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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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      VISION Policy Briefing: Domestic violence and abuse and mental and physical health

        Domestic violence and abuse (DVA) is prevalent within the United Kingdom (UK) and has severe and long-lasting physical and mental health consequences. An estimated 2.3 million adults in England and Wales (4.8%) experienced domestic abuse in the past 12 months. More women than men experience DVA, and women experience more repeated abuse, more physical, sexual, and emotional violence and coercive control, more injuries, and greater fear.

        We, in the VISION research consortium, investigate how DVA is related to health. This policy briefing summarises evidence from five of our recent publications. We highlight the key recommendation resulting from across the research and discuss the key findings and evidence demonstrating the prevalence of DVA and the need for a cross-government approach to violence prevention.

        Key Recommendation

        A cross-government approach to preventing violence needs to include health services, alongside justice, welfare, education and other sectors. An effective and safe NHS response to survivors of domestic violence needs to be implemented. That response, embedded in training for healthcare professionals and referral to appropriate services, stretches from identification of survivors to initial support, to addressing the mental health and other sequelae of violence. Currently, the response is sporadic and patchy, with many Integrated Care Boards (ICBs) not commissioning necessary services. Integrated commissioning, as recommended in the NICE guidelines, could help bridge silos and sectors. 

        Key findings

        • Domestic violence and abuse (DVA) affects the physical and mental health of victim-survivors.
        • About half of people who attempted suicide in the past year had experienced violence from a partner at some point in their life, and one in four experienced violence from a partner in the preceding year 
        • The type of intimate partner relationship and the type of violence and abuse affects the nature and level of physical and mental health consequences. 
        • People who use violence against their partners also tend to have worse mental health, and mental health services present an opportunity for intervention with this group. 

        To download the paper: VISION Policy Briefing: Domestic violence and abuse and mental and physical health

        To cite: Blom, N., Davies, E., Hashemi, L., Obolenskaya, P., Bhavsar, V., & McManus, S. (2025). VISION Policy Briefing: Domestic violence and abuse and mental and physical health. City St George’s, University of London. https://doi.org/10.25383/city.28653212.v3

        For further information, please contact Niels at niels.blom@manchester.ac.uk

        Positive experiences can mitigate negative effects in children with trauma

          Children with traumatic experiences in their early lives have a higher risk of obesity. But as new research from VISION researcher Dr Ladan Hashemi and colleagues at University of Auckland, New Zealand, demonstrate, this risk can be reduced through positive experiences.

          Their analysis of data from around 5,000 children in the Growing Up in New Zealand study revealed nine out of ten faced at least one significant source of trauma by the time they were eight years old. Multiple adverse experiences were also prevalent, with one in three children experiencing at least three traumatic events. Notably, certain traumatic experiences (including physical abuse and parental domestic violence) related more strongly to obesity than others. This highlights the strong connection between early-life adversity and physical health outcomes.

          Whilst researching the associations between obesity and childhood trauma, the team also explored the protective and mitigating effects of positive experiences. They defined positive experiences as:

          • mothers interacting well with their children
          • mothers involved in social groups
          • children engaged in enriching experiences and activities such as visiting libraries or museums and participating in sports and community events
          • children living in households with routines and rules, including those regulating bedtime, screen time and mealtimes
          • children attending effective early childhood education

          The findings were encouraging. Children with more positive experiences were significantly less likely to be obese by age eight. For example, those with five or six positive experiences were 60% less likely to be overweight or obese compared to children with zero or one positive experience. Even two positive experiences reduced the likelihood by a quarter.

          Among children exposed to multiple adversities, positive experiences can help mitigate the negative effects of childhood trauma. However, at least four positive experiences were required to significantly counteract the impact of adverse experiences.

          Recommendations

          • Traditional weight-loss programmes focused solely on changing behaviours are not enough to tackle childhood obesity. To create lasting change, children need positive social environments and life experiences as well as support to address the emotional scars of early trauma shaping their lives.
          • Fostering positive experiences is a vital part of this holistic approach. These experiences not only help protect children from the harmful effects of adversity but also promote their overall physical and mental wellbeing. This isn’t just about preventing obesity – it’s about giving children the foundation to thrive and reach their full potential.
          • Sure Start and providers of early childhood education and support for parents could help reduce the health inequalities resulting from exposure to violence.

          To download the paper: Identification of positive childhood experiences with the potential to mitigate childhood unhealthy weight status in children within the context of adverse childhood experiences: a prospective cohort study | BMC Public Health

          To cite: Mellar, B.M., Ghasemi, M., Gulliver, P. et al. Identification of positive childhood experiences with the potential to mitigate childhood unhealthy weight status in children within the context of adverse childhood experiences: a prospective cohort study. BMC Public Health 25, 8 (2025). https://doi.org/10.1186/s12889-024-20727-y

          For further information on the research:

          Or for further information, please contact Ladan at ladan.hashemi@city.ac.uk

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          Adverse childhood experiences associated with childhood obesity

            Adverse childhood experiences (ACEs) are potentially traumatic events or environmental factors occurring during childhood that can disrupt a child’s sense of safety, stability, and bonding. ACEs include child abuse and maltreatment, family dysfunctions, and exposure to violence outside the family. Individuals impacted by ACEs are at greater risk of developing obesity in adulthood, however, few studies have prospectively measured ACEs and obesity during childhood. Associations with the adoption of obesogenic behaviours during childhood, which directly contribute to obesity are also understudied.

            VISION researcher Dr Ladan Hashemi, along with colleagues from the University of Auckland, New Zealand, examined associations between individual and cumulative ACEs, obesity, and obesogenic behaviours during childhood (up to age 8). Using data from eight waves of the Growing Up in New Zealand study—the country’s largest birth cohort study—they developed an index to measure nine ACEs: child physical and psychological abuse, witnessing domestic violence against the mother, parental separation or divorce, parental incarceration, parental substance abuse, parental mental illness, peer bullying, and experiences of ethnic discrimination.  Their research, Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours, discovered that:

            • ACEs were prevalent among children in New Zealand with almost nine out of ten experiencing at least one ACE. Multiple adverse experiences were also prevalent, with one in three children experiencing at least three traumatic events.
            • Higher ACE scores and experience of each specific ACE were significantly more prevalent among those identified as Māori or Pacific, those living in food insecure households or in the most deprived areas.
            • Experience of two or more ACEs was associated with higher risk of adopting obesogenic behaviours such as excessive consumption of unhealthy foods and drinks, inadequate consumption of fruits and vegetables, inadequate sleep duration, excessive screen time, and physical inactivity. The risk increased as the number of ACEs increased.   
            • Six of nine assessed ACEs were associated with the development of childhood obesity. A dose-response pattern was observed, with obesity risk increasing as the number of ACEs increased.

            Exposure to ACEs contributes to the population-level burden of childhood obesity, potentially influencing obesity outcomes through associations with unhealthy, obesogenic behaviours. The findings highlight the importance of a holistic understanding of the determinants of obesity, reinforcing calls for ACEs prevention and necessitating incorporation of ACEs-informed services into obesity reduction initiatives.

            Recommendations

            • Childhood obesity reduction efforts may benefit from considering the role of ACEs. Understanding and addressing the social determinants of obesity, such as family and social environments, may be important in the context of traditional behavioural change interventions targeting nutrition, sleep, screen time, and physical activity
            • Interventions that reduce children’s exposure to violence could help reduce levels of obesity and associated ACEs
            • Violence reduction and family support should feature in the government’s Tackling Obesity strategy

            To download the paper: Full article: Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours

            To cite: Hashemi, L., Ghasemi, M., Mellar, B., Gulliver, P., Milne, B., Langridge, F., … Swinburn, B. (2025). Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours. European Journal of Psychotraumatology, 16(1). https://doi.org/10.1080/20008066.2025.2451480

            Or for further information, please contact Ladan at ladan.hashemi@city.ac.uk

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            Adverse childhood experiences in firstborns associated with poor mental health of siblings

              Adverse childhood experiences (ACEs) often affect multiple children within families, yet studies tend to focus on the health outcomes of individual children, underestimating the needs of affected families. First author Dr Shabeer Syed (UCL Great Ormond Street Institute of Child Health), VISION Director and Professor Gene Feder, and colleagues aimed to examine the association between firstborns exposed to ACEs between 1 year before and 2 years after birth (the first 1000 days) and the risks of mental health problems, mental health-related health-care contacts, and all-cause hospital admissions in multiple children from the same mother, compared to firstborns without ACEs.

              The first-of-its-kind study, published in The Lancet Public Health and funded by the National Institute for Health and Care Research Policy Research Programme, found that mothers whose firstborns had experienced adverse childhood experiences had a 71% increased risk of having children (aged five -18) with mental health problems, compared to mothers whose firstborn did not experience adversity.

              This translates to 12 additional children with mental health problems for every 100 mothers whose firstborn experienced adversity.

              These findings underscore the pervasive risk that early adversity can have on multiple children in the family, and the importance of early identification and sustained support for vulnerable families beyond the first 1,000 days of a child’s life.

              As part of the study, researchers analysed linked GP and hospital health records from 333,048 first-time mothers and their 534,904 children (firstborns and siblings) born in England between 2002 and 2018. They focused on six different forms of adverse childhood experiences in the firstborn child recorded during their first 1,000 days of life (from conception up until the age of two).

              These included: child maltreatment, intimate partner violence, maternal substance misuse, maternal mental health problems, adverse family environments (e.g. homelessness), and high-risk presentations of child maltreatment (e.g. unexplained child injuries).

              Over a third (37.1%) of firstborn children had at least one recorded adverse childhood experience. The most common adverse childhood experiences were living with maternal mental health problems (21.6%), followed by adverse family environments (14.5%) such as parental criminality and housing instability.

              Approximately one in five (19.8%) mothers had at least one child with a recorded mental health problem between the ages of 5 and 18.

              The risk of mental health problems was consistent across all siblings, regardless of birth order (firstborn vs thirdborn), in families where the firstborn experienced adverse childhood experiences.

              Lead author Dr Syed said: “Whilst previous research has focused on the impact of adverse childhood experiences on individual children, our study reveals a cascading health risk that extends beyond the individual, impacting on the health of siblings as well.

              “This likely stems from the continuation of adverse childhood experiences within the family. When a child or parent presents with mental health concerns, violence or other forms of adversity, it’s essential to ask about the wider family context.”

              As a result of their findings, the team are also calling for further research into the impact of early health visiting and primary care support.

              Co-author, Professor Feder, said: “General practice teams have a key role in identifying first-born children experiencing adverse childhood experiences and in supporting first-time parents to help reduce the impact of adverse childhood experiences on the whole family, including subsequent children.

              “We need further evidence for effective interventions to reduce that impact, particularly on mental health.”

              Study limitations

              The researchers could not investigate adverse childhood experiences related to fathers’ mental health or substance use as healthcare data from fathers could not be linked to their children.

              The study found that adverse childhood experiences in firstborns were associated with mental health outcomes in the first and subsequent children, but this does not necessarily mean that adverse childhood experiences cause mental health problems.

              Additionally, electronic health-care records underestimate intimate partner violence and child maltreatment due to non-disclosure and/or detection and under-recording by clinicians.

              To download the paper: Adverse childhood experiences in firstborns and mental health risk and health-care use in siblings: a population-based birth cohort study of half a million children in England – The Lancet Public Health

              Or for further information, please contact Shabeer at s.syed.16@ucl.ac.uk

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              Cybercrime victimisation and the association with age, health and sociodemographic characteristics

                By Ben Havers, PhD Candidate at the Dawes Centre for Future Crime, University College London

                The UK has an ageing population; the Office for National Statistics (ONS, 2024) has predicted that the number of people aged 85 and over will increase from 1.6 million (2.5% of the total population) to 2.6 million (3.5%) over the next 15 years. Concerningly, a recent Age UK report (2024) revealed that more than one in three over 65s lack the basic skills to use the internet successfully. This would suggest that the number of older adults ill-equipped to deal with online threats is set to grow.

                This blog describes a recent study conducted by Ben Havers (University College London) and colleagues, including Professor Sally McManus from VISION, exploring how cybercrime victimisation, repeat victimisation and financial impact are associated with age and other sociodemographic and health-related characteristics.

                The authors analysed data from the 2019-2020 Crime Survey for England and Wales, an annual national crime victimisation survey carried out by the ONS. The survey is administered via face-to-face interviews with more than 35,000 adults across England and Wales. Participants are asked whether they have been a victim of crime in the past 12 months, and other personal information on topics such as housing, work and health.

                Some of the key findings of the study were:

                • People aged 75+ were most likely to experience repeat cybercrime victimisation and associated financial loss than younger demographics.
                • Men were more likely to experience victimisation and repeat victimisation than women. A plausible explanation is that men, who have been found to take more risks than women generally (Hudgens & Fatkin, 1985), may also engage in riskier behaviour or activities online, leaving them more vulnerable to malicious actors.
                • People of Black and mixed/multiple ethnicity were more likely to be cybercrime victims than participants of White ethnicity. Research on the drivers behind ethnic disparities in crime victimisation in the UK and abroad is limited. Salisbury and Upson’s ( 2004) crime survey analysis found that people of Black and minority ethnicity are more likely than White people to fall victim to crime in general. Future research might explore differing patterns and types of internet use, and systemic disadvantages, for example linguistic barriers to safe cyber navigation.
                • Worse cognitive, physical, mental and general health were associated with greater risk, across the ages. This relationship is likely to be bidirectional as poor health might increase the risk of cybercrime (Abdelhamid, 2020) and being a victim of cybercrime may worsen mental health (Rhoads, 2023).

                The findings from this study indicate that future developments in online platform and process design, as well as multi-agency collaboration and information sharing, should focus on (a) empowering older adults to detect fraudulent activity before loss is incurred, and (b) removing barriers to reporting so that support can be provided before the individual is victimised a second or third time.

                To read or download the article for free: Cybercrime victimisation among older adults: A probability sample survey in England and Wales | PLOS ONE

                To cite: Havers, B., Tripathi, K., Burton, A., McManus, S., & Cooper, C. (2024). Cybercrime victimisation among older adults: A probability sample survey in England and Wales. PLOS ONE, 19(12), e0314380. https://doi.org/10.1371/journal.pone.0314380

                Or for further information, please contact Ben at benjamin.havers.20@ucl.ac.uk

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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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                  Domestic abuse in cancer care: Improving the identification and support

                    Although few studies have explored people’s experiences of domestic abuse and cancer, we know the two co-occur. The few studies we do have show that cancer can trigger an escalation of abuse. But there are no published domestic abuse interventions in the cancer setting.

                    In an attempt to plug that gap, Sandi Dheensa, University of Bristol researcher, and colleagues, including VISION Deputy Director Estela Capelas Barbosa, have conducted a service evaluation on a domestic abuse intervention for hospital-based cancer professionals. Their study, Identifying and responding to domestic abuse in cancer care: a mixed methods service evaluation of a training and support intervention – European Journal of Oncology Nursing, is the first to evaluate a DA training (and support) intervention for cancer professionals in England.

                    The key findings demonstrate that cancer and DA frequently co-occur, and that training and support intervention of hospital-based cancer staff increased the rate of DA identifications. There is an appetite for DA and cancer training amongst hospital-based cancer staff.

                    The evaluation contributes further evidence of the benefit of hospital-based domestic abuse coordinator roles and contributes new evidence for the feasibility of adapting the role for a specific context.

                    To read the article or download the paper free of charge:

                    Identifying and responding to domestic abuse in cancer care: a mixed methods service evaluation of a training and support intervention – European Journal of Oncology Nursing

                    To cite:

                    Identifying and responding to domestic abuse in cancer care: a mixed methods service evaluation of a training and support intervention. Dheensa, Sandi et al. European Journal of Oncology Nursing, Volume 0, Issue 0, 102724

                    Or for further information, please contact Sandi at sandi.dheensa@bristol.ac.uk

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                    Prior homelessness and associations with health and violent victimisation

                      By Dr Natasha Chilman, Research Associate, UKRI Population Health Improvement (PHI-UK), Population Mental Health Consortium, Kings College London

                      In the United Kingdom, we have the highest rate of homelessness compared to other high-income countries. For many people homelessness is a temporary, although often very impactful, experience in their lives. However, there is a paucity of research and data looking at people who are formerly homeless and living in private households (i.e., rented or owned accommodation).

                      This blog describes a new study which fills this gap, conducted by Dr Natasha Chilman from King’s College London and colleagues, including Professor Sally McManus from VISION.

                      The study authors analysed data from the Adult Psychiatric Morbidity Surveys, which is a nationally representative survey of adults living in private households in 2007 and 2014. Out of 13,859 people, 535 people reported previous experience of homelessness.

                      Some of the key findings of the study were:

                      • A staggering 40% of people who formerly experienced homelessness had experienced violence in their homes at some point in their lives, compared to 7% of people who had never been homeless.
                      • A quarter (24%) of people who formerly experienced homelessness reported experience of sexual abuse, compared to less than 5% of people who had never experienced homelessness.
                      • Almost half (45%) of the formerly homeless group were currently experiencing depression or anxiety, compared to just 15% of people who had never experienced homelessness. People who formerly experienced homelessness were also experiencing more severe symptoms of these common mental disorders.
                      • There were strong associations between former homelessness and health conditions, across common mental disorders, physical health conditions, alcohol/substance dependence, and multimorbidities. These associations persisted even after adjusting for a range of potential confounders, including indicators of socio-economic position and smoking.
                      • Adjusting for adverse experiences including violence and abuse attenuated associations between former homelessness and alcohol/substance dependence related health outcomes, but not mental/physical health.

                      The findings from this study highlight the urgent need for long-term integrated healthcare support for people who are formerly homeless to continue after they have secured private housing. There were severe inequalities in experiences of violence and sexual abuse for people who have experienced homelessness, underscoring the importance of both violence and homelessness prevention, and of trauma-informed approaches to support.

                      To read the article or download the paper free of charge:

                      The public health significance of prior homelessness: findings on multimorbidity and mental health from a nationally representative survey | Epidemiology and Psychiatric Sciences | Cambridge Core

                      To cite:

                      Chilman N, Schofield P, McManus S, Ronaldson A, Stagg A, Das-Munshi J. The public health significance of prior homelessness: findings on multimorbidity and mental health from a nationally representative survey. Epidemiology and Psychiatric Sciences. 2024;33:e63. doi:10.1017/S2045796024000659

                      Or for further information, please contact Natasha at natasha.chilman@kcl.ac.uk