A Hospital Tells Police Where Fights Happen, And Crime Drops(npr.org)
npr.org
A Hospital Tells Police Where Fights Happen, And Crime Drops
http://www.npr.org/blogs/health/2013/09/19/224052451/a-hospital-tells-police-where-fights-happen-and-crime-drops
45 comments
When crime drops, police can get laid off.
Real crime statistics dropping? Or fear/perception of crime dropping?
I remember reading about the negative side-effects of crime-stat systems a few years ago.
When the systems were first installed, they provided a ton of good information and the crime rate dropped. Homicides were reduced, less gang activity, etc.
Well after a couple of years of reducing crime by double digit percentages, suddenly that became the standard. So there were perverse incentives to do things like classify crimes as lesser offenses. If you can talk people into only complaining about assault, your rape crime count can go down.
At the same time, if there isn't enough crime, you don't need as many cops. So there are also incentives to write more tickets and criminalize more things. Since it's now a crime to walk with your shoes untied, the police can say "Look, this year arrests are up 10%! We're really doing a good job!" or "New kinds of crime are taking over, we need some people for a task force.".
When the systems were first installed, they provided a ton of good information and the crime rate dropped. Homicides were reduced, less gang activity, etc.
Well after a couple of years of reducing crime by double digit percentages, suddenly that became the standard. So there were perverse incentives to do things like classify crimes as lesser offenses. If you can talk people into only complaining about assault, your rape crime count can go down.
At the same time, if there isn't enough crime, you don't need as many cops. So there are also incentives to write more tickets and criminalize more things. Since it's now a crime to walk with your shoes untied, the police can say "Look, this year arrests are up 10%! We're really doing a good job!" or "New kinds of crime are taking over, we need some people for a task force.".
I think the Freakonomics authors talked about this study... the study's authors noticed there was some gaming of the statistics going on because while most stats dropped, the rate of certain offenses held steady. The stubborn offenses were the ones that were much trickier to reclassify as lower level crimes, like homicide or arson.
That certainly hasn't been the case in Canada.
Does that ever actually happen?
Just don't lay off the analyst!
Don't forget that this is in the UK, so in addition to the things mentioned above there are quite likely a ton of CCTV cameras that could be utilised better. Or based on the hospital data new ones could be installed as deterrents.
What's the difference between digital monitoring and pen/paper monitoring?
The difference, in this case, is the collector of the information is sanitizing the information before providing it to law enforcement. Law enforcement isn't standing in the halls making copies and "sanitizing" those copies as the paperwork travels from one office to another. By "sanitizing" I mean trusting law enforcement to perform privacy-related sanitation without oversight to verify.
So the difference is that you trust the hospital to sanitize the data, and you don't trust the LEO to do the same.
I agree to the point I wish police were banned from owning drones of any type, but fire and search and rescue should be encouraged to add drones to their set of tools. If something that needs police attention comes up, they can be told.
A related, and well studied, debate in medicine was about the right of privacy for inmates in a correctional institute. Until the final version of HIPAA inmate health information was not considered protected like for the general population.
Once upon a time ago it was intensely debated whether the effect of disclosures of drug or weapon possession to prison administration would negatively affect prisoner cooperation and the quality of healthcare. Inmates were known for storing weapons or drugs in their rectum, physicians worried that if an X-Ray were to reveal such objects and if they were required to disclose them that inmates would stop accepting X-Rays and general health would decline.
The general consensus of studies that examined this issue showed that this did not in fact happen[1]. It was found that as long as only things that risk the health of the general population (i.e. drugs don't need to be reported but weapons do) were reported there were no adverse effects.
Extrapolating to the general population, one could conclude that this hospital's practices wouldn't discourage people from going to the hospital. Criminals that would be discouraged by this policy would likely not be going to the ER prior to its implementation (similar to how inmates with knives in their rectum still won't go to a physician despite HIPAA protection) because they're afraid of being caught doing something illegal. You can't really do anything for this subset of the population however you can help the majority by sharing this information with the police while causing minimal (or no) harm to any individual patient.
[1] I read this in "Doing Right" by Hebert, PC. In the book they cited a study but I no longer have it, if someone really wants this reference I can go hunt for it. I wouldn't recommend buying this book as it's ridiculously overpriced.
Once upon a time ago it was intensely debated whether the effect of disclosures of drug or weapon possession to prison administration would negatively affect prisoner cooperation and the quality of healthcare. Inmates were known for storing weapons or drugs in their rectum, physicians worried that if an X-Ray were to reveal such objects and if they were required to disclose them that inmates would stop accepting X-Rays and general health would decline.
The general consensus of studies that examined this issue showed that this did not in fact happen[1]. It was found that as long as only things that risk the health of the general population (i.e. drugs don't need to be reported but weapons do) were reported there were no adverse effects.
Extrapolating to the general population, one could conclude that this hospital's practices wouldn't discourage people from going to the hospital. Criminals that would be discouraged by this policy would likely not be going to the ER prior to its implementation (similar to how inmates with knives in their rectum still won't go to a physician despite HIPAA protection) because they're afraid of being caught doing something illegal. You can't really do anything for this subset of the population however you can help the majority by sharing this information with the police while causing minimal (or no) harm to any individual patient.
[1] I read this in "Doing Right" by Hebert, PC. In the book they cited a study but I no longer have it, if someone really wants this reference I can go hunt for it. I wouldn't recommend buying this book as it's ridiculously overpriced.
A good example of data-sharing being put to productive use. Apparently with an 3200% ROI. Not bad.
We all know a lot of crimes go unrelated but I never thought certain classes of crimes would be so significantly under-represented.
We all know a lot of crimes go unrelated but I never thought certain classes of crimes would be so significantly under-represented.
[deleted](1)
Bad idea, people won't go to the hospital. Reminds me of the story about the CIA going undercover as polio vaccinators in Pakistan and now legitimate vaccinators are being chased off and polio rates are increasing.
They were pretending to be doing Hepatitis B vaccinations in an attempt to confirm the presence of Osama bin Laden in the area: https://en.wikipedia.org/wiki/Poliomyelitis_in_Pakistan#Fact...
Did you even read the article? It's concerned with drink-related violence (not gang violence), and states fairly clearly that generally the reason that these types of crimes are not reported is because they happen in clubs/bars and the perpetrator is often not known. They clearly state that data is anonymised, and there's absolutely no suggestion that the reports are ever used for criminal investigations.
The main issue that this programme tackles (apparently quite effectively) is that the police often aren't even aware that an assault has taken place (and so can't target the area it happened in).
Certainly in some gang-related crimes the victims refuse to talk to anyone, but this is a very different situation. How is reducing violent crime by somewhere between 30 and 40% a bad idea?
The main issue that this programme tackles (apparently quite effectively) is that the police often aren't even aware that an assault has taken place (and so can't target the area it happened in).
Certainly in some gang-related crimes the victims refuse to talk to anyone, but this is a very different situation. How is reducing violent crime by somewhere between 30 and 40% a bad idea?
I agree that it's probably a bad idea to publish a story about this program.
I'm guessing the type of guys getting into fights in Cardiff bars are going to stop telling the hospital staff when they realize it could lead to their favorite bar getting targeted by the police or even shut down.
I'm guessing the type of guys getting into fights in Cardiff bars are going to stop telling the hospital staff when they realize it could lead to their favorite bar getting targeted by the police or even shut down.
How long are you able to report a crime after the fact?
I remember being hit by a car on my bike (a famously under-reported incident), but both myself and my girlfriend physically/emotionally were in rough shape all day. We forgot to report it, then it ended up slipping out of our minds.
This is a challenging problem to solve with technology, similar to getting patients to take their daily medication on time.
I remember being hit by a car on my bike (a famously under-reported incident), but both myself and my girlfriend physically/emotionally were in rough shape all day. We forgot to report it, then it ended up slipping out of our minds.
This is a challenging problem to solve with technology, similar to getting patients to take their daily medication on time.
Disclaimer: I am not a lawyer. This information may be US-specific.
AFAIK you can file a police report at any time. Whether your report leads to any results is probably negatively correlated with how long you wait to file it, but you can't be sure it won't until you actually report it.
However, many crimes (especially more minor ones) have a statute of limitations, where the crime can't be prosecuted after a certain amount of time.
And older investigations are harder -- a witness in a house adjacent to the crime scene may have remembered hearing a crunch followed by a car speeding away at the time of the accident if interviewed the following day or week, but may have utterly forgotten, or moved away and be impossible to locate, or have become unable to testify due to developing mental incapacity or becoming deceased, if the day in question was months, years, or decades ago. Likewise, the next day there might be tire marks, bike parts, or other physical evidence at the crime scene, but after months or years it will have deteriorated or totally disappeared.
Also police surely know that older investigations are harder, so in addition to the problems with the evidence itself, having an older case you might not be assigned as many police resources because they know there's a lower probability of success, and it's their duty to taxpayers to use their limited number of detectives, etc. on the cases they have the best likelihood of solving, so those taxpayer dollars are used most efficiently.
But this doesn't mean you shouldn't report it. You don't know exactly how your crime will be classified (assault? traffic offense? attempted homicide?), so you don't know what the statute of limitations actually is.
It might be that your report provides the missing piece of a puzzle -- there might be a cold case file in the police station saying, "A local mechanic noticed a car brought in for repairs had bike parts embedded in the grille and blood on the tires, the license and owner information was entered in the case file, and we're pretty sure we know who was driving. But no hit-and-runs had been reported recently, we know a jury won't convict without an identifiable victim, and the investigation was closed due to reaching a dead end."
AFAIK you can file a police report at any time. Whether your report leads to any results is probably negatively correlated with how long you wait to file it, but you can't be sure it won't until you actually report it.
However, many crimes (especially more minor ones) have a statute of limitations, where the crime can't be prosecuted after a certain amount of time.
And older investigations are harder -- a witness in a house adjacent to the crime scene may have remembered hearing a crunch followed by a car speeding away at the time of the accident if interviewed the following day or week, but may have utterly forgotten, or moved away and be impossible to locate, or have become unable to testify due to developing mental incapacity or becoming deceased, if the day in question was months, years, or decades ago. Likewise, the next day there might be tire marks, bike parts, or other physical evidence at the crime scene, but after months or years it will have deteriorated or totally disappeared.
Also police surely know that older investigations are harder, so in addition to the problems with the evidence itself, having an older case you might not be assigned as many police resources because they know there's a lower probability of success, and it's their duty to taxpayers to use their limited number of detectives, etc. on the cases they have the best likelihood of solving, so those taxpayer dollars are used most efficiently.
But this doesn't mean you shouldn't report it. You don't know exactly how your crime will be classified (assault? traffic offense? attempted homicide?), so you don't know what the statute of limitations actually is.
It might be that your report provides the missing piece of a puzzle -- there might be a cold case file in the police station saying, "A local mechanic noticed a car brought in for repairs had bike parts embedded in the grille and blood on the tires, the license and owner information was entered in the case file, and we're pretty sure we know who was driving. But no hit-and-runs had been reported recently, we know a jury won't convict without an identifiable victim, and the investigation was closed due to reaching a dead end."
Depends on the country and the crime. In Canada it is 24-48 hours to report your tires being slashed, 1 year to prosecute a vehicle collision, but 25 years for something like rape and/or molestation.
In most places in the US I believe there is no statute of limitations for murder.
In the UK there are some prosecutions and investigations taking place related to allegations of child abuse going back to the 1970's which have only recently been reported. I don't think there is any general statute of limitations here for criminal prosecution.
This is interesting. Hospitals in Austria are actually required by law to report such incidents as far as I know. The same is true for results of domestic violence.
Isn't this the case in the US as well, for injuries like gunshot wounds? Or is that just Hollywood telling me that?
No, gunshot wounds are definitely required to be reported. But fights/blunt trauma and the like of non mortal wounds probably aren't required to be reported.
You are right, if you go to a hospital in Austria with certain wounds, police has to come and question you.
They wont force you to report, but they will definitely try to convince you to tell them where you got the wound from.
They wont force you to report, but they will definitely try to convince you to tell them where you got the wound from.
i wonder whats the modus operandi around this ?
let me explain - in India, it is mandatory for hospitals to reports all "unnatural" incidents to the police - which means crime, traffic accidents, etc. Now because of the already understaffed police and/or corruption in the force itself, what happens is that the hospital tends to withold critical care until the police report is completed. In recent times, this has snowballed into a huge controversy and caused some other laws being passed to ensure care first.
Now here's the issue - this is still a gray area. Let's say you are a newly minted doctor working in the hospital and a patient comes in with several injuries and who tells you that there is a gang incident in a pub and likely many people are injured. What is the mandated process - do you have to make a police report first, or do you provide medical care first ? Doing either can result in the doctor being blamed for something or other.
Or is there a dedicated "liason" whose job is to do the reporting and leave the care to the doctors. Which would mean staffing for a role like that would be difficult in a non-publicly funded medical institution.
let me explain - in India, it is mandatory for hospitals to reports all "unnatural" incidents to the police - which means crime, traffic accidents, etc. Now because of the already understaffed police and/or corruption in the force itself, what happens is that the hospital tends to withold critical care until the police report is completed. In recent times, this has snowballed into a huge controversy and caused some other laws being passed to ensure care first.
Now here's the issue - this is still a gray area. Let's say you are a newly minted doctor working in the hospital and a patient comes in with several injuries and who tells you that there is a gang incident in a pub and likely many people are injured. What is the mandated process - do you have to make a police report first, or do you provide medical care first ? Doing either can result in the doctor being blamed for something or other.
Or is there a dedicated "liason" whose job is to do the reporting and leave the care to the doctors. Which would mean staffing for a role like that would be difficult in a non-publicly funded medical institution.
Going by the article and my knowledge of the UK healthcare system, it's almost certainly care first, report later. It seems that the hospital is collating records of fights over longer periods of time - perhaps weeks or months - and providing that data to police. The article isn't really about reporting of individual crimes, but broader statistics for more targeted policing.
Unintended side-effect:
When two gangs fight and people get injured but don't want the police to know about the location of the fight (an illegal clubhouse?), wounds are either ignored or stitched up by backalley doctors.
When two gangs fight and people get injured but don't want the police to know about the location of the fight (an illegal clubhouse?), wounds are either ignored or stitched up by backalley doctors.
> When two gangs fight and people get injured but don't want the police to know about the location of the fight (an illegal clubhouse?),
Gangs tend to use social networks to organise fights. People in the UK tend to get wounds treated.
(http://www.scotland.gov.uk/Publications/2011/07/05130225/3)
> 89. Another innovative idea being taken forward is the sharing of 'anonymised' information collected at Accident and Emergency (A & E) departments in hospitals concerning the incidence of violence and use of weapons at particular geographical 'hotspots' so that police can track violence trends and take preventative measures. Many victims of violence do not report the crime to the police but do attend at A & E with their injuries. The National Violence Surveillance Network established by the Cardiff University Violence Research Group in England and Wales found that such measures led to decreased numbers of wounded victims attending A & E as a result of violence and a decrease in serious assaults reported to the police. A pilot study is underway in Lanarkshire hospitals along the same lines.
Here's what the Royal College of Nursing says about reporting crime: (http://www.rcn.org.uk/__data/assets/pdf_file/0009/287793/03....). This mentions the Cardiff Model.
2006: (http://www.independent.co.uk/news/uk/crime/the-streets-of-sc...)
> But doctors have admitted that the vast majority of stab wounds treated in the city's hospitals go unreported to the authorities. The scale of the violence is feared to be much greater than officially acknowledged.
[...]
> Last September the United Nation's crime research institute said Scotland was the most violent country in the developed world. Scots were nearly three-times more likely to be the victims of violent assaults than people living in the United States. More than 50 per cent of knives found by the police in Scotland are seized in Glasgow. Stabbings account for half of all murders.
2011: (http://www.heraldscotland.com/news/home-news/shocking-rise-i...)
> According to the newly-published annual Global Study on Homicide, the homicide rate in Glasgow stood at 3.3 per 100,000, compared to 1.6 in the English capital.
> The report also shows Scotland’s homicide rate remains higher than in many other European countries, including England and Wales, Poland, Hungary, Croatia, Spain, Portugal and Italy. Figures for France were not available.
2013: (http://www.scotsman.com/news/glasgow-knife-crime-falls-by-a-...)
> There were 903 assaults involving blades in the period 2012-2013, compared with 1,439 the year before, a fall of 37 per cent. The rate is down 57 per cent since 2006-2007, when 2,138 knife attacks were recorded in the city.
> Officers have attributed the fall in knife crime to an increase in stop and search procedures across Glasgow. In November, 2007 the number of such searches carried out in the city was 4,356. Five years on, this figure has risen to 26,669.
Gangs tend to use social networks to organise fights. People in the UK tend to get wounds treated.
(http://www.scotland.gov.uk/Publications/2011/07/05130225/3)
> 89. Another innovative idea being taken forward is the sharing of 'anonymised' information collected at Accident and Emergency (A & E) departments in hospitals concerning the incidence of violence and use of weapons at particular geographical 'hotspots' so that police can track violence trends and take preventative measures. Many victims of violence do not report the crime to the police but do attend at A & E with their injuries. The National Violence Surveillance Network established by the Cardiff University Violence Research Group in England and Wales found that such measures led to decreased numbers of wounded victims attending A & E as a result of violence and a decrease in serious assaults reported to the police. A pilot study is underway in Lanarkshire hospitals along the same lines.
Here's what the Royal College of Nursing says about reporting crime: (http://www.rcn.org.uk/__data/assets/pdf_file/0009/287793/03....). This mentions the Cardiff Model.
2006: (http://www.independent.co.uk/news/uk/crime/the-streets-of-sc...)
> But doctors have admitted that the vast majority of stab wounds treated in the city's hospitals go unreported to the authorities. The scale of the violence is feared to be much greater than officially acknowledged.
[...]
> Last September the United Nation's crime research institute said Scotland was the most violent country in the developed world. Scots were nearly three-times more likely to be the victims of violent assaults than people living in the United States. More than 50 per cent of knives found by the police in Scotland are seized in Glasgow. Stabbings account for half of all murders.
2011: (http://www.heraldscotland.com/news/home-news/shocking-rise-i...)
> According to the newly-published annual Global Study on Homicide, the homicide rate in Glasgow stood at 3.3 per 100,000, compared to 1.6 in the English capital.
> The report also shows Scotland’s homicide rate remains higher than in many other European countries, including England and Wales, Poland, Hungary, Croatia, Spain, Portugal and Italy. Figures for France were not available.
2013: (http://www.scotsman.com/news/glasgow-knife-crime-falls-by-a-...)
> There were 903 assaults involving blades in the period 2012-2013, compared with 1,439 the year before, a fall of 37 per cent. The rate is down 57 per cent since 2006-2007, when 2,138 knife attacks were recorded in the city.
> Officers have attributed the fall in knife crime to an increase in stop and search procedures across Glasgow. In November, 2007 the number of such searches carried out in the city was 4,356. Five years on, this figure has risen to 26,669.
Yeah, Glasgow is a bit of an outlier; a nasty mixture of poverty, unemployment, alcohol, and sectarianism gives it a long history of knife crime in some areas.
So the hospital started sharing its information with the police, after removing names and other identifying information.
Strange, I thought they were obligated to call the cops when someone with obvious such injuries went to the hospital. You know, if you have a black eye, broken nose and a stab wound, "I fell from the stairs" probably not gonna do it.
Strange, I thought they were obligated to call the cops when someone with obvious such injuries went to the hospital. You know, if you have a black eye, broken nose and a stab wound, "I fell from the stairs" probably not gonna do it.
Laws don't mandate this like they do for gunshot wounds. Doctors do have discretion, and if they feel that there is a danger to the public (i.e. a nutjob stabbing people) they are legally able to report it (it wouldn't be a HIPAA violation).
That said, due to the litigious nature of the US some patients are still likely to sue and/or generate bad press. While it's unlikely that a court would find the doctor/hospital guilty of any HIPAA violations it's a giant headache the hospital and their lawyers don't want to deal with.
That said, due to the litigious nature of the US some patients are still likely to sue and/or generate bad press. While it's unlikely that a court would find the doctor/hospital guilty of any HIPAA violations it's a giant headache the hospital and their lawyers don't want to deal with.
Better idea - save the data to a server, make an API (free), and let engineershelp visualize where the violence is occuring / predict where it will occur based on date/time
So, basically, you want someone else to do all the legwork and give you access to their data for free. Cool, we'll get right on that.
Thanks.
also - "their data" is public information anyways (or at least should be) - is basic crime statistics
I'm not claiming it's secret information that they own. But this is like the FOIA. Some smartass comes along, hears about FOIA, and declares "Well they should just digitize the entire archive, make it available in a queriable SQL database, and be done with it". The problem is, while the public has a right to the information, the representation, the storage of that data has issues. Digitizing millions of pages of records is not an afternoon's work (triply so if you want OCR). The reason we don't have such a database is not because John Spook is too lazy to spend thirty minutes doing it.
When you put hundreds of thousands of man-hours into digitizing an archive, there's essentially a cost/value-add. If there wasn't a value-add, why would you want this hypothetical database anyway? The crime information is public, why don't you just go compile it yourself!
When you put hundreds of thousands of man-hours into digitizing an archive, there's essentially a cost/value-add. If there wasn't a value-add, why would you want this hypothetical database anyway? The crime information is public, why don't you just go compile it yourself!
by leg work, you mean saving this 'shared information' to a database ? - ya get on it
It's so easy to dismiss considerable amounts of work as trivial when you don't have to do it, isn't it?
Yes doctor, you just hit the "save to SQL database" right here on your plastic clipboard...
Yes doctor, you just hit the "save to SQL database" right here on your plastic clipboard...
Whatever. Nothing special.
The whole thing of hospitals reporting violence police sounds is a gangster movie cliche: someone gets shot and his friends rush him to a disgraced dentist who removes the bullet on the kitchen table with a splash of whiskey and a dirty switchblade.
The whole thing of hospitals reporting violence police sounds is a gangster movie cliche: someone gets shot and his friends rush him to a disgraced dentist who removes the bullet on the kitchen table with a splash of whiskey and a dirty switchblade.
They didn't need to indiscriminately take patient records out of their backend systems or monitor the hospitals networks and reverse engineer http and packets. They didn't need to target individuals who are repeat offenders or violate any privacy consideratio.
I'd say 150 years ago the nurse was telling the sheriff the boys keep getting too roudy at the saloon, too.