A public-health article in this week’s issue of THE LANCET proposes that an understanding of policing and the criminal justice system-especially the concept of deterrence-is integral to the implementation of effective public-health strategies worldwide.
Jonathan Sheperd from the University of Wales, Cardiff, UK, discusses how deterrence is an established theme in criminal justice, but comments on how its role in prevention of assault has been treated with ambivalence-and hostility-in medicine. The article also states how a new development in medicine has been the study of the effectiveness of criminal laws by epidemiologists; the introduction of laws requiring gun owners to keep firearms locked away, for example, has been shown to cause reductions in accidental deaths of children. Similarly, evaluation of state laws that restrict handgun purchase has demonstrated reductions in violent offences.
Jonathan Shepherd concludes: “The extent to which offenders can be persuaded, through knowledge of criminal and health risks, not to injure others is emerging from studies of the health effects of firearm and other crime legislation, and from macro-level studies and controlled experiments of police interventions. There is convincing evidence that motorists can be deterred from alcohol-impaired driving, and recognition that specific, targeted, and visible police work and increasing certainty of punishment are effective interventions. By contrast, duration of imprisonment and generic police initiatives such as blanket increases in police numbers seem to have little effect on deterrence, at least in the context of the decline in US homicide rates since 1991, to which demographic and economic factors seem to have contributed little. Together with established and cost-effective preschool education and early family support, targeted policing and increasing rates of conviction should be integrated into strategies for injury prevention.”
Contact: Professor Jonathan P Shepherd, Department of Oral Surgery, Medicine, and Pathology, University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XY, UK; T/F) +44 (0)2920 742442; E)shepherdjp@cardiff.ac.uk
Journal
The Lancet