Violence and Abuse Prevention and Support

Violence and abuse prevention and support concerns the recognition, prevention, and response to interpersonal violence and abuse — including intimate partner violence, child maltreatment, elder abuse, and sexual violence — understood as a public-health problem with serious and lasting health consequences. For community and public health nursing it spans prevention across the population, identification, and support for survivors.

Definition

Violence, in the public-health sense defined by the World Health Organization, is the intentional use of physical force or power, threatened or actual, against oneself, another person, or a group, that results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation; abuse refers to the mistreatment of a person, including physical, sexual, emotional, or financial harm and neglect.

Scope

This entry covers the public-health framing of violence, the main forms of interpersonal violence and abuse, their health consequences, levels of prevention, and the evidence on what helps prevent violence and support survivors. It is reference-educational and population-level. It does not provide protocols for individual cases; suspected abuse should be addressed through appropriate safeguarding and clinical pathways.

Core questions

• How is violence defined and classified as a public-health problem rather than only a criminal or private one?
• What are the major forms of interpersonal violence and abuse and their short- and long-term health consequences?
• How does the public-health prevention model — primary, secondary, and tertiary, and the socio-ecological framework — apply to violence?
• What does the evidence say about preventing violence and supporting survivors, and what is the nurse's role in recognition and response?

Key concepts

• Public-health typology of violence (self-directed, interpersonal, collective)
• Intimate partner and gender-based violence
• Child maltreatment and elder abuse
• Socio-ecological model of risk
• Primary, secondary, and tertiary prevention
• Adverse childhood experiences
• Trauma-informed and survivor-centred care

Mechanisms

The public-health approach treats violence as preventable and as patterned by risk and protective factors operating at individual, relationship, community, and societal levels — the socio-ecological model set out in the WHO World Report on Violence and Health. Violence and abuse harm health directly through injury and indirectly through chronic stress, mental illness, risky coping, and adverse effects across the life course, with childhood adversity linked to later physical and mental disease. Prevention spans stopping violence before it starts (primary), early identification and response (secondary), and reducing long-term harm and supporting recovery (tertiary), within a survivor-centred, trauma-informed frame.

Clinical relevance

For community and public health nurses, this topic explains why violence and abuse are core public-health concerns, how prevention is structured, and why recognition, safety, and a survivor-centred response matter. It is descriptive orientation only; identification of suspected abuse must be handled through local safeguarding, legal, and clinical pathways, and this entry is not a basis for managing any individual case.

Epidemiology

Interpersonal violence is a major global cause of death, injury, and disability, and intimate partner and sexual violence against women is widespread across regions, as documented in WHO multi-country work and synthesised in The Lancet's violence-prevention series (Ellsberg et al., 2015). The health consequences extend well beyond physical injury to include depression, post-traumatic stress, substance use, and increased long-term morbidity, particularly where violence occurs in childhood.

Evidence & guidelines

The WHO World Report on Violence and Health (Krug et al., 2002) established the public-health framing and the socio-ecological model. The Lancet series on violence against women and girls (Ellsberg et al., 2015) synthesised prevention evidence, finding that some interventions can reduce violence within programme timeframes. WHO clinical and policy guidelines (WHO, 2013) set out survivor-centred responses to intimate partner and sexual violence. This entry summarises framing and evidence and is not itself a clinical or safeguarding protocol.

History

Violence was long treated as a matter for the criminal-justice system rather than health, but from the 1980s and 1990s a public-health approach emerged, framing violence as preventable and patterned by modifiable risk factors. The World Health Organization's 2002 World Report on Violence and Health consolidated this framing globally, and subsequent work extended the evidence base on prevention and on survivor-centred response.

Debates

Universal screening for intimate partner violence in health settings

Routine enquiry can identify otherwise hidden abuse and connect survivors to support, but evidence on whether universal screening improves outcomes is mixed and raises concerns about safety and consent; guidance generally favours selective, prepared enquiry with clear referral pathways over indiscriminate screening.

Key figures

• Etienne Krug
• James Mercy
• Linda Dahlberg
• Mary Ellsberg

Seminal works

• krug-2002
• ellsberg-2015

Frequently asked questions

Why is violence treated as a public-health problem?

Because it is widespread, causes major health harm, and is patterned by identifiable risk and protective factors, the public-health approach treats violence as preventable — focusing on understanding and changing the conditions that produce it rather than only on punishing it after the fact.

What does a survivor-centred, trauma-informed response mean?

It means responding in ways that prioritise the safety, dignity, choices, and confidentiality of the person who has experienced violence, and that recognise the effects of trauma, rather than imposing actions on them; it emphasises listening, ensuring safety, and offering support and referral.