Hertfordshire’s Police and Crime Commissioner has done something visionary. He has set up a fund for communities to put together “innovative local schemes which aim to make our communities safer”. This fund is linked to the Police and Crime Plan for Hertfordshire, which takes an “everybody’s business” approach to reducing crime and making communities safer.
Less than an hour later I had tweets and emails asking me what evidence communities could use. Then people started asking me how they could develop and put evaluation frameworks around bids. Then partners asked – can we use the Herts Public Health Partnership Fund given to LSPs and Districts to match fund where there are clear links and overlaps? (The overwhelming view of the Public Health Board was yes.)
This set me thinking, what does Public Health have to bring to the table? More years ago than I care to remember, I produced briefings on crime and community safety among other work I did in community safety and crime reduction. My public health training helped me find the evidence and organise it into tools which went to statutory crime and disorder reduction partnerships.
I often say one of the ways I describe Public Health about four Ps:
- A Perspective (or Mindset) which focuses on
- Populations and sub-populations; which is
- Prospective (it looks to what can be improved, prevented or avoided) and goes retrospective to understand where we are today
- Protective – seeking to protect communities and individuals from risk to health and life
The mindset of Community Safety is very similar. Both Public Health and Community Safety work in similar ways: through communities, through skilling people up, commissioning and using interventions which have evidence of effectiveness and sometimes, when the evidence is silent, going back to good theory to build an intervention and evaluate whether it works.
Crime impacts on Health in a range of ways, and there is a great deal of literature on this. Things like acquisitive crime to feed drug habits, and the devastation of domestic violence and hate crime are perhaps the ones that spring readily to mind. But there are other issues too:
- Evidence suggests that ongoing stress from high levels of crime and high fear of crime contributes to a stress pathway that can lead to mental ill-health, poor resilience and even heart disease and stroke.
- Victims of crime are more prone to physical and psychological ill-health on an ongoing basis.
- Disabled people are typically more victimised for property crime than the general population
- Hate Crimes have enduring mental health consequences
- Victims of violence often develop adverse coping mechanisms which develop health problems
- Ongoing phantom pain and unexplained symptoms among people who are victims are not uncommon
By contrast, communities which have strong self-efficacy (i.e. they believe they can do what they need to) are more resilient (i.e. they can handle challenges and problems more easily and return to a good state of functioning more readily), healthier and more able to address issues of relevance to their communities like crime and disorder. They also have lower fear of crime.
Building resilient communities
So how do we build resilient communities? In essence where people share the same place and public realm we need to support communities find strengths, self-confidence, skills and solutions at individual and interpersonal level, have strong links with each other and develop a sense of affinity for those they live next to and nearby. Where people share the same identity (sexuality, faith, nationality) finding common ground and sharing common interests are salient. This is neither new nor rocket science.
But often we lack the insight of the behavioural sciences. And it can be quite simple to harness these. We talk about community development in the UK. In the US they talk about Community Advocacy. Community Advocacy has at its hear building capacity in communities to help themselves, to do, to believe in themselves. The approach works in Community Safety as well as Health. It is particularly effective for marginalised communities and those experiencing hate crimes and has a strong track record in the US. The role of a range of diversity groups such as Faith Communities in Health Advocacy in the US is particularly striking, working as they do for very marginalised communities. We have much to learn from them.
Building resilient communities is something which public health and community safety could do together, because everyone benefits. Addressing specific types of crime (hate crime, domestic violence) also brings ongoing benefits to both agendas.
The Public Health Contribution
Taking just the range of issues above, Public Health has a lot to bring to the table. The prestigious John Jay College of Criminal Justice actually has a whole programme of courses on health and crime. I am going to list just some of the things public health can bring to the table:
- Sharing epidemiological skills so we can understand better the distribution of crime in time and place
- Working together on public resilience and mental health agendas
- Finding and appraising evidence for effective interventions (see my next blog post)
- Helping NHS commissioners and providers respond early and effectively to victims of crime
- Training Police and others in preventing victims of hate crime becoming more traumatised
- Providing drug and alcohol services and pathways which cut crime and disorder and help people with problems
- Providing training to communities who want to implement and evaluate programmes
- Sharing evaluation, evidence appraisal and policy appraisal skills with people in crime reduction
- Ensuring services for those likely to become victims of hate crime encourage and support people to report
- Ensure the cycle of crime in troubled families is broken by finding effective interventions for people to thrive
- Find interventions which help children thrive emotionally and value themselves and others
- Using the public health role in licensing to the best good of communities
The new landscape of the NHS means NHS Clinical Commissioning Groups are responsible authorities for Community Safety Partnerships. This could be seen as yet another burden on new CCGs. The challenge is to find ways of integrating the CCG agendas with the community safety agenda, and picking some concrete issues and projects to start with.
My next blog post will do two things: signpost agencies to sources of good evidence in crime reduction, and signpost them to resources to help them evaluate interve