This is a quick-read version of A public health approach to violence reduction: Strategic Briefing (2021), which highlights its key messages. To gain a greater understanding of the topic you can download a digital copy and read the full resource.

Introduction

Purpose of this briefing

Well-resourced and holistic public health approaches have the potential to generate significant and lasting reductions in violence. To do so, however, they require the buy-in and engagement of a range of organisations working together to tackle drivers of violence at societal, community, relationship and individual levels.

This briefing has a threefold purpose:

• It distils the core features of public health approaches and explains their potential for reducing violence.
• It outlines how system leaders can ensure they play their part in creating and implementing public health approaches to violence reduction.
• It explores some of the potential problems and possible solutions associated with public health approaches.

The causes of violence are deep-rooted and complex, crossing not only multiple areas of people’s lives, but also the scope and remit of different organisations and professionals. For this reason, it is important that efforts to make societies safer are seen as shared and mutual endeavours. No single organisation should bear the burden of reducing violence alone.

This briefing outlines three main ways in which system leaders and senior managers across local government and key partner agencies can ensure their organisations are making a positive contribution to public health approaches to violence reduction:

• By facilitating and engaging in multi-agency collaboration that brings together all organisations and professionals whose remit includes (or should include) the reduction of violence.
• By adopting approaches that value and actively engage with the lived experiences of communities, families and young people, so as to ensure services are genuinely tailored to local need.
• By creating and promoting effective policies, practices and learning opportunities, underpinned by evidence and committed to ethical standards around equality, diversity and anti-racism.

Violence: Definitions, causes, scope and nature

Key points:

• Interpersonal violence affects people of all ages, but those aged 16-24 are disproportionately likely to be affected - both as victims and perpetrators.
• Women are far less likely to be the perpetrators of this type of violence compared to men.
• While street-level violence between young people often attracts media headlines, it is important to note that a significant amount of violence takes place in the home, involving family members or those acquainted with one another.
• Although homicide has a devastating impact on the lives of those affected, the prevalence of homicide in England and Wales is relatively low when considered in the context of the size of the country’s total population. Violence resulting in physical injury, however, is a problem that affects a sizeable proportion of the population.

Origins and expansion of the public health approach

Key points:

• The core feature of public health approaches to violence reduction is that responses should be evidence-led, rather than driven by ideology or dogma.
• Being evidence-led means collecting and generating the best possible evidence on the nature and scope of the problem, and rigorously evaluating the effectiveness of any responses designed to reduce violence.
• While whole system, multi-agency collaboration should not be conflated – nor viewed as in conflict - with the term ‘public health approach’, such collaboration has come to be seen as an important component that facilitates the development of effective public health approaches.

Implementing an effective public health approach: Putting principles into practice

Key points:

• Multi-agency collaboration, meaningful engagement with communities, families and young people, and establishing effective internal policies, practices and enabling an ongoing learning culture, are all central steps in improving understanding and responding to violence.
• Multi-agency collaboration can play a key role in creating the conditions through which public health approaches to violence reduction can be developed and implemented. To support such collaboration, guidance can be drawn from toolkits (see, for example, WHO, 2020) and recent case studies exhibiting best practice (for example Future of Essex, 2019).
• Engagement with communities, families and young people constitutes an important part of public health approaches, as it enables services to be informed by the best available evidence, and tailored to local need. To facilitate effective engagement, basic principles can be followed (see, for example, Home Office, 2014) and lessons learned from case studies (for example, Greater London Authority, 2020).

Potential problems and possible solutions

Losing sight of the macro-level drivers of violence:
Regional and local level actors should join together to communicate, with a collective voice, the responsibility and opportunities that central government has to tackling drivers of violence - especially at a societal level.

Causing unintended harm:
Ensure the problem is conceptualised accurately and appropriately – which necessitates meaningful, ongoing, inclusive engagement with communities – and ensure that individual rights are protected through co-produced solutions. Social work professionals and other advocacy agencies have a key role to play in this regard.

Paying insufficient attention to local context:
Adopt place-based approaches, co-designed with communities, which are sensitive to local variations in drivers of violence and inequalities based on gender, ethnicity and social class.

Challenges of evidencing success:
Wherever possible, help to support and facilitate rigorous evaluations of interventions designed to reduce violence and its drivers.

Conclusion: Realising the potential of a public health approach to reducing violence

The core feature of public health approaches is that they centre on careful efforts to collect and evaluate data to better understand the nature of a particular social problem and how to address it, rather than basing policy and practice on ideology or dogma. As such, public health approaches encourage ways of working that will often challenge systems to adapt and improve, based on the best available evidence.

There are three main things system leaders can do to create the conditions in which public health approaches are liable to thrive:

• Help to facilitate and engage in multi-agency collaboration that brings together all organisations and professionals whose remit and concern includes the reduction of violence. To this end, guidance can be drawn from relevant toolkits case studies that exhibit best practice in this area.
• Engage with communities, families and young people to ensure services are informed by the best available evidence and tailored to local needs. To facilitate this, basic principles of effective engagement can be followed and lessons learned from relevant case studies.
• Pursue inward-facing initiatives that centre on the establishment of appropriate and effective policies, practices and learning, underpinned by the best available evidence, as well as a culture of curiosity and continuous improvement, to facilitate and advance public health approaches to violence reduction.

It is important that system leaders come together and speak with a collective voice to highlight the societal level drivers of violence – such as poverty, inequality and systemic racism – which central government must accept its role and responsibility in addressing.