Trends in violence in England and Wales 1995-2000: An accident and emergency perspective

Background Prevention of violence-related injury has become an important public health issue but national, regional and local data are lacking. The aims of this study were to determine trends, seasonality and rates of violence-related injury according to Accident and Emergency (A and E) recorded data in England and Wales over a 5 year period, 1995-2000. Methods A stratified sample of 58 major A and E departments in England and Wales were recruited for the study. Electronic data on age, gender and date of attendance of all those reporting violence-related injury over a 5 year period, May 1995 to April 2000, were retrieved. Injury rates (number of injured per 100 resident population) were computed and ordinary least-squares regression analysis was used to evaluate linear and non-linear trends in these time series data. Results A total of 353442 (258719 males: 73 per cent) violence-related attendances were identified. Overall annual violence-related attendance did not change significantly (p >0.05) but attendance of females aged 11-17 years increased steadily and significantly (p <0.05) over the 5 year period. Health-region, gender- and age-specific increases in violence-related attendance slowed (p <0.05). Compared with spring there were significantly lower levels of violence in autumn and winter for both males and females (p <0.05). Violence affecting males aged 18-30 years was not subject to seasonality. Males, those aged 18-30 years and those living in the northern and western regions in England and Wales were at highest risk of violence-related injury. Conclusions This national study from the perspective of health services suggests that violence did not increase over the period 1995-2000. Slowing of age-, gender- and health-region-specific increases in violence-related injury suggests that violence is coming under control. The reasons for significant trends in individual urban centres deserve further study, and could provide important new directions for violence prevention.