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Examining the differing trends of violence between Wales and England

Violence is a public health problem, with significant individual, economic, health and social care costs. Monitoring violence trends and distribution is a key step of a public health approach to violence prevention.

Health service data in England and Wales are used to monitor temporal change in violence prevalence. However, administrative data relies on service contact and recording practices, while nationally representative surveys, such as the Crime Survey for England and Wales (CSEW), record information on violence even when services were not sought. The Office for National Statistics (ONS) uses CSEW to estimate prevalence of violent crime and changes over time, publishing these for England and Wales combined. Therefore, there is a need to examine whether trends in violence in Wales differ from trends in England, which is the aim of this report.

Dr Polina Obolenskaya led the study, Temporal trends in prevalence of violence in Wales: analysis of a national victimisation survey, with VISION colleagues Dr Anastasia Fadeeva, Emma Barton, Dr Alex Walker, Lara Snowdon and Professor Sally McManus. Using CSEW data, for years 2002–2020, they compared trends in prevalence of violence victimisation between Wales and England, for all adults and by gender.

Country-disaggregated data shows that the prevalence of violence was generally lower in Wales than in England for the first decade of the century. Analyses by gender shows further disparities between countries. Males in Wales and England and females in England experienced a decline in violence victimisation between 2002 and 2015 but there was no decline in violence for females in Wales until after 2016. This decline in violence for females in Wales differed for females in England who experienced an upturn in prevalence of violence from 2015.

Different patterns of violence in England and Wales indicate that relying on combined estimates of violence for England and Wales in strategy development and planning in Wales should be avoided. Further work is required to understand why trends differ between England and Wales, including analyses accounting for socioeconomic and demographic characteristics of each population, as well as thorough considerations of potential policy drivers.

Recommendation

Given differences in prevalence and trends in violence between Wales and England, relying on estimates based on the countries combined to inform strategic planning in Wales is problematic. Using Wales-specific estimates and trends in violence is therefore recommended.

To download: Temporal trends in prevalence of violence in Wales: analysis of a national victimisation survey

To cite: P. Obolenskaya, A. Fadeeva, E.R. Barton, A. Walker, L.C. Snowdon, S. McManus, Temporal trends in prevalence of violence in Wales: analysis of a national victimisation survey,
Public Health, Volume 245, 2025,105775, ISSN 0033-3506, https://doi.org/10.1016/j.puhe.2025.105775.

For further information, please contact Polina at polina.obolenskaya@citystgeorges.ac.uk

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Perpetrators of domestic abuse against older adults: A rapid evidence assessment

Despite increased research on issues related to aging and older age, abuse of older adults (defined as 60 or over in this study) is a neglected area of academic study. Most of the available evidence is currently found within the elder abuse field; although there is no agreed definition of elder abuse, most incorporate abuse by perpetrators outside of the family (such as carers, people in positions of trust and in some cases strangers) meaning evidence on intimate partner and family member perpetrators is subsumed within these studies. Most studies on domestic abuse have paid limited attention to older age, and in many cases restrict the focus to intimate partner violence among young adults.

PhD student, Merili Pullerits at the Violence and Society Centre at City St George’s University of London, collaborated with colleagues Hannah Bows (Durham University), who led the study, and Natalie Quinn-Walker (University of Wolverhampton), to examine the existing, published research on the demographic and health characteristics, and the offending behaviours and histories of perpetrators of domestic violence and abuse against adults aged 60 and over. 

Using a systematic methodology, searches were conducted in five databases: MEDLINE Complete, APA PsychInfo, CINAHL Complete, SociINDEX with Full Text, Criminal Justice Abstracts with Full Text, and Web of Science (Core Collection), resulting in 75 papers being included in the review.

Their rapid review found that much of the available evidence comes from the elder abuse field, with only a fifth of the included studies taking a specific domestic abuse perspective. Because elder abuse studies often group together all abuse types across varied relationship contexts, such studies make  becomes difficult to extract findings on domestic abuse, potentially hiding important differences. Additionally, the review found that non-intimate partners, that is (adult) children or other family members, tend to be the most frequently reported perpetrator group, although this varied according to the design and methodology of the studies. Most perpetrators tend to be male, and, where information is available, poor health, and drug and alcohol problems are often reported.

The research team concluded that more evidence is required on perpetrators of domestic violence and abuse using a broader range of data sources and research methods.

Recommendation

Evidence on those that use domestic violence and abuse on older people should be situated within the conceptual lens of domestic abuse. Policy and practice should urgently review whether existing risk assessment tools and perpetrator programmes are suitable given that a substantial proportion of domestic abuse against older adults is perpetrated by younger sons, daughters or other family members.

To download: Perpetrators of domestic abuse against older adults – a rapid evidence assessment

To cite: Hannah Bows, Merili Pullerits, Natalie Quinn-Walker, Perpetrators of domestic abuse against older adults – a rapid evidence assessment, Aggression and Violent Behavior, Volume 82, 2025, 102056, ISSN 1359-1789, https://doi.org/10.1016/j.avb.2025.102056.

For further information, please contact Hannah at hannah.bows@durham.ac.uk

Funding: This study was funded by a Home Office (Domestic Abuse Perpetrators) grant.

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Challenges for evidence syntheses on homicide in a global context

Data and evidence on violence are a few of the many core elements necessary for prevention. They inform decision-making by policy makers, provide corroboration for claims-makers, and exist as a means of empowerment for advocates and activists. However, evidence required for prevention is currently fragmented across different systems of knowledge production, creating challenges in the form of missing data.

Viewed through the sociology of quantification and knowledge production, VISION Co-Investigator Dr Elizabeth Cook, provides methodological and ethical reflections on conducting a global systematic review of sex/gender-disaggregated homicide data. In doing so, she highlights epistemological and ontological differences that risk becoming obscured in global, comparative work on violence. 

The systematic review she draws on in her critique, Conflating the map with the territory: Challenges for evidence syntheses on homicide in a global context, consisted of a four-step search strategy: electronic database searches, hand searches of statistics, ministry, and police websites, citation tracking, and email survey of statistics offices.

Studies were included if they reported prevalence data on homicide which was sex/gender-disaggregated (by victim/offender relationship, sexual aspects, and/or motivation) by both women and men. From 194 WHO-recognised countries, data were available for just under half (n = 84). However, there were pronounced differences between countries and regions regarding the availability of data.

Evidence syntheses are just one way of trying to make sense of this vast body of evidence in a transnational context. Viewed through sociological work on quantification and epistemic communities, Lizzie has provided reflections on a global systematic review to establish the prevalence of sex/gender disaggregated homicide by country, region, and globally. 

Recommendation

To avoid conflating the ‘map with the territory’ as others argue, moving towards critical knowledge synthesis as a way to build in contestation and to decenter assumptions of objectivity in the global systematic review of sex/gender-disaggregated homicide data.

To download: Conflating the map with the territory: Challenges for evidence syntheses on homicide in a global context

To cite: Cook, E. A. (2025). Conflating the map with the territory: Challenges for evidence syntheses on homicide in a global context. International Sociology, 0(0). https://doi.org/10.1177/02685809251336694

For further information, please contact Lizzie at elizabeth.cook@citystgeorges.ac.uk

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Workplace violence and fear of workplace violence: An assessment of prevalence in the UK by industrial sector

Workplace violence is a significant problem with underexamined productivity effects. In a global survey, just under 1 in 5 workers reported exposure to psychological violence and harassment at work, and 1 in 10 reported exposure to physical violence during their working-lives. In the United Kingdom (UK), the Health and Safety Executive (the regulator for workplace health and safety) found 1% of all adults of working age, in the 12 months prior, experienced a physical assault or threat of assault at work.

Workplace violence covers a broad range of adverse social interactions and behaviours committed by or towards employees. It includes encounters between colleagues and between workers and service users. It can also include incidents of domestic abuse experienced at work, with abusers known to pursue victims in the workplace.

Direct and indirect exposure to violent acts or threats of violence at work can be anticipated to lead to anxiety and fear of further victimization. Workplace violence, especially when persistent, may cause psychological disorders including common mental disorders (CMD) of generalized anxiety and depression.

VISION researchers Dr Vanessa Gash (City St George’s University of London) and Dr Niels Blom (University of Manchester) used the United Kingdom Household Panel Study, a nationally representative survey with mental health indicators to examine the prevalence of violence and fear of violence by sector and the effect of violence on common mental disorders (CMD) risk. They also supplemented the analyses with the views of those with lived experience.

Their study, Workplace violence and fear of violence: an assessment of prevalence across industrial sectors and its mental health effects, examined variance in the prevalence of workplace violence and fear of violence in the UK by industrial sector and determined the mental health effects thereof using longitudinal data.

Results showed that a high prevalence of workplace violence and fear of workplace violence was found in multiple different UK industrial sectors – >1 in 10 workers were exposed to violence in the last 12 months in 30% of sectors and >1 in 20 workers were exposed in 70% of sectors. Workers employed in public administration and facilities had the highest risks of workplace violence. The second highest sector was health, residential care, and social work. Workplace violence increased CMD risk as did fear of violence at work. Also, the effect of violence and fear of violence on CMD remained when the researchers investigated CMD one year later. 

Recommendation

The researchers recommend better recognition of the extent to which workplace violence is experienced across multiple sectors and call for better systems wide interventions to mitigate the associated harms.

To download: Workplace violence and fear of violence: an assessment of prevalence across industrial sectors and its mental health effects

To cite: Gash, V, Blom, N. ‘Workplace violence and fear of violence: an assessment of prevalence across industrial sectors and its mental health effects’. Scandinavian Journal of Work, Environment & Health. https://doi.org/10.5271/sjweh.4230

For further information, please contact Vanessa at vanessa.gash.1@citystgeorges.ac.uk

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Healthcare responding to violence and abuse in Brazil

Domestic violence against women (DVAW) is a public health issue and a breach of human rights, yet evidence on effective interventions remains limited, particularly in low-income and middle-income countries. In Brazil, around one third of women have reported current or previous experiences of DVAW, especially perpetrated by intimate partners. Brazil has a comprehensive policy framework on DVAW, however, their implementation has been piecemeal and low priority.

The research team, led by VISION co-Deputy Director Dr Estela Capelas Barbosa, aimed to evaluate changes in identification and referral to specialist support associated with system-level strategies implemented within Brazilian primary healthcare (PHC) to strengthen the response to DVAW as part of the Healthcare Responding to Violence and Abuse (HERA) programme.

The HERA Programme was an international collaboration, involving research partners in the UK, Brazil, Sri Lanka, Nepal and Palestine, which aimed to strengthen the healthcare system response to DVAW, in order to ultimately ensure better outcomes for women and children.

The researchers explored before and aftereffects using difference-in-difference techniques in a quasi-experimental design, using observational data. HERA intervention in Brazil was implemented in eight PHC clinics, while 33 served as controls. Data on DVAW identification and referral were obtained from the national Epidemiological Surveillance System.

Results indicated that the HERA implementation strategies were effective in increasing identification and referral of women who experienced violence and presented at primary care clinics. By prioritising the needs and experiences of women, under a gender and human rights perspective, the strategies may also have enhanced the quality of interactions between healthcare providers and patients.

To the research team’s knowledge, this is the first Brazilian study using a quasi-experimental design to evaluate a system-level set of implementation strategies to DVAW. It provides compelling evidence for the effectiveness of culturally tailored strategies aimed at improving the response of PHC settings to DVAW. The findings reveal significant improvements in both identification and referral rates. The evidence not only underscores the intervention’s potential but offers a valuable framework for policymakers and healthcare providers seeking to implement effective strategies in similar contexts, particularly in low- and middle-income settings.

To download: Healthcare responding to violence and abuse in Brazil: a quasi-experimental difference-in-differences analysis – ScienceDirect

To cite: Estela Capelas Barbosa, Stephanie Pereira, Loraine J. Bacchus, Manuela Colombini, Gene Feder, Lilia Blima Schraiber, Ana Flávia Pires Lucas d’Oliveira, Healthcare responding to violence and abuse in Brazil: a quasi-experimental difference-in-differences analysis, The Lancet Regional Health – Americas, Volume 47, 2025, 101114, ISSN 2667-193X, https://doi.org/10.1016/j.lana.2025.101114.

For further information, please contact Estela at e.capelasbarbosa@bristol.ac.uk

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The impact of parental intimate partner abuse on young adult relationships

Intimate partner violence and abuse (IPVA) has the potential to be physically and psychologically damaging across generations. Childhood exposure to IPVA may place young people at greater risk of IPVA within their own relationships. It is estimated that a quarter of UK adults have grown up in a household where parental IPVA has taken place.

The research team, including VISION Director Professor Gene Feder and led by Dr Annie Herbert (University of Bristol), aimed to provide estimates for the relationship between IPVA among mothers, and IPVA in their children’s own relationships as young adults.

They studied the intergenerational effects of prospectively-reported IPVA in a UK general population birth cohort and examined effects according to different subtypes of maternal IPVA victimisation (psychological [and to an extent, controlling behaviours], and physical) and young adult IPVA victimisation and perpetration (psychological [including controlling behaviours], physical, and sexual). This is the first prospective longitudinal study on intergenerational effects of IPVA in the UK.

The researchers found a modest association between maternal IPVA (partner-to-mother victimisation) and IPVA victimisation among their children as young adult women, and between maternal IPVA and IPVA perpetration in young adult men.  After adjusting for potential confounding factors, the association for victimisation among women lessened, but a weak positive association for perpetration among young men remained. This finding was consistent with some previous reviews of studies on intergenerational effects of IPVA. The strongest association was for perpetration by men growing up around physical IPVA victimisation.

The findings showed that maternal IPVA victimisation is responsible for up to 10% of cases of IPVA in young adult relationships, largely concentrated amongst young people who experienced complex adversity including child maltreatment. Services supporting domestic violence cases in families should consider wider trauma, including history of child maltreatment.

To download: The impact of parental intimate partner violence and abuse (IPVA) on young adult relationships: a UK general population cohort study – The Lancet Regional Health – Europe

To cite: The impact of parental intimate partner violence and abuse (IPVA) on young adult relationships: a UK general population cohort study. Herbert, Annie et al. The Lancet Regional Health – Europe, Volume 0, Issue 0, 101278

For further information, please contact Annie at annie.herbert@bristol.ac.uk

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Start for Life Outcomes Framework: Identifying candidate indicators

In 2021, the Government in England recognised the importance of supporting parents to give their babies and young children under two years of age the best start in life. There was a public commitment to publish a Start for Life Outcomes Framework. The Department of Health and Social Care in England then commissioned the NIHR Children and Families Policy Research Unit to undertake a five-month rapid responsive study to identify and provide a commentary on candidate indicators for this framework.

The research team, including VISION Deputy Director and Senior Lecturer at University of Bristol, Dr Estela Capelas Barbosa, identified candidate indicators to monitor population health of babies, young children, and their families. The project’s secondary focus generated principles for a framework to monitor service performance for this population. 

They conducted two rapid reviews with systematic searches to identify existing outcomes frameworks and core outcome sets that recommended relevant indicators for monitoring both population health and service performance.

Forty-seven candidate indicators were identified, of which 36 met the priority criteria. Many indicators featured in existing frameworks and had some relevant data already collected at scale in England. However, data were often not reported/available separately for adults or households with children and/or by age of child.

Significant further work is needed to develop frameworks to monitor population-level outcomes for babies or assess the quality of services. Frameworks require a clear purpose and consideration of unintended consequences from focusing on some indicators and not others.

The Public Health Outcomes Framework is already a rich resource with 24 (66%) of the 36 priority
indicators already featuring in some form.

To download the summary and / or report: Start for Life Outcomes Framework: Identifying candidate indicators

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A Scoping Review: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the UK

Domestic violence and abuse (DVA) harms individuals from all backgrounds, yet the experiences and needs of different communities vary significantly. The Crime Survey for England and Wales (CSEW) estimated that over 1.4 million women and 751,000 men experienced DVA in the year ending March 2023. Black and minoritized women may face heightened vulnerability to DVA due to factors such as socio-economic deprivation, racism, and exposure to specific forms of violence such as so-called honor-based abuse, female genital mutilation or forced marriage.

In addition, minoritized “survivor–victims” of DVA may face intersecting challenges within their socio-political and community context that impede their ability to disclose DVA and may experience social stigma and fears of racism from service providers for example.

This scoping review maps the existing available literature on Black and minoritized women’s experiences with specialist DVA services in the UK to summarize current understanding and identify knowledge gaps.

The research team, comprised of Penelope E. Lowe from University of Roehampton, VISION researchers Sally McManus, Ravi K. Thiara, Estela Capelas Barbosa and Ladan Hashemi, and Pardis Asadi Zeidabadi from City St George’s UoL, and Sumanta Roy of Imkaan and a VISION Advisory Board member, conducted a comprehensive search across multiple databases and gray literature sources. 

Thematic analysis of the findings revealed three main themes: additional service needs, barriers to accessing support, and the pivotal role of “by and for” services. The team concluded that “by and for” services—provided by and for minoritized women—which adopt an intersectional approach are crucial in addressing the unique needs of Black and minoritized “survivor–victims”, particularly in terms of language support, practical assistance, and community-related support. There is a need for more peer-reviewed literature to recognize the role of “by and for” services, using diverse methodologies to support Black and minoritized communities better.

To download the article: Black and Minoritized Women’s Experiences of Specialist Domestic Violence Service in the United Kingdom (UK): A Scoping Review

To cite: Lowe, P. E., McManus, S., Asadi Zeidabadi, P., Thiara, R. K., Roy, S., Capelas Barbosa, E., & Hashemi, L. (2025). Black and Minoritized Women’s Experiences of Specialist Domestic Violence Services in the United Kingdom (UK): A Scoping Review. Trauma, Violence, & Abuse, 0(0).  https://doi.org/10.1177/15248380251335038

For further information, please contact Penelope at penelope.lowe@rutgers.edu

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The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

Child maltreatment (CM) and parental domestic violence and abuse (pDVA) impose considerable lifelong adverse outcomes on those affected. Approximately 8.5 million adults in England and Wales are estimated to have been exposed to CM (physical, sexual or emotional abuse or emotional or physical neglect of a child by a parent or caregiver) before their 16th birthday. Despite sharing multiple family and environmental risk factors, the economic burden of child exposure where they co-occur has not previously been estimated in detail.

VISION researcher Professor Gene Feder estimated average lifetime societal costs resulting from CM or childhood exposure to pDVA, and incremental costs for scenarios where they co-occur with lead researcher Dr Kevin Gilbert at the University of Cambridge and others.

The findings showed that lifetime costs for childhood exposure to CM and/or pDVA, were £71,309 per child (non-fatal exposure), and £1,292,377 per CM fatality, with £27.8 billion projected costs (2013 UK birth cohort).

Total costs for exposure to pDVA alone was £1.0 billion (£16,639 per child exposed), rising to £2.0 billion (£71,037 per exposed child) for children reporting awareness of pDVA. Co-occurring CM and pDVA imposed greater costs than either alone, including costs from child perpetration of intimate partner violence.

As a result of the research the team concluded that CM and/or pDVA exposure incurs large personal and societal economic burdens. Costs from both pDVA exposure and intergenerational transmission of IPV perpetration highlight the importance for policies to address both CM and domestic violence and abuse in affected households.

Given the scale of burden accrued over the life course after CM and/or pDVA exposure, this model can provide a framework upon which policy makers can identify the best use of resources to maximise the societal benefits from the effective interventions needed to tackle a complex social issue.

To download the article: The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

To cite: Herbert K, Feder G, Gilbert R, Powell C, Howarth E, Morris S. The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK. Child Abuse Negl. 2025 Mar 31;163:107435. doi: 10.1016/j.chiabu.2025.107435. Epub ahead of print. PMID: 40168916.

For further information, please contact Kevin at kch28@medschl.cam.ac.uk

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Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

Domestic violence (DV) is a violation of human rights and a major public health problem that damages the health of women and their families. In the occupied Palestinian territories, 29% of women have a lifetime exposure to intimate partner violence, the most prevalent form of DV.

Despite the existence of national policies to prevent and respond to DV, implementation within the Palestinian primary health care system has been weak. The research team, including VISION researcher Professor Gene Feder, developed, piloted, and evaluated a system-level intervention, including training for health care providers and care pathways for women patients. The aim of the evaluation was to determine the feasibility and acceptability of the HEalthcare Responding to violence and Abuse (HERA) intervention.

The adaptation of a previous (HERA) intervention was implemented in primary health care
settings in Palestine, informed by stakeholder meetings, interviews with clinic managers and health care providers (HCP), facility-level readiness data, and findings of a previous pilot study. The training component of the intervention, delivered by the Palestinian Counseling Centre, included a train-the-trainer session, two clinic-based training sessions, and reinforcement sessions for front-line healthcare providers in four clinics.

Healthcare providers were trained to ask about DV, give immediate support, and offer a referral to a nurse case manager. The care pathway beyond the case manager was either referral to a primary-care based psychologist or social worker or to a gender-based violence focal point external to the clinic that coordinated referrals to appropriate external services (e.g. police, safe house, psychologist, social worker).

For the evaluation, the researchers employed a thematic analysis of post-intervention semi-structured interviews with HCP and trainers, and observations of training sessions and field notes. Provider Intervention Measure (PIM) data on changes in HCP attitudes and practice were analysed with descriptive statistics. Identification and referral rates for women disclosing DV 12 months before and 12 months after the intervention were obtained from clinic registries. The research team also developed a theory of change to triangulate the qualitative and quantitative data.

Results showed that the training proved acceptable to HCPs and there was evidence of positive change in attitudes and readiness to engage with women patients experiencing DV. Compared to the year before the intervention, there was a reduction in the number of patients disclosing DV during the intervention and of referrals in three of the four clinics. This reduction may be explained by the impact of the Covid 19 pandemic on clinic priorities, lack of time, persisting HCP fear about engaging with DV, and HCP rotation between clinics.

The delivery of the training component of the HERA intervention within the Palestinian primary
healthcare system proved partly feasible and was acceptable to HCPs, but contextual factors limited HCP implementation of the training in practice.

To download the article: Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

For further information, please contact Nagham at naghamjoudeh@gmail.com