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Violent injury varies widely across England and Wales as does the price of alcohol. While the links between alcohol consumption and violence are well established in the medical and epidemiological literature, a causal link is questionable. This paper cuts through the causative argument by reporting a link between the general price of alcohol and violence-related injury across the economic regions of England and Wales. It examines the influence of the real price of alcohol and identifies an 'April effect' that coincides with the annual uprating of alcohol prices for excise duties, on violence-related injuries recorded at Emergency Department attendance. The data are monthly frequency of violent injury rates covering the period 2005–2014 across the economic regions. The principal finding is that a one-way relationship between the real price of alcohol and violent injury is established, and tax policy can be used to reduce the incidence of violent injury and the associated health costs. [ABSTRACT FROM AUTHOR]

Background The National Violence Surveillance Network (NVSN) of emergency departments (ED), minor injuries units and walk-in-centres in England and Wales has brought clarity to contradictory violence trends derived from crime survey and police data. Gender, age-specific and regional trends in violence-related injury in England and Wales since 2010 have not been studied. Methods Data on violence-related injury were collected from a structured sample of 151 EDs in England and Wales. ED attendance date and age and gender of patients who reported injury in violence from 1 January 2010 to 31 December 2014 were identified from attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. Results In total, 247 016 (178 709 males: 72.3%) violence-related attendances were identified. Estimated annual injury rate across England and Wales was 4.4/ 1000 population (95% CI 3.9 to 4.9); males 6.5/1000 (95% CI 5.6 to 7.2) and females 2.4/1000 (95% CI 2.1 to 2.6). On average, overall attendances decreased by 13.8% per year over the 5 years (95% CI -14.8 to -12.1). Attendances decreased significantly for both genders and all age groups (0-10, 11-17, 18-30, 31-50, 51+ years); declines were greatest among children and adolescents. Significant decreases in violence-related injury were found in all but two regions. Violence peaked in May and July. Conclusions From an ED perspective, violence in England and Wales decreased substantially between 2010 and 2014, especially among children and adolescents. Violence prevention efforts should focus on regions with the highest injury rates and during the period May-July. [ABSTRACT FROM AUTHOR]

The paper examines the influence of the real price of beer on violence-related injuries across the economic regions in England and Wales. The data are monthly frequency of violent-injury collected from a stratified sample of 58 National Health Service Emergency Departments 1995–2000. An econometric model based on economic, socio-demographic and environmental factors was estimated using panel techniques. It is shown that the rate of violence-related injury is negatively related to the real price of beer, as well as economic, sporting and socio-demographic factors. The principal conclusion of the paper is that the regional distribution of the incidence of violent injury is related to the regional distribution of the price of beer. The major policy conclusion is that increased alcohol prices would result in substantially fewer violent injuries and reduced demand on trauma services. [ABSTRACT FROM AUTHOR]

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&E) recorded data in England and Wales over a 5 year period, 1995–2000. [ABSTRACT FROM PUBLISHER]

Abstract: 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. [Copyright &y& Elsevier]

Abstract: Purpose: Injury records from Emergency Departments (EDs) have been studied over the last decade as part of the work of the National Violence Surveillance Network (NVSN) and provide information about local, regional and national violence levels and trends in England and Wales. The purpose of the current study is to evaluate overall, gender, age-specific and regional trends in community violence in England and Wales from an ED perspective from January 2005 to December 2009. Methods: Violence-related injury data were collected prospectively in a stratified sample of 77 EDs (Types 1, 3 and 4) in the nine Government Office Regions in England and in Wales. All 77 EDs were recruited on the basis that they had implemented and continued to comply with the provisions of the 1998 Data Protection Act and Caldicott guidance. Attendance date, age and gender of patients who reported injury in violence were identified using assault-related attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends. Results: In total 221,673 (163,384 males: 74%) violence-related attendances were identified. Overall estimated annual injury rate was 6.5 per 1000 resident population (males 9.8 and females 3.4 per 1000). Violence affecting males and females decreased significantly in England and Wales over the 5-year period, with an overall estimated annual decrease of 3% (95% CI: 1.8–4.1%, p <0.05). Attendances decreased significantly for both genders across four out of the five age groups studied. Attendances were found to be highest during the months of May and July and lowest in February. Substantial differences in violence-related ED attendances were identified at the regional level. Conclusions: From this ED perspective overall violence in England and Wales decreased over the period 2005–2009 but increased in East Midlands, London and South West regions. Since 2006, overall trends according to Crime Survey for England and Wales (CSEW), police and ED measures were similar, though CSEW and ED measures reflect far greater numbers of violent incidents than police data. Causes of decreases in violence in regions need to be identified and shared with regions where violence increased. [Copyright &y& Elsevier]

Objectives: Relationships between violence-related injury and potential risk factors in England and Wales were investigated over a five-year period, 1st May 1995 to 30th April 2000., Methods: Records from all 10 economic regions of England and Wales relating to price of alcohol, youth real income, wealth, ethnic density, dates of major sporting events and seasonality were studied with reference to violent injury data derived from 58 Emergency Departments (EDs) over the same period. Panel estimation and multi-level modelling was used to evaluate associations between variables., Results: Overall, 353,443 violence-related A&E attendances were identified over the five-year period. High regional violence-related injury rates correlated with low real price of alcohol as measured by price of beer. Rates of violence were higher during summer months and on days of major sporting events., Conclusions: Risk of injury in violence was closely linked to alcohol price. Beer price rises should therefore reduce violent injury. Injury reduction efforts should be intensified during the summer and on days of major sports events.