"Ignoring the violence": healthcare policy recommendations for the prevention of community violence re-victimization

Screening for social determinants of health in clinical care: moving from the margins to the mainstream

Background

Screening for the social determinants of health in clinical practice is still widely debated.

Methods

A scoping review was used to (1) explore the various screening tools that are available to identify social risk, (2) examine the impact that screening for social determinants has on health and social outcomes, and (3) identify factors that promote the uptake of screening in routine clinical care.

Results

Over the last two decades, a growing number of screening tools have been developed to help frontline health workers ask about the social determinants of health in clinical care. In addition to clinical practice guidelines that recommend screening for specific areas of social risk (e.g., violence in pregnancy), there is also a growing body of evidence exploring the use of screening or case finding for identifying multiple domains of social risk (e.g., poverty, food insecurity, violence, unemployment, and housing problems).

Conclusion

There is increasing traction within the medical field for improving social history taking and integrating more formal screening for social determinants of health within clinical practice. There is also a growing number of high-quality evidence-based reviews that identify interventions that are effective in promoting health equity at the individual patient level, and at broader community and structural levels.

Inner-city victims of violence and trauma care: the importance of trauma-center discharge and aftercare planning and violence prevention programs

Inner-city trauma centers often provide care for disproportionately indigent populations who are victims of violence. Many of these victims of violence often return to the trauma center with more violent injuries. Research has shown that a majority of these individuals who return to the trauma center for care are expensive to treat, are uninsured and have significant social problems. Two potential policy approaches are discussed: (1) the use of violence prevention programs to attempt to reduce violence in the immediate community and subsequently reduce the number of victims of violence who are treated in trauma centers and (2) the use of aftercare and discharge models that form an alliance between the trauma center and social service providers in the community. Nontraditional interventions will require the collaboration with hospital departments (emergency medicine, surgery, trauma, social work) and outside agencies, such as the courts and probation and parole. Case management, discharge planning, continuous care treatment teams, and violence intervention models offer positive alternatives to the current method of addressing the multiple problems of victims of violence who frequent the ED.

Policy recommendations for the use of victim-offender mediation to redress criminal actions

Understanding how to respond effectively and efficiently to crime victims and their offenders, and identifying what policies assist victims in having their victimization redressed is a major social concern. Social workers have contact with these vulnerable populations in many different ways, yet the social work profession, in general, is unfamiliar with how to redress victims through restorative justice. Restorative justice is an innovative method of viewing crime, and a paradigm shift is required when considering the application and implication of various forms of restorative justice. It is imperative to keep various justice options available, as the effects of crime are detrimental. Though reported rates of juvenile and adult crime have decreases during the last decade, the costs associated with crime to society remain high. Many victims do not report crimes, and if professionals such as medical personnel fail to identify crimes, then these costs may be even higher than currently reported. Regardless, however, of the costs associated with crime, victims deserve having justice evaluated, at least in part, in terms of what they need and want. Likewise, it is imperative to evaluate the effects of victim- offender mediation (VOM), a form of restorative justice, on offenders as they too deserve potential rehabilitation and the chance to redress the harm they caused their victim(s). This paper discusses crime effects, provides an overview of VOM, and concludes with policy recommendations concerning the use of victim-offender mediation.