Intended for healthcare professionals

Feature Violence Prevention

The surgeon solving violent crime with data sharing

BMJ 2020; 371 doi: (Published 14 October 2020) Cite this as: BMJ 2020;371:m2987
  1. Shivali Fulchand
  1. The BMJ
  1. sfulchand{at}

Sharing data to prevent violence is a revelation that came to Jonathan Shepherd 30 years ago—and is now significantly cutting violent injuries worldwide, writes Shivali Fulchand

It was a busy morning in 1982 in the operating theatre at Pinderfields Hospital, Wakefield. Jonathan Shepherd, a specialist surgical trainee in Leeds, was attending to a surgical list involving head and neck injuries. “There are always more assaults during the miners’ strikes,” his colleague said. The conversation moved on, but the comment stuck with Shepherd: are there really more assaults during a strike, he wondered?

Violence is the cause of 1.4 million deaths a year and is considered a global health issue by the World Health Organization.1 Although homicide causes less than 1% of deaths, it can be as high as 10% and, in some countries, is the leading cause of death in 15-49 year olds.2 Hospitals in England and Wales recorded 190 747 emergency department attendances related to violent crime in 2017.

That off-the-cuff comment in 1982 turned into a PhD for Shepherd and a model that would be adopted by cities around the world, dramatically lowering the rates of violence in each and championing a public health approach to violent crime.


Shepherd initially wanted to explore whether police data on violent crime matched the data from hospital emergency departments. In 1983 his PhD at Bristol University revealed that only 25% of violent crimes noted by Bristol Royal Infirmary’s emergency department were recorded by Bristol’s police force.3 “That was the biggest shock in my career,” he says. Data from Denmark later echoed this, finding that police were aware of only 26-31% of violent crimes from 1991 to 2002.4

Shepherd’s research found three recurring reasons why people weren’t reporting assaults to the police. First, patients didn’t want their own conduct …

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