Trends in violence in England and Wales 2000-2004: An accident and emergency perspective

Purpose: To evaluate overall, gender and age-specific trends in violence in England and Wales from an accident and emergency (A&E) perspective. Methods: Violence data were collected from a sample of 32 major A&E departments in the ten Government Office Regions of England and Wales over 5 years, 1st January 2000-31st December 2004. Attendance date, age, and gender of patients who reported injury in assault were studied. Time series statistical methods were used to detect national trends in overall violence and violence in which males and females were injured. Separate time series analyses were carried out for the five age groups (0-10, 11-17, 18-30, 31-50, and 50+ years). Results: 203,819 (150,050 males: 74%) violence-related attendances were identified. Overall estimated annual injury rate was 6.4 per 1000 resident population (9.5 and 3.5 for males and females, respectively). There was a significant decrease in overall violence-related A&E attendance in England and Wales over the five-year period (p < 0.05; 20% in Wales and 13% in England). There were significant decreases in A&E attendance for both males and females and all age groups (p < 0.05). There were regional differences in violence-related A&E attendances with decreases in Wales, East Midland, London, North West and West Midland and increases in North East, Yorkshire and Humberside and South West regions. Violence-related A&E attendances were highest during the months of May to September and during December (p < 0.05). Conclusions: This national study from the perspective of health services suggest that overall levels of violence decreased over the period 2000-2004 in England and Wales. Increases were not detected for any age group or gender. The reason for regional difference in trends in violence deserves further study.