Digital technologies have become a fundamental part of adolescent communication and romantic relationships across the globe. While technology enables adolescents to feel more connected, it also introduces new ways to perpetrate and experience intimate partner violence (IPV). This paper synthesizes emerging evidence about global digital IPV to critically examine the current state of knowledge about adolescent digital IPV and make recommendations for the incorporation of digital IPV into global-level frameworks. We identify that although there are many similarities to in-person IPV, unique digital affordances, such as absence of interpersonal cues, lack of immediate social feedback, remote surveillance, permanence, and anonymity, create a new context to perpetrate and experience IPV, which may exacerbate psychological and developmental harm and complicate prevention and intervention. Despite this, digital adolescent IPV is missing from global frameworks that critically influence policy, funding, and research. Global frameworks should incorporate the unique challenges of digital adolescent IPV by establishing a specific taxonomy, creating a global research agenda, and developing guiding principles for prevention and intervention. Recommended guiding principles for policy and practice include prioritizing recognition of adolescents as a high-risk population, respect for adolescent participation in digital platforms while teaching digital competence, co-creation with adolescents, and partnership with technology platforms to affect change at the design-level. This paper concludes that global frameworks for digital adolescent IPV are critical in order to mobilize coordinated research, evidence-based programming, and adolescent-centered policies to combat digital IPV and develop technology to foster resilience and healthy relationship development worldwide.
Background Home health care (HHC) is expanding in response to population aging, but evidence on long-term trends, economic-related inequality, and horizontal inequity in service use remains limited in China. This study examined national trends in utilization, economic-related inequality, and horizontal inequity in HHC among older adults in China from 2016 to 2023. Methods We conducted a serial cross-sectional study using the 2016, 2018, 2020, and 2023 waves of the China Longitudinal Aging Social Survey, including 45,930 survey-wave observations from community-dwelling adults aged 60 years or older. HHC utilization was assessed in each wave. Economic-related inequality was quantified using the concentration index, while need-standardized inequity was assessed using the horizontal inequity index after adjustment for health-related needs. Concentration index decomposition was used to identify contributors to inequality. Results Overall HHC utilization increased from 5.77% in 2016 to 12.33% in 2023. The subgroup increases were observed among urban residents (6.24% to 16.06%) and participants in eastern China (8.20% to 21.07%). Over the same period, the concentration index rose from near zero to 0.30, indicating a shift toward marked pro-rich inequality. The horizontal inequity index increased in parallel, from 0.02 to 0.24. The largest positive contributions to pro-rich inequality were from the urban employee basic pension (65.59%) and residence in the western (20.07%) and central (15.89%) regions, while community health worker density (per 1000 population) made a negative contribution (-17.41%). Conclusions HHC utilization expanded among older adults in China between 2016 and 2023, yet economic-related inequality and need-standardized inequity widened. As HHC expands, policies should improve financial protection for low-income older adults, strengthen primary care capacity, and reduce regional disparities to promote equitable access.
