By Kieran Mccartan, PhD, & David Prescott, LICSW
In recent years, professionals, researchers, and other interested people have made a slow but certain shift towards understanding sexual offending as a public health issue as well as a criminological and psychological challenge. This understanding has led to conversations about the role of the developmental, psychological, social, and behavioural histories of people who commit sexual abuse as precursors to abuse. Those discussions have in turn linked to understanding and implementing adverse childhood experiences, trauma informed care, strengthens based approaches, and other elements of rehabilitation and desistance at the levels of research, theory, and practice. In the UK we are seeing a close joining together of Public Health England, The NHS, and Ministry of Justice to discuss the prevention of, and response to, serious violence. Prevention of sexual and other serious forms of violence and abuse, is gaining momentum and we are now talking about primary, secondary and tertiary prevention more in a criminal justice frame than ever before; although, we still have a way to go with quaternary prevention (which is the harmful effects of overmedicalisation on patients health, or in criminal justice terms how overly putative criminal justice responses prevent desistence and facilitate reconviction). However, despite all this movement, the vast majority of public dialog is about responding to individual cases and people, not at a population level.
An emerging part of criminology, which has always been a multidisciplinary endeavor by its very nature, is Epidemiological Criminology (abbreviated as EpiCrim) (Waltermaurer & Akers, 2014). Epidemiology is a subdivision of public health and it focuses on health, and health-related issues, at a population level. Ultimately it is a methodology for understanding the health of a population and how this relates to individual members of said population. EpiCrim is defined as:
“the explicit merging of epidemiological and criminal justice theory, methods and practice. Consequently, it draws from both criminology and public health for its epistemological foundation. As such, EpiCrim involves the study of anything that affects the health of a society, be it: crime, flu epidemics, global warming, human trafficking, substance abuse, terrorism or HIV/AIDS.” (Lanier, 2014)
At its core, EpiCrim is about how different disciplines can come together to explain the intersection of crime and heath, and therefore it has relevance for the prevention of crime, the response to crime and the management of people who have committed crimes (especially via prison, probation/parole and social care). So how does this translate into sexual offending and sexual abuse?
The international growth in sexual abuse prevention research and practice over the past 10 years or so speaks to the relevance of EpiCrim for our field. Sexual offending, especially in westernized, anglophone countries, is becoming rooted in a in a health and justice frame. This is clear evidence of EpiCrim in action! It is now possible to discuss the societal and individual correlates of sexual offending and the contributions of health, psychology and behavior to them. Sexual abuse research has a number of methodological approaches that link marco and micro-level data about sexual abuse together. Currently, our field is also starting to see more calls for research and funding streams linked to this intersection of health and justice, both in terms of first-time prevention and treatment/relapse prevention. Research already exists, at a theoretical level, that ties Child Sexual abuse to EpiCrim principles (Skvortsova, 2013). This indicates that EpiCrim fits a theoretical gap in the field of child sexual abuse that existing theories have not bridged because it brings together behavioral, individual and societal elements. It therefore links the individual to society. Many would argue that EpiCrim acts as an umbrella for all three of the main stages of prevention (primary, secondary and tertiary). We would argue that it also includes quaternary prevention. EpiCrim acts, therefore, as a box to house research and practice into the developmental, social, health and psychological correlates of sexual offending in a way that can be used use in a cross-disciplinary fashion. As Lanier (2014) states, EpiCrim means that we have a common point of reference and a shared lexicon across social care and justice for thinking about crime; however, we in criminal justice related fields need to learn how to convey that message to the population in a constructive, easy to navigate fashion.