Chief Medical Officer, 2013
Home Office, 2019
These areas span policing and judicial services, healthcare services, and providers of specialist services, like refuges. People who use violence and people who experience violence have contact with a range of other services such as housing and social security. While sharing many related goals, these services are often not aligned. There are differences in the populations they engage with, the outcomes they prioritise and measure, and the definitions they operationalise. The data generated by these different systems often remain fragmented, limiting scope for coherent and joined up strategies for violence reduction and health recovery.
The consortium is:
Violence harms health. By applying a complex systems approach to develop an overarching theory of change of violence, health and society, we aim to identify linkages across social systems and sectors that clearly show the relationship between violence and health. We focus on health inequalities as well as health outcomes and analyse violence as one of the social determinants of health at a system-wide scale. The development of our approach involves co-production of knowledge between the VISION researchers, our project partners, people with lived experience of violence, and other stakeholders, so it can be applied in practice and policy development. The VISION theory of change will provide a framework to inform pathways to reduce violence and health inequalities and improve health outcomes.
The consortium is developing and applying a measurement framework for violence and abuse to enable system-wide collaboration across crime, justice and health disciplines and practitioner communities, and to overcome the fragmentation based on current, divergent measurement systems. We are translating data into categories that are comparable between sectors, surveys, and administrative data. This mostly employs existing – often underutilised - datasets, rather than collecting new data. We curate and de-identify datasets to become more accessible to our project partners and other stakeholders. We work with project partners who manage surveys, offering new question sets about violence and using the data to render visible inequalities, including by sex, gender, age, ethnicity, and migration, as well as socio-economic inequalities.
The consortium is generating a national integrated dataset of violence, health, and society drawing on data from our project partners. The integrated dataset utilises data extracted from surveys and administrative sources, re-curated according to VISION’s new measurement framework. The data will be linked using statistically robust probabilistic individual profiles. We will also generate specialised datasets, including violence in crime surveys, criminal justice trajectories of victims and perpetrators over 15 years, technology-facilitated domestic abuse, and a global dataset.
The newly integrated dataset will be one source employed to investigate pathways between violence, health, and society and to test and further develop the theory of change. Violence affects health (mental and physical) and health affects violence (perpetration, vulnerability), so considering directionality in pathways is key. While there is an established correlation between social inequalities and violence, there are challenges in the specification of causal pathways. These are affected by socio-economic, gender, and ethnic inequalities and are mediated by multiple social systems that also interact to shape each other, including health, justice, specialised services, welfare, and governance. A complex systems approach enables the analysis of causal pathways to take account of the mutual adaptation of these systems.
Drawing on the improved knowledge base from the previous objectives (the theory of change, improved measurement, the integrated evidence and national dataset, and specification of pathways) VISION will develop tools to assess interventions. This includes a system-wide cost-benefit framework for violence. We will apply these to specific evaluations, working with project partners who use data to prioritise interventions to be evaluated. Evaluations will feedback to the theory of change to improve practices, policy, and governance.