Public health consultant, Farrah Hart, discusses how a public health approach can help address community safety in London.
I have lived in London, on and off, for about 20 years, and I very much consider myself a Londoner. Tower Hamlets, where I live, is one of the boroughs that is most affected by crime and disorder. It is also one of the poorest, with the highest levels of deprivation overcrowding and child poverty. These two aspects of where I live are intrinsically linked.
A public health approach acknowledges that your life circumstances - including traumatic experiences in childhood, deprivation, racism and discrimination – mean that some people and communities are more likely to be affected by crime and violence. Crime and violence are not considered in isolation, but rather as a symptom of the environment and influences that impact on individuals throughout their lives. This is certainly the case for violence impacting young people, where a disproportionate number of young Black Londoners are represented as both victims and perpetrators. Young Londoners living in poverty are also more likely to be affected, and those at risk of violence are more likely to suffer from multiple and complex health issues, including mental and physical health problems, learning difficulties, and substance misuse.
A public health approach recognises that crime and violence are not inevitable and can be prevented, and that’s one of the reasons why the Mayor set up London’s Violence Reduction Unit (VRU) in 2019.
The VRU is a team of specialists who bring people together across London to better understand why violence happens and how to prevent it. They work to reduce harm and exploitation of children and young people, whilst increasing their opportunities, engagement and influence. Other targets include increasing wellbeing and achievement in education, which are dramatically improved through attendance; as well as working with communities impacted by violence. The VRU forges partnerships across London to help bring about change, whilst also conducting research and generating evidence about what works to reduce violence. To date, the Mayor has invested £35.4 million in the VRU, alongside funding from the Home Office. As a Public Health Consultant in the newly established GLA Group Public Health Unit, I work to support London’s Violence Reduction Unit as it leads the public health approach to reducing violence, from City Hall.
This work has far-reaching consequences for communities, and those who might otherwise be tragically lost to violence. The pandemic saw a worrying rise in the number of serious incidents relating to child deaths, and around 1/3 of children and young people’s deaths (aged 0-19) in the UK are preventable. I am working with partners, including OHID, NHS England (London Region), and London Directors of Public Health to develop a new strategy to tackle child mortality, including older children’s deaths from violence. Included within this will be the great work that the VRU does to save young Londoners’ lives, demonstrating that we as a City are serious about tackling child mortality across the life course in London, going beyond health and social care and really linking up partners across the system.
Alongside my work with the VRU, I support the Mayor’s Office for Policing and Crime (MOPAC) to help feed public health considerations and advice into decisions made on policing and crime. The establishment of the GLA Group Public Health Unit as a shared service for MOPAC and the VRU builds on a solid foundation of joint working.
Earlier this year the Mayor published his Violence Against Women and Girls Strategy, which takes a public health approach to protect women’s right to safety, focusing on preventing violence against women and girls from happening in the first place. While MOPAC leads on delivering the strategy and the VRU leads on the prevention side of VAWG, tackling Violence Against Women and Girls is very much a combined City Hall initiative.
MOPAC works to ensure victims receive better engagement with and outcomes from the criminal justice system, and addresses the behaviour of the perpetrators of abuse. In my role, I support MOPAC to better engage with partners from the health sector, who are an essential part of the wider system to tackle violence against women and girls. As well as bringing local authority public health and NHS input to the strategy, I worked closely with MOPAC and the VRU to convene a roundtable between health and policing partners, where key discussions could take place around the NHS’s role in preventing and tackling violence against women and girls.
Our Unit is working with MOPAC on the London Drugs Forum, which brings together regional leaders to take a whole-London approach to drug enforcement and treatment, building partnerships between criminal justice and health authorities at strategic and local level. The Government’s drug strategy requires local authorities to set up their own local partnerships and plans to tackle drugs and drug harms. But with 33 local authorities across London, and with drug issues crossing boundaries, the London Drugs Forum recognises that there are some issues that would benefit from London-wide harmonisation or a single London-wide approach.
The GLA Group Public Health Unit has been working with MOPAC and the VRU to identify priority areas where we can work together to make the biggest improvements for Londoners through public health, including safeguarding the mental health of victims of crime and increasing trust and confidence in the police.
Our work together is driven by the huge opportunity that public health has to reduce violence and make our city safer. Although the system is complex, the issue is politically charged at a national level and there is at times a conflict between the punitive and public health approach. We need to draw upon the evidence of what works by taking an approach that is underpinned by data and intelligence, seeks evidence of effectiveness to tackle the problem, and look for system-level solutions. Our ultimate goal is having a better, healthier, and safer environment for Londoners.
Farrah Hart, Public health consultant