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Violence in later life: Life course and physical and mental health trajectories

Research has demonstrated that violence is associated with worse health in older age. Most of the evidence, however, comes from cross-sectional studies. Research showing how health changes over time in people who have experienced lifetime violence is very scarce.

To address this gap, VISION researchers, led by Dr Anastasia Fadeeva with colleagues Dr Polina Obolenskaya, Dr Estela Capelas Barbosa, Professor Gene Feder and Professor Sally McManus, used seven waves of data from the English Longitudinal Study of Ageing (ELSA) collected between 2006 and 2019 (waves 3 to 9), to examine the associations between parental physical abuse in childhood and any physical or sexual violence across the life course, with the subsequent changes in depressive symptoms, the likelihood of probable depression, and long-standing limiting illness.

The team used a sample of 6171 participants aged 50 and over who answered all questions about violence exposure in wave 3 of ELSA, while information about their health was collected from wave 3 to 9.

The VISION study provides new evidence that health consequences are sustained throughout later life. Results showed that violence of different kinds predicts poorer physical and mental health in older age. Furthermore, the health disparities between victims and non-victims did not reduce over time. This was evident in both men and women.

The findings highlight the value of implementing violence prevention measures throughout the life course, not only to mitigate immediate consequences of violence and abuse but also to reduce the burden of ill health in older age. The results also underscore the need to identify modifiable risk factors such as violence in order to inform polices aiming to promote healthy ageing. More longitudinal data, including from administrative sources, are needed to further demonstrate the associations between different types of violence and health outcomes as people age.

Recommendation

Healthy aging could be improved by preventing violence across the life course. Reducing and addressing experiences of violence at a younger age could reduce the burden of – and inequalities in – poor health in later life.

To download: Violence across the life course and physical and mental health trajectories in later life: a 13-year population-based cohort study in England

To cite: Anastasia Fadeeva, Polina Obolenskaya, Estela Capelas Barbosa, Gene Feder, Sally McManus, Violence across the life course and physical and mental health trajectories in later life: a 13-year population-based cohort study in England, The Lancet Healthy Longevity, Volume 6, Issue 7, July 2025, 100738 https://doi.org/10.1093/bjc/azaf064

For further information, please contact Anastasia at anastasia.fadeeva@citystgeorges.ac.uk

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Online and offline stalking victimisation in the Crime Survey for England and Wales

Stalking is a global phenomenon described as a pattern of repeated, intrusive behaviours that cause fear, alarm, and distress in the victim/survivor. Over the past two decades, offline stalking, a repeated pattern of behaviours such as physically following a person, which causes fear and distress, has been complemented through online and digital means also known as cyberstalking. Cyberstalking includes the use of the internet, email, and/or systems such as geo-location trackers to further the perpetrators’ reach and amplify the feelings of harassment experienced by a victim/survivor. 

Technology-facilitated harassment is increasingly common, but there is a lack of longitudinal analysis quantifying cyberstalking and its impact on victim/survivors. To address this empirical evidence-based gap, VISION researchers Drs Madeleine Janickyj and Leonie Tanczer at University College of London and Dr Niels Blom at University of Manchester, examined Crime Survey for England and Wales (CSEW) data from the years 2012 to 2020 to provide the first nationally representative look at cyberstalking over the last decade. Their paper, Online and Offline Stalking Victimisation in the Crime Survey for England and Wales: Its Predictors and Victim/Survivors’ Views on Criminalisation, assesses which demographic groups are most likely to experience it across two countries of the United Kingdom (UK; for example, England and Wales) and also explores how these experiences affect the perception of the victim/survivors.

The analysis, involving weighted and multinomial logistic regression, revealed considerable differences between online and offline stalking behaviours. Cyberstalking is not as widespread, but is increasing in prevalence faster than its offline counterpart.

The researchers also assessed the relationship between perpetrators and victim/survivors and found that less than 50 per cent of cyberstalking victim/survivors had an existing relationship with their stalker. Moreover, various demographic groups, such as females, the LGB community, and younger participants, are more likely to be stalked via both online and offline means. While females are more likely to view what happened to them as a crime, the latter two (LGB and younger participants) more often perceive these experiences as wrong but not necessarily a crime. Although these experiences increasingly affect participants, they do not alter their perception of the event in the same way, exposing that these online experiences are thought of differently from those offline.

Recommendation

To further the analyses of cyber-enabled and cyberstalking, some adjustments could be made to the existing stalking experiences that participants are asked about. One current question merges receiving cards, letters, or text messages, combining online and offline experiences. Separating this item into two questions would give more accurate data regarding cyberstalking.

To download: Online and Offline Stalking Victimisation in the Crime Survey for England and Wales: Its Predictors and Victim/Survivors’ Views on Criminalisation

To cite: Madeleine Janickyj, Niels Blom, Leonie Maria Tanczer, Online and Offline Stalking Victimisation in the Crime Survey for England and Wales: Its Predictors and Victim/Survivors’ Views on Criminalisation, The British Journal of Criminology, 2025;, azaf064, https://doi.org/10.1093/bjc/azaf064

For further information, please contact Maddy at m.janickyj@ucl.ac.uk

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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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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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VISION member awarded UKDS Impact Fellow to study violence and mental health impacts in older age

Dr Anastasia Fadeeva

VISION Research Fellow, Dr Anastasia Fadeeva, has been awarded a UK Data Service (UKDS) Fellowship.

Anastasia’s interest and education in medicine increased her awareness of the impact of social determinants on people’s health. This led to an MSc in Public Health at London Metropolitan University followed by a PhD at Northumbria University and a career in health services and public health research.

As a UKDS Fellow, Anastasia will look at the issues of violence in older age, the long-term impacts of violence on mental health, and the lack of reliable data.

For more information about Anastasia and her work, see her blog on the UKDS website or email her at anastasia.fadeeva@citystgeorges.ac.uk.

The UKDS is funded by the UKRI and houses the largest collection of economic, social and population data in the UK. Its Data Impact Fellowship scheme is for early career researchers in the academic or the voluntary, community, and social enterprise (VSCE) sector. The purpose of the programme is to support impact activities stemming from data-enhanced work. For further information on the UK Data Service please see: UK Data Service

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Physical health conditions and intimate partner violence: A gendered issue

Intimate partner violence (IPV) is a widespread global public health issue with serious and long-lasting consequences. While much research has focused on the mental health consequences of IPV, such as depression and PTSD, there is limited evidence on its association with physical health.

This study explored how different types and number of types of IPV are linked to specific physical health conditions, and whether these associations differ between men and women. VISION researchers Dr Ladan Hashemi, Dr Anastasia Fadeeva and Professor Sally McManus, with Nadia Khan, City St George’s UoL, examined this using data from the 2014 Adult Psychiatric Morbidity Survey.

Key findings include:

  • Women were more likely to experience IPV and a higher number of IPV types than men.
  • Women’s experience of lifetime and 12-month IPV were significantly associated with 12 and 11 different physical health conditions, respectively, while men’s experience of lifetime and 12-month IPV were significantly associated with 4 and 1 conditions, respectively.
  • Different types of IPV types were associated with different types of physical health condition, particularly among women.
  • A cumulative association between experiencing a greater number of IPV types and an increased risk of physical health conditions was evident for women but not for men.

The research concludes that IPV is a gendered issue, with stronger associations between IPV and physical health evident in this data for women than for men. This may be because women are more likely to experience more and multiple types of IPV, more frequently, and more often with injury. Healthcare systems must recognise IPV as a priority issue, ensuring support is tailored to those affected.

Recommendation

  • Healthcare systems need to address IPV as a priority health issue for the female population. Gender-informed approaches in IPV intervention strategies and healthcare provision are required. This means emphasising the development of IPV-responsive healthcare systems and comprehensive IPV curricula in medical and health training.

To download the paper: Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey – Ladan Hashemi, Anastasia Fadeeva, Nadia Khan, Sally McManus, 2025

To cite: Hashemi L, Fadeeva A, Khan N, McManus S. Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey. Women’s Health. 2025;21. doi:10.1177/17455057251326419

For further information, please contact Ladan at ladan.hashemi@citystgeorges.ac.uk

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Synthetic datasets enable linkage and a longitudinal understanding of experiences of violence and health impacts and consequences

Violence is a complex social problem and a public health issue, with implications for the health and social care systems, police and justice systems, as well as significant productivity losses for those who experience it. Analysing data collected by these systems can aid understanding of the problem of violence and how to respond to it. In social research, analysing administrative records together with survey data has already enabled better measurements of violence and its costs, capturing experiences of both victim-survivors and perpetrators across multiple points in time and social and economic domains.

Ideally, data from the same individuals would enable linkage and a longitudinal understanding of experiences of violence and their (health) impacts and consequences. However, most studies in violence-related research analyse data in silo due to difficulties in accessing data and concerns for the safety of those exposed. This is particularly the case for data from third sector specialist support services for victims or perpetrators of violence which has, to VISION’s knowledge, not been linked or combined with other datasets. Because these services provide person-centred trauma-informed care and there is a risk that information on their service users may be used against them in courts or by immigration authorities, direct data linkage is not possible and alternatives are needed.

With this research, VISION researchers Dr Estela Capelas Barbosa, Dr Niels Blom, and Dr Annie Bunce provide a proof-of-concept synthetic dataset by combining data from the Crime Survey for England and Wales (CSEW) and administrative data from Rape Crisis England and Wales (RCEW), pertaining to victim-survivors of sexual violence in adulthood. Intuitively, the idea was to impute missing information from one dataset by borrowing the distribution from the other.

The researchers borrowed information from CSEW to impute missing data in the RCEW administrative dataset, creating a combined synthetic RCEW-CSEW dataset. Using look-alike modelling principles, they provide an innovative and cost-effective approach to exploring patterns and associations in violence-related research in a multi-sectorial setting.

Methodologically, they approached data integration as a missing data problem to create a synthetic combined dataset. Multiple imputation with chained equations were employed to collate/impute data from the two different sources. To test whether this procedure was effective, they compared regression analyses for the individual and combined synthetic datasets for a variety of variables.

Results show that the effect sizes for the combined dataset reflect those from the dataset used for imputation. The variance is higher, resulting in fewer statistically significant estimates. VISION’s approach reinforces the possibility of combining administrative with survey datasets using look-alike methods to overcome existing barriers to data linkage.

Recommendations

  • Imputing missing information from one dataset by borrowing the distribution from the other should be applicable for costing exercises as it permits micro-costing. 
  • Compared to traditional research, VISION’s proposed approach to data integration offers a cost-effective solution to breaking (data-related) silos in research.

To download the paper: Look-alike modelling in violence-related research: A missing data approach | PLOS One

To cite: Barbosa EC, Blom N, Bunce A (2025) Look-alike modelling in violence-related research: A missing data approach. PLoS ONE 20(1): e0301155. https://doi.org/10.1371/journal.pone.0301155

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

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Call for Frontiers in Sociology abstracts: Enhancing data collection and integration to Reduce health harms and inequalities linked to violence

Frontiers in Sociology is currently welcoming submissions of original research for the following research topic: Enhancing Data Collection and Integration to Reduce Health Harms and Inequalities Linked to Violence.

This edition is guest-edited by Dr Estela Capelas Barbosa (University of Bristol and the UKPRP VISION research consortium), Dr Annie Bunce (City St. George’s, UoL and the UKPRP VISION research consortium), and Katie Smith (City St. George’s, UoL / University of Bristol).

Submissions should focus on any of the following:

  • advancing measurement approaches which emphasise cross-sector harmonisation to better evaluate interventions, address health inequalities, and reduce violence
  • addressing any form of violence (e.g., physical, non-physical, technology-facilitated) and its impacts on health, social and economic well-being, and marginalised groups, considering intersections of age, gender, ethnicity, disability, and religion

Research using existing datasets or primary data (quantitative or qualitative), cross-sectoral and cross-disciplinary approaches (e.g., sociology, criminology, public health), and lived experience perspectives is encouraged.

Contributions may include conceptual reviews, methodological innovations, empirical studies and systematic reviews on themes such as health inequalities, intervention effectiveness, outcome measurement, data harmonisation, and linkage strategies.

Abstracts are due by 7th April 2025, and the deadline for manuscripts is 28th July 2025.

For details of the different article types accepted and associated costs, please follow this link https://www.frontiersin.org/journals/sociology/for-authors/publishing-fees.

For more information and to submit an abstract or manuscript, please use the “I’m interested” link below or visit the Research Topic page here https://www.frontiersin.org/research-topics/67291/enhancing-data-collection-and-integration-to-reduce-health-harms-and-inequalities-linked-to-violence. 

This special edition provides an excellent opportunity to advance knowledge in this critical area. Please do reach out and contact us if you have any questions: annie.bunce@city.ac.uk

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Implications of changing domestic abuse measurement on the Crime Survey for England & Wales

The Office for National Statistics (ONS) is making a major decision this month on the future of Crime Survey for England and Wales (CSEW) Domestic abuse measurement and monitoring.

Last year, ONS ran an experiment where half of the CSEW sample got the domestic abuse module used since 2005, and the other half got a new module that is not comparable with the previous one. ONS intend to move over entirely to the new module in the next data collection (2025/26).

Loss of the existing module has major implications: it is world-leading, uses globally comparable items, and with trend data going back to 2005. Without consistently administered core items from that module, it will no longer be possible to:

  • Produce long-term trends over time in domestic abuse for England and Wales.
  • Group a decade of survey years together to have enough cases to robustly examine domestic abuse in particular regions, minoritised groups, and by other protected characteristics for many years. This is essential for understanding inequalities in violence and subsequent service contact, and whether these are changing.

The new module is problematic for many reasons:

  • Is not a standardised measure, has undergone little validation or psychometric testing, and is not comparable with anything used previously or in any other country or study.  
  • It separates data collection between former and current partner based on relationship status at the time of the interview, not at the time of abuse. This distinction creates confusion for interpretation of analysis and may be misinterpreted. The distinction is also problematic for classification of casual and other relationship types.
  • The overhaul of the module was intended to align measurement with the Domestic Abuse Act 2021 definition, but it appears that domestic abuse as recognised by that Act cannot be identified by this module.

We urgently recommend that before losing this world-leading time series and relying on an untested, not comparable, and flawed new approach to DA measurement in England and Wales, that ONS:

  1. Pause: continue the split-sample data collection for one more year.
  2. Test the new approach: fully compare data collected using the new and old modules data so the validity and utility of the new measures can be evaluated appropriately, and its impact on inequalities assessed.
  3. Publish these results publicly: and fully consult once stakeholders understand all the implications of having data collected in each way before the decision to roll out new data collection is finalised.
  4. With this information, then compare all options: such as maintaining some of the existing questions alongside adding new coercive control items. This straightforward approach would ensure the utility of the survey for national trends (in both England and Wales) and analysis of inequalities and minoritised groups, while also improving the measurement of coercive control.

We urge others who feel similarly to contact ONS at CrimeStatistics@ons.gov.uk  or contact us at VISION_Management_Team@city.ac.uk if you would like to discuss.

Note that ONS is planning a raft of further changes with similar implications for trends and analysis of minoritised groups, including:

  • Removal of the sexual victimisation module from next data collection (2025/26), with redevelopment at some future date.
  • Removal and redevelopment of the nature of partner abuse questions, which cover DA survivors service use and police contact and are essential to understanding whether some groups are underserved by services.

These will further undermine continuity of data for trends and the ability to analyse minoritised groups or by protected characteristics.

For researchers interested in combining CSEW waves to enable robust analysis of inequalities by protected characteristics and for minoritised groups, VISION researcher Niels Blom has published syntax: https://vision.city.ac.uk/news/new-possibilities-created-by-crime-survey-wave-integration/.

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Natural Language Processing: Interrogating free text in mental healthcare records to capture experiences of violence

Violence can be categorised in a variety of ways for example physical, sexual, emotional, and domestic but all cause significant physical and mental morbidity within general populations. Individuals with a severe mental illness have been found to be significantly more likely to experience domestic, physical, and sexual violence compared to the general population. For these individuals, experiences of violence are important risk factors however, this is not routinely collected by mental health services.

In general data on all forms of violence has been inadequately available from healthcare records. This is partly due to the lack of routine enquiry by professionals at points of clinical contact, and partly because instances of violence are difficult to identify in healthcare data in the absence of specific coding systems.

A general challenge for using health records data for research is that the most valuable and granular information is frequently contained in text fields (e.g., routine case notes, clinical correspondence) rather than in pre-structured fields; this includes mentions of violence whether experienced as a victim or perpetrated. Capturing violence experiences across mental healthcare settings can be challenging because most instances are likely to be recorded as unstructured text data. Therefore, natural language processing (NLP), is increasingly in use to extract information automatically from unstructured text in electronic health records, particularly in mental healthcare, on clinical entities.

Dr Ava Mason from Kings College London and VISION researchers Professor Robert Stewart, Dr Angus Roberts, Dr Lifang Li, and Dr Vishal Bhavsar worked with colleagues to apply NLP across different clinical samples to investigate mentions of violence. They ascertained recorded violence victimisation from the records of 60,021 patients receiving care from a large south London NHS mental healthcare provider during 2019. Descriptive and regression analyses were conducted to investigate variation by age, sex, ethnic group, and diagnostic category.

Results showed that patients with a mood disorder, personality disorder, schizophrenia spectrum disorder or PTSD had a significantly increased likelihood of victimisation compared to those with other mental health diagnoses. Additionally, patients from minority ethnic groups for Black and Asian had significantly higher likelihood of recorded violence victimisation compared to White groups. Males were significantly less likely to have reported recorded violence victimisation than females.

The researchers demonstrated the successful deployment of machine learning based NLP algorithms to ascertain important entities for outcome prediction in mental healthcare. The observed distributions highlight which sex, ethnicity and diagnostic groups had more records of violence victimisation. Further development of these algorithms could usefully capture broader experiences, such as differentiating more efficiently between witnessed, perpetrated and experienced violence and broader violence experiences like emotional abuse.

To download the paper: Frontiers | Applying neural network algorithms to ascertain reported experiences of violence in routine mental healthcare records and distributions of reports by diagnosis

To cite: Mason AJC, Bhavsar V, Botelle R, Chandran D, Li L, Mascio A, Sanyal J, Kadra-Scalzo G, Roberts A, Williams M, Stewart R. Applying neural network algorithms to ascertain reported experiences of violence in routine mental healthcare records and distributions of reports by diagnosis. Frontiers in Psychiatry 2024 Sep 10. doi:103389/fpsyt.2024.1181739

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