WHAT IS A PUBLIC HEALTH APPROACH TO VIOLENCE?
One of the questions we get asked most frequently at the SVRU is what is a public health approach to violence? This is intended as a VERY brief guide to give a quick overview. We’ve included some key links for those who want to go into more depth:
WHAT IS PUBLIC HEALTH?
Public health is about looking after the health, well-being and safety of entire populations. Not just you, or your family, or your community but a whole country. To achieve this, we need to tackle not only disease but violence too. In 1996 the 49th World Health Assembly declared violence to be a “major and growing public health problem across the world”.
WHAT IS VIOLENCE?
This may seem obvious, but violence comes in many forms, from self-directed harm and suicide through to interpersonal violence and collective violence. Its effects can be physical, emotional, psychological or economic and last from a few moments to generations. Often different forms of violence are interrelated and can’t be treated in isolation. For example, to tackle the roots of gang violence we may also need to address areas such as, though not limited to, domestic violence, adverse childhood experiences and self-harm through addiction. The WHO provide a typology of violence.
WHO CAN HELP?
Public health isn’t just about medicine, it draws on a broad range of knowledge from epidemiology and sociology to criminology, education and economics. For public health to work it’s crucial that as many people, and organisations, from across society work together. Everyone from teachers and doctors to prison officers and scientists. Preventing violence is NOT just the job of the police. We all have a role to play.
HOW DOES IT WORK?
The public health approach is a science-based four-step process:
- What’s the problem?
The first step is to gather data to reveal the who, what, why, where and when of the problem. This can be crime data but also information from hospitals, schools and a range of other sources.
- What are the causes?
Next look for evidence on the factors that put people at risk of experiencing, or perpetrating, violence as well as the factors that can protect them.
- What works and for whom?
Using the data gathered the next step is to design, implement and (crucially) evaluate a violence intervention.
- Scale it up!
If the intervention works, then scale it up across the organisation/community/country while evaluating how well it works and its cost-effectiveness.
WHEN DID THE SVRU ADOPT A PUBLIC HEALTH APPROACH TO VIOLENCE?
The World Health Organisation released the ‘World report on violence and health’ in 2002. It was the first comprehensive review of the problem of violence on a global scale. The SVRU was formed in 2004/5 by Strathclyde Police and was heavily influenced by the public health principles the WHO report put forward to tackle violence. We became the first police body in the world to join the WHO Violence Prevention Alliance (VPA), a membership we proudly retain today. You can find out more about the VPA here.
IS VIOLENCE INFECTIOUS?
Violence shares many of the same features as infectious diseases – it is capable of being passed from one generation to the next and one community to another. When American epidemiologist Gary Slutkin gathered maps and data on gun violence in Chicago he found that violence spread across the city in the same way as a viral outbreak. Click here to view his Ted talk on the subject.
IS VIOLENCE PREVENTABLE?
Public health is all about prevention. Just as it is better to vaccinate against a disease than it is to treat the disease, it is better (and cheaper) to prevent violence happening in the first place than to react once it has occurred. Three steps to prevention are often referred to as:
- Primary prevention – to tackle the conditions which allow violence to develop and breed. This first stage is the key stage to long-term prevention.
- Secondary prevention – early intervention to stop things getting worse if prevention hasn’t been possible.
- Tertiary prevention – responding to violence once it has occurred, treating it’s effects and rehabilitating the people/areas affected. This is the most expensive option so the earlier the intervention the better for individuals, communities and wider society.
However, even before primary prevention can occur the first, and biggest, step is persuading other individuals and organisations that violence is actually preventable. There is no such thing as ‘an acceptable level of violence’.
There’s a wealth of information on the public health approach to violence available online. Here’s a few links which may be of interest:
- The ‘World health report on violence, 2002’
- The World Health Orgnisation’s Violence Prevention Alliance
- Centers For Disease Control and Prevention
- Mosaic Science articles – 1. Violent crime is like infectious disease 2. The Briefing: Violent crime as an epidemic and the public health approach to violence prevention
- UK Faculty of Public Health
*These are external links and posted purely for interest. The SVRU is not responsible for the content on these sites and does not necessarily endorse the content or views expressed.