more effective to
devise alternative avenues to lower the prevalence of IPV over the long run (Arroyo et al., 2016).
According to studies, the prevalence of intimate partner violence (IPV) among Puerto Rican women
living on the mainland is increasing (Niolon et al., 2017). However, these women are increasingly failing to
disclose violent attacks. Preserving family unity is superior in Puerto Rican society (Alvidrez, 2012), and all
other concerns become second-class dilemmas. In concert with Abraido-Lanza et al. (2016), Familismo
emphasizes cultural norms and values unique to Latino's idiosyncrasies, including devotion to one's family
and structuring it over one's desires. Abraido-Lanza et al. (2016) inform about the value that cultural norms
comprise in Latino culture serving as a protective factor since the family may step in to aid if necessary.
However, the construct is based on a patriarchal structure that downplays the relevance of women in
society and their ambitions (Niolon et al., 2007).
Despite disagreeing with such concepts, females continue to follow naturalized habits ingrained in
them from an early age (Galanti, 2014). Another cutting-edge method for reducing violence against women

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is to examine sociocultural patterns and practices, particularly those that undermine gender equality
(Galanti, 2014). It has been discovered that social norms that promote IPV, such as detrimental gender
norms, also include recognized risk factors for IPV (Niolon et al., 2017). Given that children begin imitating
seen behaviors as good yet harmful, intimate partner violence and detrimental gender norms develop from
childhood (Niolon et al., 2017). It is crucial to challenge these standards to impart the ability to form secure
and healthy bonds (Abraido-Lanza et al., 2016). Encouraging adults and peers to actively participate in
devising safe settings in the neighborhood and at work are critical for addressing the social variables
influencing the behaviors of individuals and neighborhoods (Niolon et al., 2017). Outlining and assessing
the fundamental determinants of social indicators perpetuating disparities and detrimental behaviors across
genders, socioeconomic strata, and racial groupings require in-depth analysis that brings to the forefront
hidden reasons coercing women to succumb to IPV (Abraido-Lanza et al., 2016).

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