CRIMINAL JUSTICE

AJPH PUBLIC HEALTH DIALOGUE

Understanding Police Violence as a Mutual Problem

See also Morabia, p. 421, and Gilbert, p. 457.

This past Thanksgiving, I was in Chicago visiting family when a cellphone video of a police officer taking down a man hit the local airwaves. The images showed an officer using an emer- gency maneuver that resulted in the man’s head hitting the pavement. There was an imme- diate outcry; it was said that the takedown was unwarranted, yet another case of “rogue policing.” Lost in the clamor was that the man was intoxicated and had verbally threatened, licked, and spit on the officer. The man further refused ambulance transport, and the officers them- selves took him to the hospital for care. At the time of this writ- ing, two officers remain under in- vestigation, while the man was bailed out of jail (he had out- standing parole violations) amid claims that he was “thrown onto the sidewalk with no regard for his life” (https://bit.ly/37piikW).

Is this another example of police violence or simply an of- ficer trying to protect himself? If all politics are local, then most opinions are personal. I will freely admit that my view of law en- forcement comes from more than 20 years of working night shifts in the emergency department, watching officers and deputies protect society’s most vulnerable. To be quite honest, I am most often impressed at the restraint police officers exhibit when

dealing with violent and abusive people and when faced with imminent threats to life and limb. The idea that unthinking vio- lence is somehow basic to law enforcement system seems con- tradictory to my lived experi- ence. Individuals and institutions within the law enforcement community want to do right, and while one might argue that they do so not out of goodness but out of fear of public backlash, every- one recognizes that law enforce- ment officers can only dotheir job well if they do so with restraint, impartiality, and integrity. There are bad cops, just as there are those ill-suited to any profession, and sometimes people who clearly do not belong in police work can slip through the cracks. But it is a certainty that within law en- forcement nobody likes a bad cop.

WHAT IS POLICE VIOLENCE?

Part of the problem is that we do not know what “police vio- lence” really is or the true scope of the problem. Obasogie and Newman note that the exact definition of police violence is vague, and is most often a subjective interpretation of the constitutional minimum that the “use of force must be reasonable.”1(p286)

Statistics on police violence as a whole are hard to come by, but data on police shootings are more available. The 2015 Police Vio- lence report from the Mapping PoliceViolenceWebsiteindicates that there were 1152 people killed in police shootings that year. The context of the event is also important: more than 1000 of these fatalities were reported to be armed (https:// mappingpoliceviolence.org). In these cases, a true threat may well have been perceived at the moment of the use of deadly force. The threat to law en- forcement officers is real; 42 officers were killed by gunfire in 2015 (https://n.pr/2rEKFg8).

While research clearly shows that racial minorities are dispro- portionately more likely to be the recipients of deadly force, other works describe the disparity in prevalence as a result of the as- sumption that Blacks and Whites are equally likely to encounter police. It seems a reasonable middle ground to presume that these disparities, while unques- tionably present, themselves are a function of the population

encountered by law enforce- ment; unfortunately, this population is highlighted by overrepresentation of racial and ethnic minorities rooted in so- cioeconomic factors also com- mon to disparities in income, education, and health.

What is “reasonable force” is in the eye of the beholder, and more often than not that be- holder is a Monday-morning quarterback of a situation they never truly understand. It is easy to jump on the bandwagon that police are agents of vio- lence while one is sitting in the stands.

NEEDING EACH OTHER That is why I am surprised that

the public health community, which places value in commu- nity, collaboration, and under- standing stakeholders’ views, writes in the first sentence of the 2018 American Public Health Association (APHA) policy “Addressing Law Enforcement Violence as a Public Health Issue,” that “Physical and psychological violence that is structurally mediated by the sys- tem of law enforcement results in deaths, injuries, trauma, and stress that disproportionately affect marginalized populations . . .”

ABOUT THE AUTHOR Howard Rodenberg is physician advisor for clinical documentation integrity, Baptist Health, Jacksonville, FL.

Correspondence should be sent to Howard Rodenberg, Physician Advisor, Clinical Docu- mentation Integrity, Baptist Health, 3563 Philips Highway, Building A, Suite 108, Jack- sonville, FL 32207 (e-mail: [email protected]). Reprints can be ordered at http:// www.ajph.org by clicking the “Reprints” link.

This editorial was accepted January 16, 2020. doi: 10.2105/AJPH.2020.305585 Note. The opinions expressed herein are those of the author and do not reflect those of Baptist

Health.

456 Editorial Rodenberg AJPH April 2020, Vol 110, No. 4

(https://bit.ly/37iFrFD). The text of the document reinforces this adversarial message while failing to recognize any of the challenges of police work.

While the position state- ment does make positive rec- ommendations, most notably the need to address the underlying social determinants of health, those points are lost in the rhet- oric sure to set law enforcement on the defensive. That is not the way to build collaboration. It is no wonder that the Statement of Policy on Police Violence and Racism from the National As- sociation of County and City Health Officials (NACCHO), a group comprising public health leaders who work with law en- forcement on a daily basis, takes a much different tone, emphasiz- ing understanding of police roles and mutual collaboration while making similar points (https:// bit.ly/2TBrYW8). Surprisingly, the hostility espoused by the APHA does not seem to exist on the law enforcement side, with works highlighting ways in which our worlds can align and support one another through

growing awareness of our interconnections.2–5

SOLUTIONS There is no doubt that police

departments can do better. Obasogie and Newman provide a content analysis of use-of-force policies that provides a theoreti- cal grounding for terms and conditions that apply to these critical incidents.1 The Mapping Police Violence project has also demonstrated that changes in use-of-force policies can de- crease the numbers of fatalities that result from police shootings. Effective measures include re- quiring officers to use all other means before shooting, requir- ing that all use of force be re- ported, banning chokeholds and strangleholds, establishing a con- tinuum for the use of force, and requiring that de-escalation tech- niques be brought into play (https://mappingpoliceviolence. org). Each of these measures has its own implications for officer selection and training, and they

appear to be measures that may be agreed to by all parties with a minimum of disruption to cur- rent law enforcement program- ming. More importantly, they can be promoted in a spirit of collaboration to concurrently re- duce risks to both police officers and the community. I believe that thesemeasuresarebestadvocatedat the community level, where rela- tionships between local officials already exist, with public health agencies taking the lead in estab- lishing community consensus around workable solutions.

A few years ago, NACCHO developed a badge-shaped logo torepresentpublichealth (https:// bit.ly/37mfWnh). The shape linked us to the other members of the public protection family who wear the badge, including fire safety, emergency medical services, and law enforcement. And the family does a lot bet- ter around the Thanksgiving table engaging in mutually supportive dialogue than in hurling invective at the quality of the stuffing.

Making police violence an issue of inherent bad faith and

racism, where one party is thought morally superior to the other, does not facilitate solu- tions. Understanding police vi- olence as a mutual problem to be resolved just might.

Howard Rodenberg, MD, MPH

CONFLICTS OF INTEREST The author has no conflicts of interest to declare.

REFERENCES 1. Obasogie OK, Newman Z. Police vio- lence, use of force policies, and public health. Am J Law Med. 2017;43(2-3):279–295.

2. Robert V. Wolf Center for Court In- novation. Law enforcement and public health.February2012.Availableat:https:// www.courtinnovation.org/sites/default/ files/documents/LawEnfPubHealth.pdf. Accessed February 12, 2020.

3. Shepherd JP, Sumner SA. Policing and public health—strategies for collabora- tion. JAMA. 2017;317(15):1525–1526.

4. van Dijk A, Crofts N. Law enforcement and public health as an emerging field. Policing Soc. 2017;27(3):261–275.

5. van Dijk AJ, Herrington V, Crofts N, et al. Law enforcement and public health: recognition and enhancement of joined- up solutions. Lancet. 2019;393(10168): 287–294.

Keon Gilbert Comments

See also Morabia, p. 421, and Rodenberg, p. 456.

Police-involved shootings challenge our thinking about the intersections of race, gender, class, and place, which are em- bedded in everyday practices and policies governing law enforce- ment. The Mapping Police Violence (MPV) Web site estimated that 1164 people in the United States were killed by police in 2018.1 Howard Rodenberg’s essay (p. 456) re- flects a collective cognitive dis- sonance that comes with new reports of officer-involved

shootings that structure four socially accepted views: (1) po- lice are good and serve our communities to ensure safety; (2) police have dangerous and stressful jobs; (3) training, ethics, and values guide police behav- iors; and (4) if you are arrested, hurt, or killed by police—these “justify” use of force.

Evidence documenting police-involved shootings chal- lenge these views and are less understood because of the lack of data collected over time and

across all police agencies, limiting the precision and magnitude of estimates. MPV reported 104 unarmed Black people being killed by police in 2015. What is not reported in Rodenberg’s comments is that unarmed Black people are five times more likely than White people to be killed by police. In 2015, 50 police officers were shot and killed, while many

more died resulting from other causes such as suicide.2 Is it the general community or just Black and Brown residents who are the risk to police? As crime rates decline, policing in poor, Black, and Brown neighborhoods in- creases, and this becomes a fatal risk for being killed by police in those neighborhoods.3

Rodenberg’s essay stems from an incident with Bernard Kersh in Chicago, Illinois, which exem- plifies the lack of police training to

ABOUT THE AUTHOR Keon L. Gilbert is with the Department of Behavioral Science and Health Education at Saint

Louis University, College for Public Health and Social Justice, 3545 Lafayette Ave, St Louis, MO 63104 (e-mail: [email protected]). Reprints can be ordered at http://www.ajph. org by clicking the “Reprints” link.

This comment was accepted January 14, 2020. doi: 10.2105/AJPH.2020.305590

AJPH PUBLIC HEALTH DIALOGUE

April 2020, Vol 110, No. 4 AJPH Gilbert Editorial 457

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