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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

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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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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Migrants’ experiences of violence while in insecure migration status

Violence is a major public health issue. Moreover, there is evidence that violence is significantly related to social inequality. Existing studies have found links between violence and gender, ethnicity, place of residence and socioeconomic status.

Although economic globalization impacts trade, goods, and services, the movement of people has been increasingly restricted since the 1990s. The number of people globally who live with insecure migration status is difficult to estimate, but includes people worldwide undertaking irregular journeys and crossing international borders without authorization, people living without the correct immigration documentation, and people in temporary or dependent statuses in destination countries.

The global movement of people in the context of strict immigration laws and policies places significant numbers of people in insecure migration status worldwide. Insecure status leaves people without recourse to legal, governmental or social protection from violence and abuse.

This review synthesized qualitative studies that reported how migrants associated physical and physically enforced sexual violence they experienced with their insecure migration status. VISION researchers, Andri Innes, Annie Bunce, Hannah Manzur, and Natalia V. Lewis, generated robust qualitative evidence showing that women experienced sexual violence while in transit or without status in a host state, and that they associated that violence with their insecure migration status. This was the case across the various geographic routes and destination countries.

They found evidence that women associated intimate partner violence with lacking (legal) access to support because of their insecure migration status. Women connected their unwillingness to leave violent circumstances, and therefore their prolonged or repeated exposure to violence, with a fear of immigration removal produced by their insecure migration status.

To protect people in insecure migration status from experiencing violence that they associated with their migration status, it’s necessary to ensure that the reporting of violence does not lead to immigration enforcement consequences for the victim.

To download the paper: Experiences of violence while in insecure migration status: a qualitative evidence synthesis | Globalization and Health | Full Text

To cite: Innes, A., Bunce, A., Manzur, H. et al. Experiences of violence while in insecure migration status: a qualitative evidence synthesis. Global Health 20, 83 (2024). https://doi.org/10.1186/s12992-024-01085-1

For further information, please contact Andri at alexandria.innes@city.ac.uk

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VISION/VASC Webinar Series: Measuring the global burden of morbidity associated with violence against women and children

This event is in the past.

We are pleased to announce our next webinar for the VISION and Violence & Society Centre (VASC) Webinar Series on Tuesday, 1 October 2024, 1300 – 1350.

Joht Chandan, Clinical Professor of Public Health at the University of Birmingham, will present his research on measuring the global burden of morbidity associated with violence against women and children.

Joht has spent considerable time working on designing and delivering a public health approach to abuse and violence. This includes research into finding what works to support survivors of violence, abuse and maltreatment as well as methods to improve surveillance in the context of violence against women and children. For example, his research has shown that survivors of domestic abuse are nearly three times more likely to suffer from mental ill health during their lifetime and have above-average rates of diabetes, heart disease and death.    

To register for the event in order to receive the Teams invitation, please contact: VISION_Management_Team@city.ac.uk

The purpose of the series is to provide a platform for academia, government and the voluntary and community sector that work to reduce and prevent violence to present their work / research to a wider audience. This is a multidisciplinary platform and we welcome speakers from across a variety of fields such as health, crime, policing, ethnicity, migration, sociology, social work, primary care, front line services, etc. If interested in presenting at a future Series webinar, please contact: VISION_Management_Team@city.ac.uk

The VISION/VASC Webinar Series is sponsored by the UK Prevention and Research Partnership consortium, Violence, Health and Society (MR-V049879) and the Violence and Society Centre at City, University of London.

Workplace bullying and harassment harms health

Workplace bullying and harassment (WBH) is bad for people’s health, and this negative health impact can manifest in a variety of ways and be long-lasting.

Over a decade ago the UK government initiated the Fair Treatment at Work survey, aiming to ‘place the issue of bullying at work on employers’ agendas’, yet there has been no major initiative since.

Using data from the 2014 Adult Psychiatric Morbidity Survey, VISION researchers Annie Bunce, Ladan Hashemi and Sally McManus, along with Carrie Myers and Charlotte Clark from City St George’s, University of London and Stephen Stansfeld from Queen Mary, University of London, examined the prevalence and nature of WBH among workers in England, and associations with mental health.

A clear picture of the severity of the problem of WBH in England is painted by four key findings.

  1. One in ten people in paid work reported having experienced WBH in the past year. This is likely to be an underestimate due to underreporting for various reasons;
  2. Those who reported bullying were more likely to be in a financially disadvantaged position;
  3. Over half of people who reported having been bullied at work identified the perpetrator as a line manager; and
  4. Clinically diagnosed common mental disorder was more than twice as likely in employees with experience of WBH compared with those without, and those exposed to WBH were also twice as likely as others in paid work to screen positive for PTSD.

Taken together these findings demonstrate that WBH is common in UK workplaces, it may be driven and exacerbated by issues of inequality, power and hierarchical organisational structures, and it is associated with depressive and anxiety disorders severe enough to warrant health service intervention and treatment.

This power dynamic should not be forgotten when addressing issues in the workplace, but the complexity of workplace environments creates challenges for identifying, understanding and addressing bullying. Reports of WBH can coincide with performance concerns from managers, and, whilst behaviours intended as legitimate performance management activities might be misinterpreted as bullying by the employee, it is also possible that HR practitioners attribute managerial bullying behaviours to legitimate performance management practice to exonerate mangers and protect the organisation.

This links to a recently published piece for The Conversation by Sally McManus and Kat Ford (Bangor University), which sets out how companies can influence and perpetuate violence in society, including via employment practices that conceal the extent of bullying, sexual harassment and other forms of workplace violence (for further information see Six ways companies fuel violence (theconversation.com).

Also, structural issues in the workplace can create pressure for managers which they then take out on those they manage, managers can be victims of WBH themselves, and organisational culture may perpetuate WBH.

Given such complex power dynamics, it is recommended that organisations involve employees at all levels in the development of policies, and collaboratively review the implementation and performance of policies regularly to ensure they are working for the people they are intended to protect. Rather than prescribed ‘tick box’ policies and responses, creative methods incorporating employees’ perspectives may more likely lead to meaningful change.

Crucially, managers and HRs might not be the most approachable people for victims of WBH. For example, other VISION research has found this to be the case for victims of intimate partner violence and abuse (see VISION Policy Series: The impact of intimate partner violence on job loss and time off work in the UK – City Vision).  Therefore, alternative sources of support need to be available within organisations, such as unions and counselling services.

For further information please see the full paper available at: Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey | BMC Public Health (springer.com)

Or please contact Dr Annie Bunce at annie.bunce@city.ac.uk

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Companies and commercial processes shape violence

VISION seeks to highlight the wider contexts in which violence occurs. To tackle the causes of violence and improve violence reduction strategies, governments tend to look to families, communities, schools, health and justice services, and community and voluntary sector organisations for solutions. While these are crucial, a broader and more radical approach is also needed.

For decades, health researchers have raised awareness of various ‘commercial determinants of health’. Initially, this work focused on industries producing harmful products like tobacco, alcohol, fast food and fossil fuels. However, the approach has expanded to show how a much wider range of companies and industries harm our health through their various practices.

We applied an existing framework to unpack the specific ways in which companies and commercial processes might shape not only our health – but also the nature and extent of violence in societies. The analysis was carried out by Kat Ford from the Public Health Collaborating Unit at Bangor University, Karen Hughes from Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Wellbeing, Public Health Wales, and VISION researchers Mark Bellis, Olumide Adisa and Sally McManus.

A summary of six of the ways in which companies can fuel violence has been published in The Conversation. They include political practices like lobbying against safety legislation, and financial practices like investing in regimes with poor human rights records. The full paper details these and other commercial processes and argues that governments need to consider the role and influence of companies if violence prevention is to be effective.

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Bystander experiences of domestic violence and abuse during COVID

VISION researchers Alex Walker, Bryony Perry, Emma R Barton, Lara Snowdon and Mark Bellis surveyed people in Wales about their experiences of being a bystander to domestic violence and abuse (DVA) during the COVID-19 pandemic, with their colleagues at University of Exeter, Public Health Wales, and University of Durham.

This research provides a unique perspective on DVA during a global pandemic, and therefore offers important new evidence that can contribute to DVA prevention during public health emergencies. 

Globally, professionals voiced concern over the COVID-19 restrictions exacerbating conditions for DVA to occur. Yet evidence suggests this also increased opportunities for bystanders to become aware of DVA and take action against it. This mixed methods study consists of a quantitative online survey and follow-up interviews with survey respondents. Conducted in Wales, UK, during a national lockdown in 2021, this article reports on the experiences of 186 bystanders to DVA during the pandemic.

The researchers found that while public health restrictions exacerbated DVA, they also increased the opportunity for bystanders to become aware of DVA, and to take prosocial action. Results support the bystander situational model whereby respondents have to become aware of the behaviour, recognise it as a problem, feel that they possess the correct skills, and have confidence in their skills, before they will take action.

Having received bystander training was a significant predictor variable in bystanders taking action against DVA; this is an important finding that should be utilised to upskill general members of the community.

For further information please see: Bystander experiences of domestic violence and abuse during the COVID-19 pandemic in: Journal of Gender-Based Violence – Ahead of print (bristoluniversitypressdigital.com)

Or contact Lara at lara.snowdon@wales.nhs.uk  

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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:

  1. A plea for the protection of health care and health professionals amid the war
  2. A plea for the preservation of public health amid war
  3. 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

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