The need for a focus on disadvantaged communities
Crime and violence have been near the top of the political agenda in Australia for the past quarter-century. The main response has been punishment - more police and more prisons. Slammed doors and a one-way ticket to ‘somewhere else’ characterise this time-hallowed and universally popular reaction to malignancy and turpitude.
In the past decade, a number of related problems with a more obvious ‘health’ flavour have risen in the charts. These problems, which include illicit drug abuse (manifested particularly in deaths from ‘overdoses’) and child behaviour problems, have not dislodged punishment from its pre-eminent position - indeed, in some respects, they have entrenched its use - but they have had the singular virtue of at least opening the door to a public health policy response.
Drug abuse well illustrates this point. Harm minimisation was, after a brief struggle, accepted in 1985 in Australia (but not the United States) as the overriding principle informing national drug strategy (Homel and Bull 1996). For this reason, it has been harder for governments faced with the drug problem simply to diagnose moral failing and prescribe law enforcement and punishment, notwithstanding recent trends. Harm minimisation requires some focus on prevention and at least a nodding acquaintance with risk and protective factors, something that until recently has been notably lacking from the crime arena (Developmental Crime Prevention Consortium 1999). More generally, the emerging evidence that much the same risk and protective factors underlie juvenile crime, child behaviour problems, mental and physical health, injury and drug use (Davison et al. 2000; Durlak 1998; Marshall and Watt, 1999) strongly suggests that there should be ‘joined up solutions’ to such ‘joined up problems.'
The rise to prominence of crime and health problems in a period of great economic prosperity perhaps illustrates ‘modernity's paradox’ (Keating and Hertzman 1999, p i) - improving economic indicators combined with deteriorating indicators of health and well-being, particularly for children and youth. Although evidence for deteriorating outcomes in Australia is patchy (Zubrick et al. 1999), available data do indicate that the health and well-being of children and young people in Australia and in other developed countries at the end of the 20th century is worse than it was in the 1950s and 60s (Eckersley 1998b; Rutter and Smith 1995a).