The Department of Health have commissioned the North West Public Health Observatory (NWPHO) to produce a high level report to provide information and evidence for policy makers, public health staff and commissioners to use in developing preventative approaches to violence.
The report entitled ‘Protecting People, Promoting Health – A public health approach to violence prevention in England’, contains new figures on the cost of violence, estimating national costs to the NHS and a wider cost to society. It also draws on the latest evidence that many of the key risk factors that make individuals, families and communities vulnerable to violence are changeable.
The 10 key points from the report are:
- There are 2.5 million violent incidents in England and Wales each year. They result in 300,000 emergency department attendances and 35,000 emergency admissions into hospital (chapter 2).
- Violence is estimated to cost the NHS £2.9 billion every year. This figure underestimates the total impact of violence on health as, for instance, exposure to violence as a child can increase risks of substance abuse, obesity and illnesses such as cancer and heart disease in later life. The total costs of violence to society are estimated at £29.9 billion per year.
- Much like many infections, violence is contagious. For instance, exposure to violence, especially as a child, makes individuals more likely to be involved in violence in later life.
- Violence shows one of the strongest inequalities gradients with emergency hospital admission rates for violence being around five times higher in the most deprived communities than in the most affluent.
- By adopting a public health approach violence can be prevented. A range of different interventions throughout the life course can reduce individuals’ propensity for violence, lower the chances of those involved in violence being involved again and ensure that those affected by violence get the support they require.
- Data on violence are increasingly available from health services, police, other routine sources and a variety of surveys. These identify individual and community level risk and protective factors. Such data can be used to target interventions at those most at risk and monitor progress. The inclusion of violence indicators in the national Public Health Outcomes Framework means robust, comparable measures of trends in violence will be available for all localities.
- A wide range of interventions are available to public health practitioners. Programmes that support parents and families, develop life skills in children, work with high-risk youth and reduce the availability and misuse of alcohol have proven effective at reducing violence. Measures to ensure appropriate identification, care and support mechanisms are in place are important in minimising the harms caused by violence and reducing its recurrence (chapters 5 and 6).
- In many cases health economic analyses are already available that demonstrate significant cost savings where violence prevention programmes have been established (chapter 5). Some areas in England are already employing these measures. If other areas followed suit financial and health benefits would be substantial.
- Violence prevention is a critical element in tackling other public health issues. Violence impacts on mental wellbeing and quality of life, prevents people using outdoor space and public transport and inhibits the development of community cohesion.
- Changes to public health and other public structures should help facilitate violence prevention. The establishment of Public Health England and locally accountable health and wellbeing boards; the movement of public health teams into Local Authorities and the election of police and crime commissioners, can be used to create multi-agency plans for violence prevention in all localities. Such plans should use the strong evidence base behind public health approaches to violence prevention to ensure public sector, private sector and community assets all contribute to violence prevention and benefit from less violence (chapter 6).
Bellis MA, Hughes K, Perkins C, Bennett, A. Protecting People, Promoting Health – A public health approach to violence prevention in England (PDF). Department of Health, 23 Oct 2012.