This is a draft presentation I will offer at Wellington, New Zealand on 29 August, 2013 at the New Zealand India Research Institute Symposium.

1. LOSS OF HEALTH DUE to
VIOLENCE: Time for VALY?
Thoughts on Measuring Violence
Against Women in India
Arindam Basu
University of Canterbury

2. This is Where I Work

3. This is Where I live

4. This is What I am Going to Talk About Today …

5. Is Violence Against Women in India Increasing?

6. 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

7. 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 (%)

8. 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 (%)

9. 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

10. 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

11. So, What’s The Story?

12. How Does This Affect Women’s Health and Well Being?

13. Exposure Versus Outcomes
Depression
Suicidal Ideations, Self Harm
Substance Abuse
HIV, STDs, Cancer …
DEATH!!!
Violence Against Women in All Forms

14. Exposure Versus Outcomes
Depression
Suicidal Ideations, Self Harm
Substance Abuse
HIV, STDs, Cancer …
DEATH!!!
Violence Against Women in All Forms …

15. Need a Summary Measurement …

16. At Birth, her Life Expectancy was 75 years

17. Violence Against her, she dies, DEAD @ 25
years, 50 years lost!

18. She Survives, but with 50% Quality of Life

19. With 50% quality of life, she has lost 25 years out of
possible 50 years she could have lived, lost 25 years

20. 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?

21. DALY = YLL + YLD

22. DALY = YLL + YLD
Disability Adjusted Life Years

23. DALY = YLL + YLD
Years of Life Lost

24. DALY = YLL + YLD
Years Lost Due to Disability

25. 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

26. Top 10 DALYs, 1999

27. Link Back Disease Burden to Violence
Depression
Suicidal Ideations, Self Harm
Substance Abuse
HIV, STDs, Cancer …
DEATH!!!
Violence Against Women in All Forms …

28. Three Sources to Pull Data From
Probability of Exposure
to Violence
Linkage Between
Exposure and Disease
Burden of Disease
Attributable to Violence

29. Source of Data

30. Risk of Exposure to Violence for Women

31. Exposure-Disease Linkages

33. Results

34. 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

35. The Case for Violence Adjusted Life
Year Estimation: Is Violence an
Outcome? Is Violence only an
Exposure?

36. 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