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A proper public health approach would treat knife crime like an epidemic

4 min read

We need a long-term, multi-agency approach to knife crime which seeks to understand and prevent its underlying causes

We are in the midst of an epidemic of violence, the likes of which we’ve not seen for a decade. Few people now deny that we face a serious crisis, and many agree that a solution is to treat violence as a public health issue.

But what does a ‘public health approach’ actually mean? It is fitting that shortly after losing my friend and former boss Tessa Jowell to brain cancer I’m able to pay tribute to her trailblazing work in this area as the first minister for public health.

Almost 20 years before public health became a buzzword around violence prevention, Tessa was putting in place a strategy which would later be described by a leading social commentator as “the success story of our time”. The teenage pregnancy strategy is an example of the sort of long-term, integrated public health approach which we so desperately need to tackle knife crime.

It was a proper, evidence-based programme with sufficient time, funding and leadership to work. It succeeded in halving teenage pregnancy rates, and is now being used as a blueprint by the World Health Organization. Most importantly, this strategy didn’t simply attempt to ‘crack down’ on teenage pregnancy, but sought to understand and prevent its underlying causes.

Speaking in the Commons in 1999, Tessa criticised “the rather pathetic hand wringing about moral decay that characterised so much of the debate about teenage pregnancy in the past”. Sadly, the debate about knife crime remains full of hand wringing about moral decay, and not enough focus on the social conditions which underpin it.

We can’t hope to solve today’s knife crime crisis solely by ‘cracking down’. Of course, offenders must be caught and punished. And the police definitely need more resources and the right tools to do their job. But every single police officer I have met has told me we can’t arrest our way out of this problem.

A proper public health approach would treat knife crime like an epidemic. We know that violence breeds violence, so we need to tackle the problem at source while immunising future generations against it.

We need to recognise that some young people are more at risk than others of early criminality because of their environments. Then we must address those environments, changing the social conditions which lie at the root of youth violence.

Mental health, social media, youth work, poverty, domestic violence, inequality, education and health are all part of this picture. To tackle a challenge like this, we need a coordinated national programme with clear outcomes and targets monitored and measured locally. A programme that puts resources into communities to work intensively with young people at risk of getting involved, but which also educates and equips our children to be resilient.

By using a similar approach, Scotland has shown us how to halve serious violence. Over 70 murders with knives between 2004 and 2005 prompted Strathclyde police to set up a violence reduction unit (VRU) because they knew they had to try something different. Expanded across Scotland, the VRU’s work has helped to almost halve the number of homicides in the country, with serious violence at a 40-year low.

One practical example of how this works is increasingly being seen in hospitals. Initiatives like Navigators in Scotland, and Redthread’s Youth Violence Intervention Programme in London embed youth workers in A&E departments to work intensively with young people who arrive with knife or gunshot wounds. These young people are the victims, but after being touched by the violence epidemic, they or their friends could be wielding the knife next. Redthread and others call this the “teachable moment” – when you can remove the young person from the revenge cycle of violence.

This is just one example among many. There are so many people across the country – from police commissioners to ex-gang members –who want to make this work. But we need a step change: a long-term and properly resourced public health approach. We owe that to our young people.

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