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A health perspective to the war in Israel and Palestine

Gene Feder, VISION Director and Professor of Primary Care at the University of Bristol, has written an opinion piece with colleagues commenting on events in Israel and Gaza from a public health and primary care perspective. Responding to the war in Israel and Palestine was published in December in the online edition of the British Journal of General Practice.

Gene and his colleagues are GPs working to further the development of family medicine in the occupied Palestinian territory, specifically in the West Bank, but with links to family medicine in Gaza through the United Nations Relief and Works Agency and through Medical Aid for Palestinians. They also have friends and family in Israel and Palestine.

They have three responses to the current crisis as informed by their work as GPs and connection to Palestinian primary care:

A plea for the protection of health care and health professionals amid the war
A plea for the preservation of public health amid war
A recognition that in the aftermath of October 7th and the invasion of Gaza, the widespread direct and vicarious trauma in Israeli and Palestinian populations will result in permanent physical and emotional damage: the former in the shape of orthopaedic, neurological, and gynaecological (as a result of rape) harm, the latter in the form of widespread anxiety, depression, and post-traumatic stress disorder which will also cascade down the generations.

Given VISION’s commitment to developing evidence on violence prevention, we will be organising roundtable meetings bringing together researchers focusing on post-conflict violence reduction. This is an opportunity for dialogue, perhaps leading to new perspectives and research including systematic assessment of sustainable post-conflict interventions as well as further joint activities.

For further information on the opinion piece, please see: Responding to the war in Israel and Palestine

Photograph by Emad El Byed on Unsplash

Dr Annie Bunce receives award at Lancet Public Health Science conference

Dr Annie Bunce, VISION Research Fellow, was awarded Best Oral Presentation at the Lancet Public Health Science conference in London this November. She presented on the Prevalence, nature and associations of workplace bullying and harassment with mental health conditions in England: a cross-sectional probability sample survey.

Annie’s research, conducted with VISION colleagues Ladan Hashemi, Sally McManus, and others, presents the first nationally representative findings on the prevalence of workplace bullying and harassment in England for over a decade. Annie analysed data from the 2 014 Adult Psychiatric Morbidity Survey (APMS) to demonstrate: the prevalence of workplace bullying and harassment (WBH) in the working population in England; the nature of WBH experienced, who it was perpetrated by and the types of behaviour it involved; and associations between the experience of WBH and indicators of adverse mental health.

The study is unique in that the APMS makes robust assessments of mental health – operationalising diagnostic criteria – which provides an accurate assessment of clinical need. Implications for employers, policymakers, health services and researchers are outlined.

For the article, please see: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02066-4/fulltext

Please contact Annie at annie.bunce@city.ac.uk for further information.

Photo by Icons8 Team on Unsplash

VISION Research Fellow chaired European Public Health Association conference symposium

We’re delighted that one of VISION’s core researchers, Dr Anastasia Fadeeva, chaired a symposium at the upcoming European Public Health Association (EUPHA) conference in November in Dublin.

The workshop, Responding to violence and abuse across the life-course, presented a range of analyses – drawing on data from New Zealand, Germany and the UK – that addressed the ways in which violence and abuse manifest at different life stages, including in childhood, among working-age adults, and in later life.

The presentations highlighted differences across the life course, as well as commonalities. They demonstrated the long-term, even life long, shadow that violence and abuse can cast over people’s health, and provided evidence of the extensive costs for society. Health impacts were shown to be broad, not only anxiety and depression, but substance dependence, chronic physical health conditions, and related health risks such as obesity.

This symposium comprised four presentations that each considered violence and abuse prevalent at a particular stage of life, and provided evidence to inform the sensitive tailoring of responses from and for families, schools, health and social services, workplace human resource employees, and care and residential homes.

For further information on the conference, please see: 16th European Public Health Conference (ephconference.eu)

Or contact Anastasia at anastasia.fadeeva@city.ac.uk

Photo by Priscilla Du Preez 🇨🇦 on Unsplash

Webinar: Parental and child mental health and intimate partner violence

This webinar is over. 27 June 2023, 17:00 – 18:30 BST, Zoom

VISION director, Professor Gene Feder, led the webinar, Interrelationships between parental mental health, intimate partner violence and child mental health – implications for practice, with Dr Shabeer Syed and Dr Claire Powell on behalf of the NIHR Children and Families Policy Research Unit.

They presented findings from a mixed methods study that seeks to improve responses to families affected by intimate partner violence (IPV) and parents and children’s mental health problems.

Then, they presented preliminary findings on the relationship between parental IPV and a range of clinically relevant adversity and mental health-related indicators (www.acesinehrs.com) in anonymised health records from parents and children presenting to GPs, A&E and hospital admissions between one year before and five years after birth.

Their research shows that 1 in 5 (20%) families experienced IPV, although only 1 in 50 (2%) had IPV recorded in the GP record. Recording of other adverse childhood experiences (ACEs) was better, with 1 in 2 (53.4%) families having at least one recorded in the early life course. Compared to families without ACEs, families with ACEs had a higher risk of parental IPV, especially when at least one parent and child had recorded a mental health problem. Gene will discuss the implications of these findings for national guidance on supporting families experiencing IPV and mental health problems, articulating how data already within medical records can help identify those families.

For further information please see: Interrelationships between parental mental health, intimate partner violence and child mental health – implications for practice – ACAMH

Photo by Sebastián León Prado on Unsplash

Different childhood adversities lead to different health inequalities

Even experiencing just one type of adverse childhood experience (ACE) increases the risks of poor health outcomes in adulthood, including health-harming behaviours, poor sexual and mental health, and crime and violence.

Among people experiencing one type of ACE, this study examined which ACEs were most strongly related to each type of health harms, using a combined study sample of 20,556 18–69 years living in England and Wales. The research team, including VISION researcher Mark Bellis, found that sexual abuse in childhood strongly predicted subsequent obesity. Sexual abuse also showed the biggest increase in later cannabis use. Household alcohol problems in childhood was the ACE most strongly associated with violence and incarceration in adulthood.

Toxic stress can arise from ACEs such as physical and sexual abuse, but other more prevalent ACEs, for example verbal abuse and parental separation, may also contribute substantively to poorer life course health.

For further information, please see: Comparing relationships between single types of adverse childhood experiences and health-related outcomes: a combined primary data study of eight cross-sectional surveys in England and Wales | BMJ Open

Or contact Mark Bellis at M.A.Bellis@ljmu.ac.uk

Photo by Adam McCoid on Unsplash

Intimate partner violence: Factor in chronic health problems

Intimate partner violence (IPV) is increasingly recognised as a contributing factor for long-term health problems; however, few studies have assessed these health outcomes using consistent and comprehensive IPV measures or representative population-based samples. Health implications of IPV against men is also relatively underexplored. Given the gendered differences in IPV exposure patterns, exploration of gender patterns in men’ and women’s IPV exposure and health outcomes is needed.

We used data from the 2019 New Zealand Family Violence Study, a cross-sectional population-based study of ~2,800 ever-partnered women and men which was conducted across 3 regions of New Zealand.

We found that women’s exposure to any lifetime IPV, as well as specific IPV types (physical, sexual, psychological, controlling behaviors, and economic abuse), was associated with increased likelihood of reporting adverse health outcomes (poor general health, recent pain or discomfort, recent health care consultation, any diagnosed physical and mental health condition). Furthermore, a cumulative pattern was observed that is women who experienced multiple IPV types were more likely to report poorer health outcomes.

Regarding men exposure to IPV, we found that while men’s exposure to IPV was associated with increased likelihood of reporting 4 of the 7 assessed poor health outcomes, specific IPV types were inconsistently associated with poor health outcomes. Experience of a higher number of IPV types among men did not show a clear stepwise association with number of health outcomes. These findings indicate that IPV against men, unlike women, does not consistently contribute to their poor health outcomes at the population level.

In sum, our findings warrant gender-appropriate clinical approaches when IPV is identified. Specifically, health care systems need to be mobilized to address IPV as a priority health issue among women. However, these findings do not warrant routine inquiry for IPV against men in clinical settings, although appropriate care is needed if IPV against men is identified.

For further information please see: Association Between Men’s Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand | Global Health | JAMA Network Open | JAMA Network and Association Between Women’s Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand | Intimate Partner Violence | JAMA Network Open | JAMA Network

Or contact Dr Ladan Hashemi at ladan.hashemi@city.ac.uk