The role of public health in helping to end violence against women and girls in Scotland

As the United Nations’ 16 days of activism to end violence against women gets underway, partners across Scotland are coming together to campaign for a fairer society. Katie Cosgrove, Programme Manager for Gender-based Violence at NHS Health Scotland, looks at the scale of the issue and some of the ways we can start to make a positive change...

"1 in 4 women in Scotland will experience domestic abuse at some point; 1 in 5 women will experience sexual assault and 1 in 8 girls will experience child sexual abuse. Next time you’re in a busy street, look around and think of how many women around you this may affect.

Violence against women and girls (VAWG) includes domestic abuse, sexual violence, child sexual abuse, commercial sexual exploitation, sexual harassment, female genital mutilation and so-called ‘honour-based violence’ such as forced marriage.

VAWG is pervasive yet unremarkable. The White Ribbon campaign says: ‘If it were between countries, we’d call it a war. If it were a disease, we’d call it an epidemic. If it were an oil spill, we’d call it a disaster. But it is happening to women, and it’s just an everyday affair.’    

In scale and impact VAWG it is a major public health issue. Its health burden is considerable but often hidden e.g. women experiencing abuse are three times more likely to have depression and anxiety, and more than twice as likely to develop PTSD, attempt suicide and to use alcohol and illegal drugs. Childhood trauma is associated with long-term physical and mental health problems, as well as higher rates of health risk behaviours like smoking, alcohol and drug use, and risky sexual behaviour.

The financial costs of VAWG to services are huge. What we can’t quantify, however, is the impact on women’s autonomy, their productivity and creativity, on the economic and social costs as a result of limited opportunities, or the constraints on women’s full participation in society.

And this context matters – our social, economic and physical environments help create health and well-being. Local communities and public services make it possible for individuals to take positive decisions about their own lives and, more importantly, feel supported to do so. How can we create a truly healthy society when such levels of abuse persist?

This year, together with COSLA, the Improvement Service & Scottish Government Public Health Reform Team, we’re holding a conference on VAWG and Public Health on the first day of the annual United Nations’ 16 days of activism to end violence against women . It also coincides with the work underway to tackle the national, shared public health priorities.

You might look at the six priorities and ask where exactly the issue sits? The answer is simple. It cuts across them all. We need concerted and collective action to create the political, economic, and social conditions that actively address the root causes of VAWG and help shift Scotland to a new norm.

Part of that longer-term solution is already underway. Next year sees the launch of Public Health Scotland, which will work with local partners across the country to help address public health issues and reduce inequalities. We need to ensure that work to end VAWG is embedded in partners’ efforts to explore new ways of improving lives using these priorities for guidance. As part of its remit of helping to deliver the public health priorities we’d like to see PHS champion this most basic of human rights to live free from the threat of violence and work with partners across Scotland to drive forward positive change.

We know the scale of the challenge, and that the problem won’t disappear overnight. We have a collective responsibility to maintain our current momentum to ensure women and girls have the respect they need to lead peaceful lives. And as conversations like these continue please don’t stand on the side lines - take the time to consider what you can do now to help build a Scotland where everybody thrives."