An information sharing partnership between health services, police, and local government in Cardiff, Wales, altered policing and other strategies to prevent violence based on information collected from patients treated in emergency departments after injury sustained in violence. This intervention led to a significant reduction in violent injury and was associated with an increase in police recording of minor assaults in Cardiff compared with similar cities in England and Wales where this intervention was not implemented.
BackgroundExcess alcohol consumption has serious adverse effects on health and results in violence-related harm.ObjectiveThis study investigated the impact of change in community alcohol availability on alcohol consumption and alcohol-related harms to health, assessing the effect of population migration and small-area deprivation.DesignA natural experiment of change in alcohol outlet density between 2006 and 2011 measured at census Lower Layer Super Output Area level using observational record-linked data.SettingWales, UK; population of 2.5 million aged ≥ 16 years.Outcome measuresAlcohol consumption, alcohol-related hospital admissions, accident and emergency (A&E) department attendances from midnight to 06.00 and violent crime against the person.Data sourcesLicensing Act 2003 [Great Britain.Licensing Act 2003. London: The Stationery Office; 2003. URL:www.legislation.gov.uk/ukpga/2003/17/contents(accessed 8 June 2015)] data on alcohol outlets held by the 22 local authorities in Wales, alcohol consumption data from annual Welsh Health Surveys 2008–12, hospital admission data 2006–11 from the Patient Episode Database for Wales (PEDW) and A&E attendance data 2009–11 were anonymously record linked to the Welsh Demographic Service age–sex register within the Secure Anonymised Information Linkage Databank. A final data source was recorded crime 2008–11 from the four police forces in Wales.MethodsOutlet density was estimated (1) as the number of outlets per capita for the 2006 static population and the per quarterly updated population to assess the impact of population migration and (2) using new methods of network analysis of distances between each household and alcohol outlets within 10 minutes of walking and driving. Alcohol availability was measured by three variables: (1) the previous quarterly value; (2) positive and negative change over the preceding five quarters; and (3) volatility, a measure of absolute quarterly changes during the preceding five quarters. Longitudinal statistical analysis used multilevel Poisson models of consumption and Geographically Weighted Regression (GWR) spatial models of binge drinking, Cox regression models of hospital admissions and A&E attendance and GWR models of violent crime against the person, each as a function of alcohol availability adjusting for confounding variables. The impact on health inequalities was investigated by stratifying models within quintiles of the Welsh Index of Multiple Deprivation.ResultsThe main finding was that change in walking outlet density was associated with alcohol-related harms: consumption, hospital admissions and violent crime against the person each tracked the quarterly changes in outlet density. Alcohol-related A&E attendances were not clinically coded and the association was less conclusive. In general, social deprivation was strongly associated with the outcome measures but did not substantially modify the associations between the outcomes and alcohol availability. We found no evidence for an important effect of population migration.LimitationsLimitations included the absence of any standardised methods of alcohol outlet data collation, processing and validation, and incomplete data on on-sales and off-sales. We were dependent on the quality of clinical coding and administrative records and could not identify alcohol-related attendances in the A&E data set.ConclusionThis complex interdisciplinary study found that important alcohol-related harms were associated with change in alcohol outlet density. Future work recommendations include defining a research standard for recording outlet data and classification of outlet type, the methodological development of residence-based density measures and a health economic analysis of model-predicted harms.FundingThe National Institute for Health Research Public Health Research programme. Additional technical and computing support was provided by the Farr Institute at Swansea University, made possible by the following grant:Centre for the Improvement of Population Health through E-records Research (CIPHER) and Farr Institute capital enhancement. CIPHER and the Farr Institute are funded by Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Chief Scientist Office (Scottish Government Health Directorates), the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute for Health Research, the National Institute for Social Care and Health Research (Welsh Government) and the Wellcome Trust (grant reference MR/K006525/1).
This Campbell systematic review examines the effects police‐initiated diversion programs on delinquent behavior, compared to traditional system processing. The review summarizes evidence from nineteen high‐quality studies, including 13 randomized controlled trials and six quasi‐experimental studies. This review includes studies that evaluated the effects of police‐led diversionary practices compared to traditional processing for youth under 18 years of age. We identified a total of 14 manuscripts representing 19 evaluations. Of these 19 evaluations, 13 used randomized controlled designs (random assignment to conditions) and 6 used quasi‐experimental designs (no random assignment to conditions). Many of these designs included two or more diversionary conditions compared to a common control (traditional processing) producing 31 treatment‐comparison contrasts for analysis. These studies were conducted between 1973 and 2011, inclusively. Most were conducted in the USA (11) with the remaining conducted in Canada (4), Australia (2), and the UK (2). The general pattern of evidence is positive, suggesting that police‐led diversion reduces the future delinquent behavior of low‐risk youth relative to traditional processing. Assuming a 50 percent reoffending rate for the traditional processing condition, the results suggest a reoffending rate of roughly 44 percent for the diverted youth. This overall benefit of diversion holds for the random assignment studies judged to be free from any obvious risks of bias. No meaningful differences were found across types of diversionary programs. Furthermore, we found no evidence to suggest these findings suffer from publication selection bias. Plain language summary Police‐led diversion of low‐risk youth reduces their future contact with the justice systemPolice‐led diversion of low‐risk youth who come into contact with the justice system is more effective in reducing a youth's future contact with the justice system compared to traditional processing. What is this review about?Youth misconduct and misbehavior is a normal part of adolescence and that misbehavior sometimes crosses the line from disruptive or problematic to delinquent. Nationally representative surveys of youth in the USA have indicated that minor delinquent behavior is normative, particularly for boys. The normative nature of minor delinquent behavior raises the question of how police should respond to minor delinquent behavior in a way that is corrective, but also avoids involving the youth in the criminal justice system beyond what will be effective in reducing future misbehavior.Police diversion schemes are a collection of strategies police can apply as an alternative to court processing of youth. Diversion as an option is popular among law enforcement officers, as it provides an option between ignoring youth engaged in minor wrongdoing and formally charging such youth with a crime. Police‐led diversion has the potential to reduce reoffending by limiting the exposure of low‐risk youth to potentially harmful effects of...
Criminology has much to offer activities to reduce the harm of violent incidents-particularly by reducing weapon-carrying and use-but the discipline's engagement with the harm reduction agenda has been limited. In addressing this, the paper identifies risk factors for carrying a weapon by a young person in England and Wales. It demonstrates that this decision is influenced by individual-, interpersonal-and community-level factors and that weapon carriers can be distinguished from other respondents using relatively few characteristics. The study also shows that defensive factors, such as victimisation and concerns about personal safety are relevant to understanding weapon-carrying, but they are outweighed by criminogenic factors such as violence, neighbourhood disorder and, importantly, lack of trust in the police.
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