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Employment consequences of intimate partner violence and abuse

Intimate partner violence and abuse (IPVA) is a global problem. Despite its prevalence, few studies have investigated the employment impact of IPVA, with existing studies spread across multiple disciplines including criminology, economics, and public health. Investigating the employment impacts of IPVA are crucial for understanding the consequences to victim-survivors and wider society.

This systematic review, Employment consequences of Intimate Partner Violence and Abuse, conducted by VISION researcher Dr Niels Blom and Flavia Andrea Lamarre, provides an overview of the main findings on the topic and identified research gaps and opportunities for future research.

Niels and Flavia identified studies via Embase, APA PsycInfo, PubMed, Social Sciences Citation Index, and two related reviews. The studies concerned the association between IPVA and absenteeism, time off from work, unemployment, and/or job loss and were peer-reviewed, English-language, quantitative studies. 

Overall, the 48 identified studies indicated a clear relationship between IPVA and absenteeism/time off work, but evidence was more mixed regarding the association between IPVA and job loss or unemployment. The limitations of current research were discussed, which included that the far majority of studies concerned the United States, investigated only victimization among women, and few used nationally representative data. Male victim-survivors, differences by ethnicity or socioeconomic class, perpetration, and how employment circumstances may help or hinder victim-survivors’ labor market involvement had received limited attention in the literature.

Filling these gaps would provide a stronger evidence-base for effective policies, enabling victim-survivors to retain their employment.

Recommendations

  1. Managers and colleagues should have access to training and assistance in aiding victim-survivors where appropriate, potentially with mandatory training for managers and HR staff.
  2. The large majority of studies stemmed from the United States, which makes it less evident whether the found associations also apply to other societal contexts. Cross-national or cross-state research could help.
  3. For a topic where employment is the central aspect, there has been remarkably little attention to employment circumstances and employers’ role. Further research is needed to examine variation across these aspects to understand what enables victim-survivors to retain employment and long-term productivity. 
  4. A minority of the studies included men. Future work could explore what explains gender differences in the employment impact of IPVA, and when they are more pronounced. Differences by race, ethnicity, sexual orientation, gender identity, and age have received limited attention, warranting further research.
  5. There has been a limited amount of work on IPVA perpetrators and their employment. Further work in this area is important.

To cite: Blom, N., & Lamarre, F. A. (2025). Employment Consequences of Intimate Partner Violence and Abuse: A Systematic Review. Trauma, Violence, & Abuse, 0(0). https://doi.org/10.1177/15248380251395105

For further information: Please contact Niels at niels.blom@manchester.ac.uk

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Frontline practitioner’s understanding of the roots of violence, and why it matters for policy and prevention

Violence continues to be a concern for policymakers and communities, notably so in urban contexts in which socio-demographic change, retrenched social support and evolving forms of exclusion affect its distribution and intensity. While many European cities experience relatively low levels of violence, the caveat to this is that many sub-areas and specific communities experience considerable variations in the form and intensity of such violence.

In this paper, Violence reduction in a changing European urban context: Frontline practitioner’s understanding of the roots of violence, and why it matters for policy and prevention, the research team, including VISION Co-Investigator Dr Elizabeth Cook, present findings from a comparative, qualitative study investigating how key stakeholders – civic and policy actors working at the interface of violence prevention and European urban communities – perceive its cause and overall nature.

Lizzie and colleagues explored the accounts of key support workers, practitioners and local policymakers because they represent essential intermediaries in processes of policy implementation, transfer and reform. The perspectives of practitioners provide insight into how social problems are constructed and under what conditions, which groups are most affected by these conditions, how solutions to such problems should be delivered in city settings (and delivered more effectively) and who should be assigned responsibility for generating effective responses. 

Informed by scholarship on street-level bureaucracy and local knowledge, the paper presents accounts that connect the risk of violence with austerity conditions and their erosion of vital social and institutional fabrics, which thereby worsening localised violence in these ‘ordinary’ cities.

The research team identified the key operating theories, ideas and observations circulating among civic actors tasked with tackling urban violence. Local practitioners understand violence to be linked to macro-economic conditions and social inequalities that sit outside their jurisdiction, but which ultimately present major challenges to the fabric of local urban life and risks to particular communities. Their commentaries build a cumulative picture that is in many ways at odds with the main thrust of many of the policies, political discussions, policing priorities and resource cuts evident in many cities across Europe in recent years.

The strongest shared conclusion is that urban violence cannot be tackled where these deeper conditions, influences and a lack of resources remain unaddressed.

Recommendations

  1. Support and invest in long-term collaborative partnerships and policy initiatives which take account of the spatial discrepancies within cities.
  2. Encourage connections between civic and state authorities which could help to relieve these frustrations, rebalance power relations and provide accountability in top-down approaches to cities experiencing destructive social, political and economic change.
  3. To increase trust in political institutions, policies must also tackle the scarcity of investment in public services, while encouraging better representation of marginalised communities in decision-making processes.

To cite: Cook, E. A., Jankowitz, S., & Atkinson, R. (2025). Violence reduction in a changing European urban context: Frontline practitioner’s understanding of the roots of violence, and why it matters for policy and prevention. European Urban and Regional Studies, 0(0). https://doi.org/10.1177/09697764251386774

For further information: Please contact Lizzie at elizabeth.cook@citystgeorges.ac.uk

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More adults showing signs of drug dependence in England

VISION co-Deputy Director, Professor Sally McManus, has published an article for The Conversation, Drug use is changing in England – with more adults showing signs of dependence. Written with Sarah Morris from the National Centre for Social Research, the article is based on their research using the Adult Psychiatric Morbidity Survey (APMS) 2023-2024 with colleagues.

The APMS is the longest running mental health survey series in the world and provides a picture of how mental health is changing across England. The national study includes people from across English society, not just those that currently use NHS services or have in the past. A random sample of approximately 7,000 adults aged 16 to 100 living in England were asked questions about their mental health, whether they used any of a range of illicit drugs, and if they had experienced signs of dependence, such as symptoms of withdrawal or increased tolerance.

Findings

  • Drug use may be more widespread
  • Non-medical use of prescription opioids may be more widespread
  • In the 16- to 24-year-old age group, the signs of drug dependence were similarly common in men and women which is a noticeable shift from past APMS findings
  • Cannabis dependence is rising
  • There appears to be a lack of specialist support as about one adult in every five who showed signs of drug dependence reported they’d ever received support or treatment for drug use

For further information: Please contact Sally at sally.mcmanus@citystgeorges.ac.uk

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Inequalities in how work and care responsibilities are distributed impact on the gender pay gap

Despite decades of progress, the gender pay gap remains a persistent feature of the UK labour market. Currently women in the UK earn approximately 11% less than men.

VISION researcher and Reader at City St George’s UoL, Vanessa Gash, writes in her article, The gender pay gap looks different depending where you are on the income ladder, for The Conversation, that the gender pay gap is not just because of differences in education or job type, but due to deeper inequalities in how work and care responsibilities are distributed.

Based on a study investigating barriers to equal pay, Vanessa and colleagues examined different predictors of the gender pay gap at the mean and for different income groups. Using the United Kingdom Household Panel Survey (UKHLS), the team provided a detailed analysis of the effects of individual work histories, with up to 40 years of retrospective data to uncover how these inequalities play out across income groups.

Findings

  • Equal pay policies must be tailored to the needs of different income groups. For wealthier households, policies that support full-time work and chip away at sex segregation may be effective so that women can more readily access better-paid jobs. But for poorer households, the focus should be on improving access to stable and better-paid jobs, while reducing discrimination and supporting flexible work arrangements.
  • Efforts to close the gender pay gap must avoid pitting the gains of high-earning women against the losses of low-earning men. In an era of rising political populism, this could undermine support for equality.
  • Promotion of good-quality employment for all and supporting equalised caregiving responsibilities is necessary.

By failing to address the barriers that prevent men and women from participating fully in both paid work and unpaid care work, reductions in the gender pay gap are unlikely any time soon.

For further information: Please contact Vanessa at vanessa.gash@citystgeorges.ac.uk

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Improving police recorded crime data with natural language processing

Understanding and preventing Domestic Violence and Abuse (DVA) is compounded by long-standing data quality issues in police records. Accurate police-recorded crime data is vital for responding to DVA, yet it often contains missing values and inaccuracies.

Across all crime types, the quality of police data in England and Wales has been a concern. While there have been improvements in overall crime data recording since 2014, individual police forces still encounter difficulties adequately recording instances of DVA in police-recorded crime datasets. 

Correcting poorly recorded or missing data at this scale is non-trivial and beyond the capabilities of manual intervention alone. Fortunately, the increasing availability of computational solutions and machine learning algorithms such as text mining and natural language processing (NLP) can augment, and to a degree, offset much of this processing. NLP is supported by a growing body of interdisciplinary research, which shows that valuable information can be automatically extracted from unstructured data such as crime reports and case summaries through technology.

However, automated prediction systems are not without risk, particularly when applied in sensitive domains such as policing. Data inherently reflects societal biases that poorly designed AI solutions can amplify, and in the context of DVA, these biases may stem from underreporting of marginalized demographic groups or inconsistencies in police recording practices.

In their recent study, Improving police recorded crime data for domestic violence and abuse through natural language processing, VISION researchers Dr Darren Cook and Dr Ruth Weir (City St George’s University of London) and Dr Leslie Humphries (University of Lancashire), evaluated the capability of supervised machine learning models to automatically extract victim–offender relationship information from free-text crime notes in DVA cases.

Both models demonstrated that such tools could serve as cost-effective and efficient alternatives to manual coding, accurately classifying relationship type in around four out of five cases. The incorporation of a selective classification function improved precision for the most challenging cases by abstaining from low-confidence predictions, though at the cost of reduced coverage. This research represents a meaningful step toward addressing concerns about the completeness and reliability of police-recorded crime data.

Recommendation

Given that police-recorded crime lost its status as an accredited official statistic in 2014 due in part to weaknesses in data collection and processing, the application of data science methods to reliably impute missing values offers a promising route to restoring confidence in these records. Police constabularies are encouraged to use the available technology and implement text mining and NLP solutions to extract valuable information from unstructured data such as crime reports and case summaries.

For further information: Please contact Darren at darren.cook@citystgeorges.ac.uk

To cite: Cook D, Weir R, Humphries, L. Improving police recorded crime data for domestic violence and abuse through natural language processing. Front. Sociol., 24 November 2025, Sec. Medical Sociology Volume 10 – 2025 https://doi.org/10.3389/fsoc.2025.1686632

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Medicine’s reckoning with genocide and crimes against humanity

Gene Feder, Professor of Primary Healthcare and VISION Director, has written an opinion piece with colleagues stating that accountability for human rights must guide every collaboration in medicine and science.

In their BMJ publication, Medicine’s reckoning with genocide and crimes against humanity, the authors build the case that in the nearly eight decades after the Genocide Convention in 1948, prevention has advanced in principle but faltered in practice. Many states remain indifferent, but medicine must not. Beginning with genocide, medical and academic leaders have a duty to implement reforms to safeguard the line between valuable collaboration and toxic complicity, break institutional silence, and declare medicine’s commitment to the right to existence and life for all peoples, in all states.

For further information: Please contact Gene at gene.feder@bristol.ac.uk

To cite: Minhas R, Shellah D, Maynard N, Goodwin-Gill G, Chalmers I, Feder G et al. Medicine’s reckoning with genocide and crimes against humanity BMJ 2025; 391 :r2277 doi:10.1136/bmj.r2277

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Impact of consecutive COVID-19 lockdowns on GP referrals of women experiencing domestic abuse in England and Wales

To curb COVID-19, three periods of severe physical distancing measures (‘lockdowns’) were imposed by the Government throughout 2020 and 2021 in England and Wales: between 23 March and 1 June 2020 (68 days), 5 November 2020 and 2 December 2020 (27 days) and between 6 January and 8 March 2021 (61 days). These lockdowns resulted in societal changes, including full or part-time school and workplace closures, and reduced community mixing.

The pandemic also necessitated a change in clinical consultations in primary care, with a shift from predominantly face-to-face to mostly remote consultations (telephone, digital and video), complicating the provision of care and support, including safeguarding. The lockdowns made it harder for people to disclose domestic violence and abuse (DVA) to health professionals, as online consultations can form barriers to support.

Long and enforced lockdowns can make it harder to disclose DVA and can have a detrimental impact on DVA victim-survivors and their families. Previous studies suggest that the COVID-19 pandemic and its lockdowns have led to an increase in DVA incidence. Refuge, the organisation running the 24-hour national DVA helpline in England, reported that calls surged by 60% during 2020 compared with the previous year. There is, however, scarce evidence on the impact of consecutive lockdowns over a period of almost 2 years on referrals from primary care to DVA support services in England.

The research team, led by Dr Jasmina Panovska-Griffiths and others including VISION researchers Professor Gene Feder and Dr Estela Capelas Barbosa, evaluated the impact of the three successive national lockdowns on the referrals from general practice (GP) to the Identification and Referral to Improve Safety DVA services. Their study, Interrupted time series and non-linear regression analyses to evaluate the impact of the three consecutive COVID-19 national lockdowns on the general practice referrals of women experiencing domestic violence and abuse in England and Wales, is the first to evaluate the continual impact of the COVID-19 pandemic and the three consecutive national lockdowns in 2020 and 2021 on DVA referrals. The researchers also explored the relationship between stringency of lockdowns and number of DVA referrals.

Anonymised data on daily referrals, interrupted-time series and non-linear regression quantified the impact of the three national lockdowns over 2020 and 2021 comparing analogous periods in the 2 years before and after, reporting incidence rate ratios, 95% Confidence Intervals and p values. Time spent at home and workplace visits over the lockdown periods were quantified as proxies for the stringency of the different lockdowns.

The first national lockdown in early 2020 led to a reduced number of referrals to DVA services. Over the second and the third lockdown, there was a possible increase in the number of referrals. The first national lockdown was more stringent (58% decline in workplace visits; 22% increase in time spent at home) than the second (34% decline in workplace visits; 14% increase in time spent at home) or the third (18% decline in workplace visits; 18% increase in time spent at home).

Increased freedom of movement alongside easier access to GP services during the two latter, less stringent, lockdowns compared with the first, stringent, lockdown could have contributed to the different trends in referrals. The research team determined that ensuring access to primary care and adequate and continuing provision of specialist support for people experiencing DVA is important during national emergencies. Further research, coproduced with DVA survivors and DVA agencies, is necessary to establish and evaluate the most appropriate support during both potential future national lockdowns and other systemic closures (eg, school holidays).

Recommendation

More stringent systemic closures will lead to a reduced number of referrals to a specialist DVA programme, while more relaxed system closures may result in increased referrals. This highlights the importance of ensuring adequate access to support, such as primary care, where people can safely disclose DVA and be referred to service providers during system closures, regardless of the stringency.

For further information: Please contact Jasmina at jasmina.panovska-griffiths@queens.ox.ac.uk

To cite: Panovska-Griffiths J, Szilassy E, Downes L, Dixon S, Dowrick A, Griffiths C, Feder G, Capelas Barbosa E. Interrupted time series and non-linear regression analyses to evaluate the impact of the three consecutive COVID-19 national lockdowns on the general practice referrals of women experiencing domestic violence and abuse in England and Wales. BMJ Public Health. 2025;3:e002408. https://doi.org/10.1136/bmjph-2024-002408

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Neighbourhood characteristics and violence rates: Investigating associations over time

Violence is a critical issue in the UK, both in terms of its impact on individuals and communities and its prominence in public and media discourse. Violence has many negative effects for victims, ranging from emotional and/or physical impacts to isolation and withdrawal from social life. Victims of violence suffer the effects for longer periods of time compared to victims of other crime types and the societal economic cost of violence is also considerable with the total cost of violence in London alone in 2018–19 was £3 billion.

Few studies have examined violence at the neighbourhood level, and even fewer have investigated how changes in neighbourhood characteristics relate to changes in violence over time. The recent study, Increases in disadvantage and instability are associated with rising violence, led by Ferhat Tura (Bournemouth University) with Oluwole Adeniyi (Nottingham Trent University) and VISION researchers Ruth Weir (City St George’s University of London) and Niels Blom (University of Manchester) investigates the association between changes in neighbourhood characteristics and changes in violence rates in England and Wales between 2011 and 2021.

They argue that rising levels of social disadvantage—particularly in relation to unemployment, poor health, lone-parent households, residential mobility, and social housing—are associated with increased neighbourhood-level violence.

The research team highlights that increased ethnic heterogeneity when it coincides with growing deprivation (e.g. poor health and no qualification) is associated with rising violence risk. There is a need to address structural inequalities through investment in housing, health, education and community stability. Policy responses should extend beyond criminal justice to promote long-term violence reduction and community well-being.

Recommendation

Social policies should focus on long-term investment in deprived neighbourhoods, including affordable and stable housing to reduce residential turnover and improve long-term outcomes for residents.

For further information: Please contact Ferhat at ftura@bournemouth.ac.uk

To cite: Ferhat Tura, Ruth Weir, Niels Blom, Oluwole Adeniyi, Increases In Disadvantage and Instability Are Associated With Rising Violence, The British Journal of Criminology, 2025;, azaf080, https://doi.org/10.1093/bjc/azaf080

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Assisted dying bill: Safeguards against domestic abuse and coercion must be strengthened

One in four women and one in seven men in England and Wales have experienced domestic abuse. Coercive and controlling behaviours are core to domestic abuse. They result in loss of autonomy and independence and are intended to isolate and reduce self-worth. Such behaviours are common but hard for health professionals to detect.

If passed, the Terminally Ill Adults (End of Life) Bill will allow people who are terminally ill and expected to die within six months to request assistance to end their lives. VISION researchers Gene Feder, Elizabeth (Lizzie) Cook and Sally McManus have written an opinion published in The BMJ that calls for safeguards in the bill need to be strengthened to prevent coercion in the context of domestic abuse.

Assisted dying requires a careful consideration of the risks posed by domestic abuse and coercion. The current bill does not fully tackle specific safeguarding concerns for patients experiencing domestic abuse which can include economic, emotional, physical, and other forms of abuse from a partner or other family member. To safeguard against domestic abuse and associated coercion, Gene, Lizzie and Sally propose a set of principles that should be part of the UK bill.

  1. For doctors responding to any request for assisted dying, training must be extensive, specialist, in person, and backed up by referral pathways.  Independent domestic abuse advocates, with expertise in recognising coercive control, could contribute to assessment of assisted dying requests. 
  2. Commitments to confidentiality and data security must not obscure assisted dying decisions and the contexts in which they occur. The bill must ensure transparency.
  3. The bill must establish accountability. Transparent data about each stage of the approval process would also enable monitoring and regular scrutiny of the processes and outcomes of assisted dying legislation.
  4. Lawmakers must resist expansion. Dementia and mental health conditions are now being considered for eligibility. These are conditions prevalent in survivors of domestic abuse. The UK bill should include clauses that limit any expansion of scope to other conditions and situations.

To read the opinion piece: Safeguards against domestic abuse and coercion in the assisted dying bill must be strengthened

To cite: BMJ 2025;390:r1914

For further information, please contact Gene at gene.feder@bristol.ac.uk

Arms industry as a commercial determinant of health

Experts are urging the medical profession to confront the global arms industry as the UK and other NATO nations dramatically increase defence spending to counter growing global aggressions, one under-recognised aspect of security debates is the role of the arms industry. And as London prepares to host the world’s largest arms fair, Defence and Security Equipment International, health professionals must do more to resist the arms industry’s influence on government agendas and its damaging effects on human and planetary health.

Looking critically across this landscape, the BMJ has produced a new series examining the role of the arms trade in health and calling for more scrutiny of its health-harming activities and its unhealthy relationship with governments.

In the series, two VISION researchers, Professor Mark Bellis of Liverpool John Moores University and Professor Gene Feder from University of Bristol, with colleagues, lay out the direct and wider harms of arms and show how weapons manufacturers use commercial strategies to subvert public health agendas and shape discourse around security and violence.

They argue that, like the tobacco, alcohol, and fossil fuel industries, the arms industry should be seen as a commercial determinant of health, where corporate practices matter as much as products when considering how industries can harm health.

These practices include marketing, lobbying, funding of think tanks and universities, and forging close relationships with governments, which the industry uses to shape public policy and regulatory environments in its favour while deflecting responsibility for its contribution to perpetuating conflict, injuries, and death.

Mark, Gene and colleagues’ analyses suggest that examining these industry dynamics can help uncover both direct and systemic health harms and inform how health considerations should feature alongside defence and profit.

They acknowledge that this is a conceptual shift but say “it is also a call to action for health professionals including researchers, policy makers, and civil society to advocate for a reorientation away from design, distribution, and deployment for profit and towards global priorities of health, human rights, and peace.”

To access the entire BMJ Series : Arms industry as a commercial determinant of health | The BMJ

To access the analyses by Mark, Gene and their colleagues:

For further information, please contact Mark at m.a.bellis@ljmu.ac.uk

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