Violence Against Women as a Public-Health Exposure: Biological Embedding, Medico-Legal Caution and Precision Prevention in the EpiWe Framework.

BACKGROUND

Violence against women is often managed as an acute clinical, social and legal event. A public-health perspective requires attention to longer-term physical, psychological and biological vulnerability. Emerging epigenetic research supports the plausibility of biological embedding of trauma, while underscoring evidentiary limits of biomarkers in medico-legal settings.

METHODS

This article was developed as a targeted evidence-informed synthesis rather than as a systematic or scoping review. Structured searches of biomedical and interdisciplinary databases were combined with selected institutional sources from WHO, European, Italian national and ISS frameworks. Sources were selected for relevance to violence against women, long-term health consequences, biological embedding, epigenetic evidence, health-system response, medico-legal caution and the EpiWe/ISS precision-prevention perspective.

RESULTS

The targeted synthesis was based on a core retained source set of 20 sources, including 14 peer-reviewed articles or reviews (70.0%) and 6 institutional, legal or policy documents (30.0%); 5 sources (25.0%) were directly related to EpiWe/ISS or ISS precision-prevention activities. Violence against women can be conceptualised as a public-health exposure extending beyond the acute episode and contributing to longer-term health trajectories. Evidence links intimate partner violence and sexual violence with adverse mental health outcomes, post-traumatic stress, chronic stress-related vulnerability and non-communicable disease profiles. Epigenetic studies are consistent with possible biological embedding, but findings remain heterogeneous, tissue-dependent and not individually diagnostic. EpiWe/ISS can be viewed as a translational model connecting structured exposure assessment, epigenetic research, longitudinal follow-up and precision prevention.

CONCLUSIONS

Epigenetic evidence should not be interpreted as individual-level forensic proof of violence exposure, biological damage or causal attribution. Its current value is translational and preventive: it may inform survivor-centred follow-up, integrated health-system pathways and medico-legal caution.