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Flood exposure and intimate partner violence in low- and middle-income countries

Nature Water volume 3, pages 296–306 (2025)Cite this article

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Abstract

Intimate partner violence (IPV) is a global public health challenge, causing physical and psychological harm to victims. Although studies have explored the impacts of various extreme weather events on IPV, there is still inadequate evidence on the association between flood exposure and IPV on a multi-country or global scale. Therefore, we utilized the Demographic and Health Surveys database to examine this association on a multi-country scale and further explored modification effects of inequality outside and within the household. This study included 340,955 ever-partnered women from 31 low- and middle-income countries across Asia, Africa and Latin America. The results showed that flood exposure was associated with increased prevalence of total IPV (percentage difference 10.78%, 95% confidence interval 8.24–13.38%), physical violence (4.94%, 2.31–7.64%), sexual violence (13.03%, 8.61–17.62%) and emotional violence (17.62%, 14.28–21.06%). We found stronger flood–IPV associations among household with greater inequality. Our findings indicate additional harm associated with flood exposure for women in low- and middle-income countries, emphasizing the role of gender inequality under climate change.

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Fig. 1: The IPV prevalence and proportion of flood exposure in 31 LMICs.
Fig. 2: Percentage difference (and 95%CI) of IPV prevalence associated with flood exposure globally and regionally.
Fig. 3: Percentage difference (and 95%CI) of total IPV prevalence associated with flood exposure in various subgroups.
Fig. 4: Percentage difference (and 95%CI) of IPV prevalence associated with flood exposure, classified by violence subtypes and possible modifiers.

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Data availability

Data on IPV are publicly available from The DHS Program (https://www.dhsprogram.com/). Flood data are publicly available from The Flood Observatory (https://floodobservatory.colorado.edu/). Temperature and precipitation data are obtained from ERA5 (https://cds.climate.copernicus.eu/).

Code availability

Custom code that supports the findings of this study is available from the corresponding author upon request.

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Acknowledgements

This research is supported by the National Natural Science Foundation of China (no. 82430105) (H.K.), the Shanghai B&R Joint Laboratory Project (no. 22230750300) (H.K.), Shanghai Municipal Science and Technology Major Project (no. 2023SHZDZX02) (H.K.), and Shanghai International Science and Technology Partnership Project (no. 21230780200) (R.C. and H.K.). The funders had no role in design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

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  1. These authors contributed equally: Yichen Guo, Yixiang Zhu.

Authors and Affiliations

  1. School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China

    Yichen Guo, Yixiang Zhu, Lu Zhou, Haidong Kan & Renjie Chen

  2. Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

    Zafar Fatmi

  3. Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany

    Cheng He

  4. Department of Environmental and Occupational Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

    Jovine Bachwenkizi

  5. IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China

    Haidong Kan & Renjie Chen

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Contributions

R.C. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: R.C. Acquisition, analysis or interpretation of data: Y.G. and Y.Z. Drafting of the manuscript: Y.G., Y.Z. and Z.F. Critical revision of the paper for important intellectual content: Y.G., Y.Z., Z.F. and R.C. Statistical analysis: Y.G., Y.Z., H.K., C.H., L.Z. and J.B. Obtained funding: R.C. and H.K. Administrative, technical or material support: R.C. Supervision: R.C.

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Correspondence to Renjie Chen.

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Guo, Y., Zhu, Y., Fatmi, Z. et al. Flood exposure and intimate partner violence in low- and middle-income countries. Nat Water 3, 296–306 (2025). https://doi.org/10.1038/s44221-025-00389-9

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