Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Intimate Partner Violence Against Low-Income Women in Mexico City and Associations with Child School Attendance: A Latent Class Analysis Using Cross-sectional Data



Few studies have investigated how intimate partner violence (IPV), and patterns of IPV experiences, may impact children’s school attendance in low- and middle-income countries.


Using baseline data from a sub-sample of 659 women in Mexico City enrolled in a randomized controlled trial who reported having a child under age 18 and in school, multilevel latent class analysis (LCA) was used to classify women based on their reported IPV experiences. Multilevel risk regression analyses examined associations between latent class membership and IPV-related disruptions in children’s schooling. Latent classes were identified in a prior study.


Overall, 23.3% of women reported their child’s school attendance was disrupted due to IPV. LCA identified four distinct classes of IPV experiences: Low Physical and Sexual Violence (39.1%); Low Physical and High Sexual Violence class (14.8%), High Physical and Low Sexual Violence and Injuries (36.5%); and High Physical and Sexual Violence and Injuries (9.6%). Compared with women in the Low Physical and Sexual Violence class, women in the High Physical and Sexual Violence and Injuries class and women in the High Physical and Low Sexual Violence and Injuries class were at greater risk of IPV disrupting children’s school attendance (ARR 3.39, 95% CI 2.34, 4.92; ARR 2.22, 95% CI 1.54, 3.19, respectively). No other statistically significant associations emerged.


High disruptions in children’s school attendance due to IPV were reported and were differentially related to patterns of IPV experiences. Findings underscore the need to understand underlying mechanisms. Future work integrating both violence against women and violence against children is needed.

This is a preview of subscription content, log in to check access.

Fig. 1


  1. Agenda Estadistica. (2008). Retrieved October 3, 2018, from https://www.salud.df.gob.mx/ssdf/media/Agenda2008/.

  2. Assaad, R., Friedemann-Sanchez, G., & Levison, D. (2017). Impact of domestic violence on children’s education in Colombia: Methodological challenges. Violence Against Women,23(12), 1484–1512. https://doi.org/10.1177/1077801216661036.

  3. Bott, S., Guedes, A., Claramunt, M. C., & Guezmes, A. (2010). Improving the health sector response to gender based violence: A resource manual for health care professionals in developing countries. Retrieved October 3, 2018, from International Planned Parenthood Federation website: https://www.ippfwhr.org/sites/default/files/GBV_cdbookletANDmanual_FA_FINAL.pdf.

  4. Collins, L., & Lanza, S. (2010). Latent class and latent transition analysis with applications in the social, behavioral, and health sciences. Hoboken, NJ: Wiley.

  5. Díaz-Olavarrieta, C., Ellertson, C., Paz, F., De, S. L., & Alarcon-Segovia, D. (2002). Prevalence of battering among 1780 outpatients at an internal medicine institution in Mexico. Social Science & Medicine,55(9), 1589–1602. https://doi.org/10.1016/S0277-9536(01)00293-3.

  6. Durand, J., Schraiber, L., Franca-Junior, I., & Barros, C. (2011). Impact of exposure to intimate partner violence on children’s behavior. Revista de Saude Publica,45(2), 355–364.

  7. Falb, K. L., Diaz-Olavarrieta, C., Campos, P. A., Valades, J., Cardenas, R., Carino, G., et al. (2014). Evaluating a health care provider delivered intervention to reduce intimate partner violence and mitigate associated health risks: Study protocol for a randomized controlled trial in Mexico City. BMC Public Health. https://doi.org/10.1186/1471-2458-14-772.

  8. Frenk, J., Gomez-Dantes, O., & Knaul, F. M. (2019). A dark day for universal health coverage. The Lancet,393(10169), 301–303. https://doi.org/10.1016/S0140-6736(19)30118-7.

  9. GEOGRAFÍA INDEY., (2013). Encuesta Nacional sobre la Dinámica de las Relaciones en los Hogares (2011). Panorama de violencia contra las mujeres en Estados Unidos Mexicanos. Mexico: INEGI.

  10. Golder, S., Connell, C. M., & Sullivan, T. P. (2012). Psychological distress and substance use among community-recruited women currently victimized by intimate partners: A latent class analysis and examination of between-class differences. Violence Against Women,18(8), 934–957. https://doi.org/10.1177/1077801212456991.

  11. Guedes, A., Bott, S., Garcia Moreno, C., & Colombini, M. (2016). Bridging the gaps: A global review of intersections of violence against women and violence against children. Global Health Action. https://doi.org/10.3402/gha.v9.31516.

  12. Gupta, J., Falb, K. L., Ponta, O., Xuan, Z., Campos, P. A., Gomez, A. A., et al. (2017). A nurse-delivered, clinic-based intervention to address intimate partner violence among low-income women in Mexico City: Findings from a cluster randomized controlled trial. BMC Medicine,15(1), 128. https://doi.org/10.1186/s12916-017-0880-y.

  13. Gupta, J., Willie, T. C., Harris, C., Abril Campos, P., Falb, K., Garcia Moreno, C., et al. (2018). Intimate partner violence against low-income women in Mexico City and associations with work-related disruptions: A latent class analysis using cross-sectional data. Journal of Epidemiology and Community Health. https://doi.org/10.1136/jech-2017-209681.

  14. Hebenstreit, C. L., Maguen, S., Koo, K. H., & DePrince, A. P. (2015). Latent profiles of PTSD symptoms in women exposed to intimate partner violence. Journal of Affective Disorders,180, 122–128. https://doi.org/10.1016/j.jad.2015.03.047.

  15. Jayasinghe, S., Jayawardena, P., & Perera, H. (2009). Influence of intimate partner violence on behaviour, psychological status and school performance of children in Sri Lanka. Journal of Family Studies,15(3), 274–283. https://doi.org/10.5172/jfs.15.3.274.

  16. Jayasinghe, S., Jayawardena, P., & Perera, H. (2014). Influence of intimate partner violence on behaviour, psychological status and school performance of children in Sri Lanka. Journal of Family Studies,15(3), 274–283. https://doi.org/10.5172/jfs.15.3.274.

  17. Kiesel, L. R., Piescher, K. N., & Edleson, J. L. (2016). The relationship between child maltreatment, intimate partner violence exposure, and acadmic performance. Journal of Public Child Welfare,10(4), 434–456. https://doi.org/10.1080/15548732.2016.1209150.

  18. Lakhani, N. (2017). “The help never lasts”: Why has Mexico’s education revolution failed? The Gaurdian. Retrieved November 14, 2018, from https://www.theguardian.com/inequality/2017/aug/15/the-help-never-lasts-why-has-mexicos-education-revolution-failed.

  19. Lanza, S. T., Dziak, J. J., Huang, L., Xu, S., & Collins, L. M. (2015). Proc LCA & Proc LTA users’ guide (Version 1 3 2). University Park: The Pennsylvania State University The Methodology Center.

  20. Lepore, S. J., & Kliewer, W. (2013). Violence exposure, sleep disturbance, and poor academic performance in middle school. Journal of Adbnormal Child Psychology,41(8), 1179–1189.

  21. McCutcheon, A. (1987). Latent Class Analysis. New York, NY: Sage Publications.

  22. Meltzer, H., Doos, L., Vostanis, P., Ford, T., & Goodman, R. (2009). The mental health of children who witness domestic violence. Child & Family Social Work. https://doi.org/10.1111/j.1365-2206.2009.00633.x.

  23. Meyer, S. R., Yu, G., Hermosilla, S., & Stark, L. (2017). Latent class analysis of violence against adolescents and psychosocial outcomes in refugee settings in Uganda and Rwanda. Global Mental Health,4, e19. https://doi.org/10.1017/gmh.2017.17.

  24. MICS. (2015). Mexico: Encuesta nacional de ninos, ninas, y mujeres 2015. Retrieved October 4, 2018, from https://mics-surveys-prod.s3.amazonaws.com/MICS5/Latin%20America%20and%20Caribbean/Mexico/2015/Key%20findings/Mexico%202015%20MICS%20KFR_Spanish.PDF.

  25. OECD. (2017). Education at a glance 2017. Retrieved October 3, 2018, from https://www.oecd-ilibrary.org/education/education-at-a-glance-2017_eag-2017-en.

  26. Pels, T., Barbera van Rooji, F., & Distelbrink, M. (2015). The impact of intimate partner violence (IPV) on parenting by mothers within an ethncially diverse population in the Netherlands. Journal of Family Violence,30(8), 1055–1067. https://doi.org/10.1007/s10896-015-9746-2.

  27. SAS Institute. (2011). SAS® 9.4 Statements: Reference. Cary, NC: SAS Institute.

  28. Sherr, L., Hensels, I. S., Skeen, S., Tomlinson, M., Roberts, K. J., & Macedo, A. (2016). Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi. International Health,8(1), 36–43. https://doi.org/10.1093/inthealth/ihv070.

  29. Sipsma, H. L., Falb, K. L., Willie, T., Bradley, E. H., Bienkowski, L., Meerdink, N., et al. (2015). Violence against Congolese refugee women in Rwanda and mental health: A cross-sectional study using latent class analysis. British Medical Journal Open,5(4), e006299.

  30. Spiegelman, D., & Hertzmark, E. (2005). Easy SAS calculations for risk or prevalence ratios and differences. American Journal of Epidemiology,162, 199–200.

  31. UNICEF. (2014). Ending violence against children: Six strategies for action (p. 66). Retrieved January 28, 2019, from United Nations Educational, Scientific and Cultural Organization website: https://www.unicef.org/publications/files/Ending_Violence_Against_Children_Six_strategies_for_action_EN_9_Oct_2014.pdf.

  32. United Nations. (2015). Sustainable development goals. Retrieved November 25, 2018, from https://sustainabledevelopment.un.org/sdg4.

  33. United Nations Educational, Scientific and Cultural Organization, & UNESCO Institute for Statistics. (2015). Fixing the broken promise of education for all (p. 145). Retrieved January 28, 2019, from United Nations Educational, Scientific and Cultural Organization website: https://data.unicef.org/wp-content/uploads/2015/12/Global-OOSCreport-Full-web_217.pdf.

  34. Wathen, C. N., & MacMillan, H. L. (2013). Children’s exposure to intimate partner violence: Impacts and interventions. Paediatics and Child Health,18(8), 419–422.

  35. Willie, T. C., Powell, A., Lewis, J., Callands, T., & Kershaw, T. (2017). Who is at risk for intimate partner violence victimization: Using latent class analysis to explore interpersonal polyvictimization and polyperpetration among pregnant young couples. Violence and Victims,32(3), 545–564. https://doi.org/10.1891/0886-6708.VV-D-16-00015.

  36. World Health Organization. (2005). WHO multi-country study on women’s health and domestic violence against women: Initial results on prevalence, health outcomes and women’s responses (p. 206). Retrieved October 4, 2018, from World Health Organization website: https://www.who.int/reproductivehealth/publications/violence/24159358X/en/.

  37. World Health Organization. (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence (p. 51). Retrieved October 3, 2018, from World Health Organization website: https://apps.who.int/iris/bitstream/handle/10665/85239/9789241564625_eng.pdf;jsessionid=8D9BC2B3B9A58BC6FB4B8AE3C87D49DB?sequence=1.

  38. World Health Organization, & Pan American Health Organization. (2012). Understanding and addressing violence against women: Intimate partner violence. Retrieved February 4, 2019, from https://www.paho.org/hq/dmdocuments/2012/vaw-ipv.pdf.

  39. Young-Wolff, K. C., Hellmuth, J., Jaquier, V., Swan, S. C., Connell, C., & Sullivan, T. P. (2013). Patterns of resource utilization and mental health symptoms among women exposed to multiple types of victimization: A latent class analysis. Journal of Interpersonal Violence,28(15), 3059–3083. https://doi.org/10.1177/0886260513488692.

Download references


The authors thank the Mexico City Ministry of Health and MEXFAM for their collaboration. The authors would also like to thank Helena Acosta from International Planned Parenthood for training the nurses in our study. The authors would also like to thank the women and nurses who participated in this study.

Author information

Correspondence to Anna Scolese.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Scolese, A., Willie, T.C., Falb, K.L. et al. Intimate Partner Violence Against Low-Income Women in Mexico City and Associations with Child School Attendance: A Latent Class Analysis Using Cross-sectional Data. Matern Child Health J 24, 360–368 (2020). https://doi.org/10.1007/s10995-020-02877-8

Download citation


  • Intimate partner violence
  • Mexico
  • Child health
  • Education
  • School health
  • Latent class analysis