England and Wales have seen marked increases in homicide, knife crime, and hospital admissions for stab-wounds, with particular concentrations in the city of London. In response the ‘public health’ approach to violence reduction has gained increasing currency, most recently in the funding of Violence Reduction Units. Interest in this approach, which seeks to address violence using prevention and education rather than policing and justice, stems primarily from Scotland, where radical reductions in violent crime over the last decade have been attributed to the adoption of a public health model.

There is however a lack of clear understanding of ‘what worked’ in the Scottish context. While there have indeed been marked declines in youth violence, the mechanisms that have driven this decrease are poorly understood. There is confusion over what public health approaches are, how they work, and the conditions under which such ideas can travel. As a result, despite significant potential, the implications of the public health approach remain unclear.

The public health approach has significant potential to contribute to violence reduction, but this is hampered by a lack of evidence as to ‘what works’.  Through interviews with key individuals involved in the Scottish violence reduction journey we will establish an expert appraisal of the causes of violence reduction in Scotland. This will be complemented by a detailed documentary analysis, investigating the social, political, and cultural conditions in which violence reduction occurred, and a series of interviews with practitioners and residents of communities affected by violence to establish a bottom-up account of change. Finally, available statistical data on violence and health will be leveraged to triangulate explanations.

Public debate around youth violence in England has in recent years reached fever pitch, yet messaging around evidence of the efficacy of differing strategies is often either inconsistent or incorrect. Public health approaches, and most recently Violence Reduction Units, are viewed by many as a progressive solution but the mechanisms that underpin successful policy transfer are not well understood. Using flexible and responsive ethnographic methods, we will track the evolution of the public health approach as it evolves in real time, through participation and attendance at key meetings and events. Observations will be complemented by a series of interviews with elite actors engaged in violence reduction in London, and interviews with local residents and youth practitioners, exploring the factors that promote or impede change. Mirroring data-collection in Scotland, relevant statistical data will be used to evaluate the extent to which policy changes are impacting on violence reduction.

There are around 2.5 million episodes of violence in England and Wales per year with an estimated annual cost to the NHS of £2.9 billion. In recent years, a raft of new initiatives has been established to tackle rising rates of violence, including regional Violence Reduction Units, the Youth Endowment Fund, and police surge funding (among many others). Youth services and violence practitioners, who deal with the sharp edge of violence, have seen deep cuts to provision. In this context, there is a significant desire for a clear and meaningful evidence-base; without it, there is a risk that scant resources will be directed into ‘quick fix’ solutions that fail to address the deeper social drivers of youth violence. Drawing together evidence from the first two streams, and in dialogue with policy, practice and citizen communities, we will distil the best evidence available to pursue the shared goal of improving young people’s lives and reducing violence.