Public funds, public safety: a scoping review of government spending decisions and their impact on interpersonal violence and suicide.

Abstract

<h4>Objectives</h4>To conduct a scoping review of research on government spending and violence.<h4>Methods</h4>We searched nine databases for peer-reviewed publications evaluating the association between government spending on public goods and services and (other- or self-directed) violent physical injury or death in the United States.<h4>Results</h4>Of 5,734 screened articles, 33 met the inclusion criteria. Over one-third of studies were published in the last ten years (n = 13). Studies most commonly evaluated spending at the state (n = 19), county (n = 5), and city (n = 5) levels. Studies examined spending on social welfare (n = 21), health (n = 12), education (n = 9), law enforcement (n = 8), and/or community development (n = 2). Outcomes were homicide/assault (n = 28) and suicide (n = 17). All studies were ecologic, 24 were serial cross-sectional, and most (n = 28) made attempts to control for confounding. Findings were mixed, but studies of social welfare, health, and education most commonly found that increased spending was significantly associated with reductions in violence.<h4>Conclusions</h4>While research has varied somewhat in methodology and findings, results of this scoping review indicate that government investments in supportive services may be promising structural interventions to prevent violence and promote safety and health.