By Guest Columnists Omid Bagheri, MPH and Julianna Alson, MPH
1.8 Billion. Imagine how that amount of money could be invested instead into healthcare, housing, education and other social determinants of health. Instead, the Centers for Disease Control and Prevention (CDC) estimates that we’re spending that much on fatal and non-fatal injuries by law enforcement, including medical costs and work lost.
In November 2018, the public health field took major strides toward addressing a critical health equity and human right issue when the American Public Health Association (APHA) adopted a resolution naming law enforcement violence as a public health issue, and urging all levels of government and public health departments to take action.
The nation’s largest organization of public health professionals, with a membership of over 25,000, the APHA adopts member-written policy resolutions that guide the organization’s legislative, advocacy, and lobbying work. Procedurally, the APHA takes policy statements through a rigorous review process, culminating with a vote at its annual meeting by a representative body of practitioners across different public health sectors. Adoption of this policy statement signifies that these sectors – as diverse as public health nursing, international health, health law, sexual and reproductive health, immigrant and refugee health, and more – agree publicly for the first time that we must take a public health approach to prevent and mitigate the harms of violence by law enforcement.
November’s milestone also signifies the victory of a three-year long campaign, led by the End Police Violence Collective, a group of public health professionals, organizers, and educators committed to anti-oppressive and anti-racist work. Inspired by generations-long grassroots movements for human rights and freedom from violence, the End Police Violence Collective came together to advocate for a public health approach to state-sanctioned violence. With guidance from grassroots movement leaders, the group used the statement and advocacy efforts to emphasize the physical and mental health effects of police violence on marginalized communities, such as people of color, immigrants, individuals experiencing houselessness, people with disabilities, the Lesbian Gay Bisexual Trans and Queer (LGBTQ) community, individuals with mental illness, people who use drugs, and sex workers.
The statement is rooted in an analysis of structural racism and the systemic nature of law enforcement violence. With a public health approach, rather than a criminal justice approach, we can shift the conversation away from the accepted idea that the criminal justice system is the most effective means to address what is ultimately social and economic challenges better addressed through public health interventions.
The statement draws on empirical evidence and a social determinants of health framework to illustrate the effectiveness of remedying the root causes of individual and interpersonal harms. Part of this includes understanding the structurally mediated forces that create harm. Often cited is the commonly held notion the behavior of individual law enforcement officers are to blame for disproportionate violence toward marginalized individuals, yet a public health approach asserts that underlying conditions of the institutions, systems, and society we live in determine our health outcomes. Eliminating or changing the the behavior of law enforcement (e.g. a downstream intervention) will not address law enforcement violence.
The statement outlines policy strategies for governmental agencies and public health professionals to address basic human need through investment in education, social, and economic opportunities and community-based alternatives to public safety that does not criminalize people. It calls for structural and systemic changes to law enforcement policies and procedures that promote violence and inhibit accountability, rather than just “tweaks” (e.g. body cameras, community-oriented policing, implicit bias trainings). It calls for better data collection and surveillance to allow a deeper understanding of the true toll of law enforcement; there is currently no single comprehensive database on deaths or injuries committed by law enforcement.
This call to action is for all of us – public health practitioners, health law advocates, and policy-makers. We can and must work across sectors to ensure the right to health of our most marginalized community members by asking the right questions and taking a true public health frame in shaping our advocacy, litigation, and policy efforts. For example, how do Washington State Department of Health, Public Health Seattle King County, and other jurisdictions collect data on law enforcement-induced injury and death? Are data disaggregated by race? How do the contracts between cities and police unions allow officers to enact violence with impunity, and inhibit accountable transparent investigation into incidents of injury or death? How do our budgets prioritize penal approaches over the social structures that support healthy communities? How can funds currently allocated to the criminal justice system be shifted to provide access to health care or housing? By asking all of these questions and more – in partnership with communities most affected by police violence – we can take up the call of APHA to advance health equity.
Read the policy statement and its call to action for policy makers and advocates here.
Omid and Julianna are both co-authors of the recently adopted APHA policy statement and based in Seattle, WA. Omid is faculty at the University of Washington School of Public Health and Director of Equity & Community Partnership at JustLeadWA. Julianna is a Research Coordinator in the Department of Obstetrics & Gynecology at the University of Washington, with a focus on reproductive justice and racial equity.