EFFECTIVENESS OF THE CARDIFF MODEL

Jonathan Shepherd Professor of Oral & Maxillofacial Surgery

Director, Violence Research Group

Boosting Global Violence Prevention

DATA MATCHING: RECORDING OF VIOLENCE BY THE POLICE AND HEALTH

SERVICESCrime surveys in Scandinavia, UK and US demonstrate low police recording ratesPolice recording varies by victim age and gender and violence location25-50% of people injured in violence (hospital data) recorded by police

VIOLENCE IN ODENSE MUNICIPALITY

869 (62%) victims

327 (23%) victims

207 (15%) victims

ODENSE UNIVERSITY HOSPITAL

POLICE

Faergemann 2006

1403 (100%) victims

Police recording not related statistically to Injury Severity Scores

13% of firearm violence recorded in Atlanta EDs not recorded by police

Kellerman el al 2003

PROTOTYPE CRIME REDUCTION PARTNERSHIP: CARDIFF VIOLENCE

PREVENTION GROUP

Statutory in UK: 373 crime reduction partnerships Crime and Disorder Act 1998 Police Reform Act 2002

Targeted policing prevents violenceEg Braga 2007

and has violence prevention diffusion effectsEg Weisburd et al 2007

National / Regional measurement

Emergency Department data

Local surveillance/prevention

HARM-BASED APPROACH:

INDEPENDENT NATIONAL CORRELATES WITH ASSAULT INJURY (ED MEASURE)

Unemployment / DeprivationEthnic minority populationAlcohol expenditureBeer priceSeason Matthews et al 2007

THE CARDIFF MODEL: ACTIVE INGREDIENTS

Data from Emergency Departments:Violence location, weapon, assailants, date/time

ED/ Public Health advocacy in crime reduction partnerships

ED and Police data combined to inform targeted policing

SUSTAINABLE ED DATA COLLECTION AND USE

Step One: 24 hour electronic data collection by ED clerical staff when patients first attend

Step Two: Monthly anonymisation and data sharing by hospital IT staff with crime analyst

Step Three: Monthly combination of police and ED data by analystStep Four: Summary of violence times, locations and weapons

by analystStep Five: Continuous implementation and updating of

prevention action planStep Six: Continuous tracking of violence trends

Menu of effective policing, situational and environmental interventions:

VIOLENCE MANAGEMENT

Targeted street patrols, street CCTV, redeployment of police from suburbs to city centre at night, licensed premises risk assessment.

Plastic glassware, fast food outlet relocationPedestrianisation of entertainment streetsSupport for victims of domestic violence to reduce repeat victimisation

VIOLENCE RELATED ATTENDANCES –CARDIFF ED

-4

-2

0

2

4

6

8

10

12

2 years before CCTV

Control towns (n=5)

CCTV towns (n=5)

Perc

enta

ge c

hang

e

2 years after CCTV

EFFECT OF CCTV ON POLICE VIOLENCE DETECTION

Sivarajasingam et al, 2003

EFFECT OF CCTV ON ASSAULTED ATTENDANCE

Control towns

CCTV towns-4

-2

0

2

4

6

8

10

12

2 years before 2 years after CCTV

Per

cent

age

chan

ge

CCTV towns

Control towns

VIOLENCE HOTSPOTS IN 21st

CENTURY CARDIFF

CHOLERA HOTSPOTS IN VICTORIAN LONDON

UK IMPLEMENTATION

Tackling Violence Action Plan 2008-11College of Emergency Medicine Guideline

Wales: Assembly GovernmentEngland: Government RegionsScotland: Violent Crime Unit

WHOImplementation of the recommendations of the World Report on Violence and Health

PREVENTING COMMUNITY VIOLENCE

Secondary Prevention: alcohol misuse

intervention

Victim contacted to identify:

Physical injury treatedCore assault data recorded and anonymisedVictim advised on police reporting

Mental health needs

Primary Prevention

Victim attends ED

Tertiary Prevention:

cognitive behavioural therapy

Combining care with prevention

ACKNOWLEDGEMENTSCardiff police, city government and ED partners Curtis Florence, Tom Simon and Rodney Hammond, CDCIain Brennan, Vas Sivarajasingam, Simon Moore Violence Research Group

Further details: www.vrg.cf.ac.uk