There are over 5.4 million South Asian individuals currently living in the United States with ancestry in Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka 12. Nearly half (46%) of those individuals identify as South Asian are women, representing a growing community with unique health needs 2. Despite this growth, research on health issues affecting South Asian Americans remains limited. Additionally, this community continues to grow, yet there is limited research on the health issues that impact this population 3. Their lifetime health outcomes reflect how the U.S. is performing in their sustainable development goals and addressing issues of disparities across different ethnic groups. As the model minority myth continues to be a stereotype that persists for Asian Americans across the country, it is important to recognize differences in health outcomes and come to solutions to address them 4.

As shown in Table 1, the study population consisted of 2,634 individuals. The majority of the study sample was between the ages of 18-29 (50.2%). Participants represented a diverse range of South Asian countries, with the largest groups identifying as being from India (24.2%), Maldives (16.3%), and Bangladesh (16%). Nearly 11 % (10.7%) of participants reported being from two or more South Asian backgrounds.

Most participants achieved a form of higher education (60.1%), holding degrees beyond high school. Further, a significant proportion of participants were employed full-time (75.6%), while 21.1% reported working part-time. Only 3.3% of the population was not employed. The distribution of household income varied widely, with 30.1% of earning between $50,000-$74,999 annually, 27.1% earning $75,000-$99,000. Additionally, 21.9% had incomes between$25,000-$49,999, while 10.8% earned between $100,000-$199,999.

The majority of participants (82.5%) were born in the U.S., while 17.5% were foreign born. Over half the participants (56.3%) reported being married or in a domestic partnership.

Overall, the study sample represented a diverse and predominantly well-educated group of South Asian-background individuals, primarily in the younger age categories, with most participants being employed full-time and earning moderate to high incomes.

Table 2 illustrates the prevalence of type 2 diabetes, gestational diabetes, and experiences of intimate partner violence within a lifetime among the study sample. Of the sample, 12% reportedto have a type 2 diabetes diagnosis, and 18.3% of those who had been pregnant reported to have had a gestational diabetes diagnosis. For intimate partner violence, 66.7% reported experiencing psychological, physical, and/or sexual in their lifetime, 56.1% reported experiencing psychological intimate partner violence, 50.2% reported experiencing physical intimate partner violence, and 52.7% reported experiencing sexual intimate partner violence. On a scale of 1-5, the average stress level of the study sample was 2.925, with a standard deviation of 0.428, indicating a higher than average level of stress compared to other members of society.

Four logistic regression models were run to assess the unique effects of the different forms of intimate partner violence on type 2 diabetes diagnosis and gestational diabetes (GDM) diagnosis. Each of the sociodemographic characteristics were included in each of the regression models to assess the variation on the dependent variables.

Table 3 and Table 4 presents the adjusted odds ratio from four multivariate logistic models for (1) lifetime intimate partner violence; (2) psychological intimate partner violence; (3) physical intimate partner violence; and (4) sexual intimate partner violence, adjusting for stress and socio demographic variables as they were significant covariates in the bivariate analysis.

In Table 3, Model 1 found that participants who experienced intimate partner violence in one’s lifetime (OR 5.818, 95% CI 3.540, 9.564) were significantly more likely to report having type 2 diabetes. Similarly, Model 2 found those participants who experienced psychological intimate partner violence (OR 3.295, 95% CI 2.320, 4.680) were significantly more likely to report having type 2 diabetes. Participants who reported physical intimate partner violence (as seen in Model 3), (OR 7.301, 95% CI 4.886, 10.909) were also significantly more likely to report having type 2 diabetes. Lastly, as seen in Model 4, participants who reported sexual intimate partner violence (OR 2.904, 95% CI 2.095, 4.025) were significantly more likely to report having type 2 diabetes.

For Table 4 examining gestational diabetes, Model 1 found that those participants who experienced intimate partner violence in one’s lifetime (OR 3.912, 95% CI 2.754, 5.555) were significantly more likely to report having gestational diabetes during a pregnancy. Similarly, Model 2 found those experiencing psychological intimate partner violence (OR 2.628, 95% CI 1.995, 3.460) were significantly more likely to report having type 2 diabetes. Participants who reported physical intimate partner violence (as seen in Model 3), (OR 2.950, 95% CI 2.259, 3.853) were also significantly more likely to report having type 2 diabetes. Lastly, as seen in Model 4 participants who reported sexual intimate partner violence (OR 3.028, 95% CI 2.309, 3.972) were significantly more likely to report having type 2 diabetes.

This study examines the intersection of intimate partner violence, stress and type 2 diabetes among South Asian women in the U.S, a population underrepresented in public health research.The findings reveal a high prevalence of intimate partner violence and a significant association between intimate partner violence and both type 2 diabetes and gestational diabetes, underscoring the urgent need to explore health consequences of IPV beyond immediate physical and physiological harm. By demonstrating the potential role of chronic stress in metabolic dysregulation, this study adds to the growing body of literature that links intimate partner violence to long-term health risks. These results have important implications for public health interventions, clinical screening, and culturally competent healthcare services tailored to the needs of South Asian women. In this discussion, we contextualize these findings within existing research, examine potential mechanisms for underlying associations, and propose policy and healthcare strategies to address these critical health disparities.

In this study, it is evident there is an alarmingly high prevalence of intimate partner violence (66.7%), with a significant association between intimate partner violence and type 2 diabetes, with physical intimate partner violence demonstrating the highest odds ratio. These results underscore the urgent need for culturally tailored interventions that address both intimate partner violence and diabetes prevention within this community. This study highlights that intimate partner violence may be a significant stressor contributing to the dysregulation of physiological systems, such as the hypothalamic-pituitary-adrenal axis, leading to glucose tolerance and diabetes 13. This emphasizes the interconnectedness of social determinants and chronic disease outcomes in marginalized populations 21.

From a public health perspective, the results align with existing literature that identifies intimate partner violence as a major risk factor for adverse physical and mental health outcomes 19.Previous research has documented the chronic stress caused by intimate partner violence and its association with conditions like cardiovascular disease and endocrine dysfunction, which are also prevalent in South Asian communities 323. Moreover, South Asians in the U.S. already face a disproportionately high risk of gestational diabetes and type 2 diabetes due to genetic predispositions and unique metabolic factors, such as insulin resistance and reduced β-cell function at lower body mass index (BMI) levels 11. The intersection of these risks suggests that addressing intimate partner violence in this population may have broader implications for reducing chronic disease and improving health equity.

The findings are particularly significant in the context of the “model minority” stereotype, which often masks health disparities within Asian American subgroups. South Asian women, despite high levels of education and employment in the study sample, reported disproportionately high rates of gestational diabetes, type 2 diabetes and intimate partner violence, pointing to the limitations of socio-economic successes as a protective factor 4. This highlights the need for nuanced public health strategies that recognize the diversity and unique challenges of South Asian women. Moreover, the prevalence of intimate partner violence in this study exceeds reported rates among other racial and ethnic groups, signaling the need for culturally specific interventions that address stigma, patriarchal norms, and systemic barriers for seeking help.

To address the health needs of South Asian women, theoretical frameworks such as the Ecological Model of Health Behavior and Intersectionality can provide valuable guidance. The Ecological Model highlights the interplay between individual, interpersonal, community, and systemic factors, making it particularly relevant for addressing intimate partner violence and type2 diabetes in this population 2224. Simultaneously, intersectionality can help identify how overlapping identities, such as gender, ethnicity, and immigration status, shape health experiences and access to care. By integrating these frameworks into intervention design, public health practitioners can create comprehensive programs that address the root causes of intimate partner violence, reduce chronic disease risks, and promote resilience among South Asian women.

A key limitation of this study is its reliance on a cross-sectional design, which precludes causal inferences between intimate partner violence and type 2 diabetes. Additionally, the self-reported nature of the data introduces the potential for recall and reporting bias, especially regarding sensitive topics like intimate partner violence. The sample, although diverse, was recruited primarily through online platforms and may not fully represent the broader South Asian population, particularly those with limited digital access or different socio-cultural contexts.Future studies should employ longitudinal designs and incorporate biomarker data to further explore the mechanism linking intimate partner violence to type 2 diabetes. Expanding recruitment methods to reach underrepresented groups, such as non-English speakers, is also essential for generalizability.

To date, there is no research that examines a potential association between intimate partner violence and type 2 diabetes diagnosis for South Asian Women in the U.S. Furthermore, limited studies exist on the prevalence and impact of intimate partner violence within this population.This study aims to address this critical gap, offering a foundational framework for future research to investigate possible causal relationships between intimate partner violence and type 2 diabetes and develop targeted culturally salient interventions.