Correlates of Violence-related Injury in England and Wales

Objectives: Injuries sustained in violence are a major cause of morbidity and mortality in England and Wales. The aims of this study were to determine the correlation between violence-related injury and potential risk factors 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 unemployment, wealth, ethnic density, dates of major sporting events and seasonality were studied with reference to violent injury data derived from 58 major Accident and Emergency (A&E) Departments over the same period. Panel estimation and multi-level modelling were used to determine 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 (p<0.05) as measured by price of beer and was robust at each level of modelling strategy. Violent injury was negatively correlated with youth unemployment (p<0.01) and real house prices (p<0.01) and positively correlated to regional ethnic density but these variables were not robust to the random coefficients model. Rates of violence were higher during summer months and on days of major sporting events (p<0.05). 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.