What the UK Knows About Violent Crime The US Cannot Understand

Is it possible that Republicans are unaware of the intrinsic connection between reducing child poverty and reducing crime, despite a wealth of evidence from around the world? This week, the Internal Revenue Service (IRS) began rolling out President Biden’s new child tax credit as part of his $ 1.9 trillion US bailout. The expanded benefits aim to lift half of the country’s smallest citizens out of poverty. As a British forensic psychiatrist and psychotherapist, this caught my attention. Although an outsider looking in, I was surprised that the legislation passed without a single Republican vote in support, especially in light of their “hard” stance on crime.

Poverty is a form of ‘adverse childhood experience’ (ACE) that affects future outcomes in life. The idea is not new: American researchers first stressed the importance of ACEs in a large study in the 1990s. Their construction has since been universally adopted and supported by the world community; WHO has even developed a ‘ACE International Questionnaire‘to guide investments and social interventions. It is easy to understand that poverty can cause problems such as malnutrition and chronic disease. But physical deprivation is only half the story. Having socially and materially disadvantaged parents can also be a form of ACE, just like the conditions of your community. Your ACE “score” is based on one point for each type of negative influence: including obviousness, such as direct abuse and material neglect. Along with parental mental illness and parental substance abuse, parental incarceration is another ACE of particular concern in the United States, given the high incarceration rate. 45% of the American population have had a family member incarcerated, which among minorities amounts to reach 63% in the black community.

For the past 30 years I have worked in the UK’s National Health Service which includes the provision of mental health care to offenders in our prisons and secure mental hospitals. I provide expert testimony on the roots of violence in criminal and family courts and have studied the research evidence on the link between poverty, social inequalities, mental health issues and different types of crime. I have seen with my own eyes in our prison population that the majority of convicted offenders come from disadvantaged backgrounds, including a disproportionate number of economically disadvantaged minorities.

The same is true in the United States, although at a on a larger scale. Recent data from the CDC and others shows how a child exposed to 4 or more types of ACE is at increased risk for criminal violence. A study of 20,000 offenders in a Florida prison found that the higher the ACE score, the more likely offenders were to commit repeated violence from a young age. The authors called this “downstream wreckage,” demonstrating how a person’s chances of becoming a serious, chronic, and violent offender increased with each additional ACE point. Half of all the prisoners they studied had been exposed to four or more ACEs. Their report ends with this warning: “The prevention of ACE in future generations is critical and a key factor in preventing crime.

In my work, I have found that ACEs regularly interact with other known risk factors for violence to make cruel states of mind more likely. We are all capable of cruelty to others, just as we all have the capacity of compassion; luckily most of us never get to the point where we act on our darkest emotions. In order for someone to reach that tipping point, several elements have to combine, which I compare to how the numbers line up in a combination lock. When it comes to serious violence, the first two variables tend to be actuarial, such as being young and male. The next two include familiar ACEs, such as substance abuse and parental neglect. But the final number that makes the lock pop, unleashing sometimes deadly violence, is idiosyncratic. I found it to be an individual experience of an intense and painful feeling with deep roots in someone’s early childhood, very often linked to early childhood trauma and unresolved feelings of horror. and shame. Shame, defined by Carl Jung as a “soul-consuming emotion”, is central to the experience of poverty because of the impact on social status and the sense of social exclusion that accompanies it.

Some will protest that a simplistic correlation between poverty and violence is unfair to the majority of people who, although poor, are honest and pro-social; I totally agree. The early ACE researchers were also aware of this, citing a range of positive influences that could counteract a person’s negative experiences during their childhood, including having caregivers, the access to a good education and social programs that support their families. The victims tend to be people who lack care and access. It is also important to understand that identifying risks through CEAs is not the same as prediction; there will be people who have been exposed to multiple ACEs who will not become criminally violent. They may be more resilient in ways we don’t fully understand, or they may just be lucky. But overall, the association between high exposure to childhood adversity and subsequent criminal violence cannot be ignored.

I understand that economic conservatives will always oppose increased government spending and are unlikely to be interested in the observations of a British doctor from a ‘socialist’ healthcare system. Rather than debating ideologies, I would highlight the data, as the proportionately much lower violent crime rate in the UK compared to the US, including homicide. I suggest that the introduction by the British government in 1977 of a similar and permanent family allowance measure to that of Bidens had some impact on rates of violence (as well as other factors, including our very different laws on the possession of firearms). I also recognize that the UK has its own serious problems of incarceration and socio-economic inequality, both of which have increased sharply in recent decades. The UK is also not the biggest social spender in terms of percentage of GDP; in 2019, the World Economic Forum report ranked the UK 8th, well below countries like Belgium, Spain and Japan, and closer to the US, ranked 10th. There is much more to do.


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The Biden administration’s upcoming legislative proposals call for an even greater investment in social programs, including making their child tax credit permanent. I wonder if the resistance to this from the right can be challenged using the crime reduction argument, which has been such a vaunted plank of Republican politics. Such a tactic could be particularly effective at a time when the right-wing redoubles its efforts to portray Democrats as “crime-lenient” and deliberately distorts some constructive ideas about law enforcement reform in the wake of George’s murder. Floyd. How can they condemn “police definancing” while rejecting funds for an ongoing social program that could be so transformative in the fight against crime? There is also a useful analogy with the Covid pandemic. Right now, governments around the world are rushing to vaccinate their citizens against this deadly virus that has changed all of our lives. I think the Biden administration’s rollout of the Child Tax Benefit today can be seen as comparable and just as urgent: a sort of “vaccination” against the rise in violent crime now and in the next generation.

Suppose this enhanced “social security for children” becomes permanent. Americans could see a profound impact on ACEs in the short and long term, as greater economic security plays its role in reducing anxiety, abuse, and criminal behavior among parents. Their increased well-being contributes to a more secure future for their children and for society as a whole. The fractured global response to the pandemic has demonstrated our fragility when we are divided in the face of a threat that knows no party. We shouldn’t have to wonder if we can convince each other that the safety and well-being of a society depends on the protection and nutrition of children as they grow older. The real question may be whether we in the US, UK or the wider world community can afford not to act.


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