Purpose The Cardiff Model has reduced violence in Cardiff, Wales through data collection in emergency departments (EDs), geospatial analysis of combined ED and police data and data-informed prevention approaches. We describe initial results of combining multiple data sources to develop an enhanced violence surveillance system in Milwaukee, WI.
Methods Geographic data on assaults was collected in a level one paediatric trauma centre. For assault incidents between 1/2015–9/2016, where a juvenile was a victim, combined ED and emergency medical services (EMS) geographic data (ED/EMS; n=935) were analysed alongside block-level police assault and violence incident data (n=1,837). Nearest neighbour hierarchical spatial clustering detected hotspots of 10 or more incidents within various distance thresholds. Overlap of police incidents in ED/EMS hotspots (and vice versa) was calculated and Spearman’s rho tested statistical associations between the datasets.
Results Over 90% of assaults in the ED/EMS dataset were not recorded by police. High density hotspots in the ED/EMS dataset did not include a majority of incidents recorded by police. Approximately 59% of ED/EMS incidents occurred in large police hotspots without police knowledge’”police were unaware of one assault incident (serviced by ED/EMS) for every 3 incidents that they recorded. The two datasets were significantly correlated at most hotspot distance thresholds.
Conclusion Preliminary analyses suggest that police, ED and EMS attend to and record some juvenile assaults without the knowledge of the other sectors. An enhanced surveillance system may result in a more comprehensive picture of community violence and could become a tool for prevention activities.
Significance More comprehensive surveillance may promote a paradigm shift from a focus on reactionary tactics and treatment of injuries to targeted place-based prevention strategies that data-informed. These efforts could lead to decreases in injuries seen in EDs, assaults reported to the police, and to significant cost savings for each dollar spent.
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