The Public Health Approach to Violence Prevention

Humans engage in a wide array of risky behaviours that can lead to serious health problems and it has long been the accepted wisdom that doctors should encourage patients to change their behaviour – give up smoking, go on a diet, use a condom – rather than wait to treat the emphysema, obesity-related heart attacks, or HIV that could be the result. Yet when it comes to violence, the discussion is often underpinned by an assumption that this is an innate and immutable behaviour and that people engaging in it are beyond redemption. More often than not, solutions have been sought in the criminal justice system – through tougher sentencing, or increasing stop-and-search (despite substantial evidence that it is ineffective in reducing crime).

A public health approach treats violence like any other health issue that causes disease or physical harm. First, you work to contain it and stop it spreading, and then you address the causes, to lower the chances of it happening again. Throughout medical history, we have learned to combat infectious diseases by containing the spread, and prevent future outbreaks by putting money into designing better public education, sanitation, medical care and housing. The idea is that the same approach used in tackling disease can be deployed to cut all forms of violent crime.

Although community policing is central to addressing violent crime and anyone breaking the law, the police cannot solve violent crime alone – prevention is crucial.

The public health approach understands that, like illness, violence can be encouraged or discouraged by contextual factors. Victims often become perpetrators, focusing on prevention could help stop the cycle of violence.

Where has it been tried?

This broad framework has taken different forms in countless settings across the world.

In Glasgow, Scotland, aligning the work of police officers, social workers, teachers and doctors to support at-risk residents with new services — including housing support and employment advice — helped to cut the city’s murder rate by 60% in a decade.

In Medellín, Colombia, mapping the locations and drivers of violence allowed the city to target infrastructure spending to offer poor residents a path out of poverty and violent crime. A cable car cut the murder rate by 94% over 15 years in one of the city’s most violent favelas.

And in Cardiff, Wales, an anonymised data sharing model between hospitals, police forces and policymakers cut police-recorded violence by 42% and now saves the city $6.6 million each year violence-related costs.

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