Portland protests seen through lens of public health
The tragic murders of Breonna Taylor, George Floyd and Rayshard Brooks by police — as well as the killings locally of Kendra James, Aaron Campbell, Keaton Otis, Jason Washington and James Jahar Akbar Perez — have incited a demand for fundamental changes to policing practices.
Oregon legislators took important steps in the interim, passing six police accountability and tactic bills aimed at strengthening police disciplinary measures, requiring officers to prevent and report fellow officers' misconduct, and creating a Joint Committee on Transparent Policing and Use of Force Reform that will make recommendations for additional legislative action. The Portland City Council also took swift action, redirecting $15 million from the Portland Police Bureau to social service initiatives. Similar reforms have been initiated in states and localities around the nation.
This increased focus on reforming police practices and redirecting police funding is appropriate, long-overdue and promising. However, to fundamentally address the issue of police violence, we must recognize it for what it is: a national pandemic with public health impacts requiring public health action. The field of public health has garnered much attention in 2020, given its leading role in our global response to COVID-19. With its focus on health and safety at the population-level, public health is equipped to tackle not only infectious diseases, but also systemic issues such as police violence.
The inequitable and disproportionate impacts of police violence on Black, Brown, Indigenous, and other communities of color are well-documented, as are the resulting health outcomes (which include anxiety, stress and mental health trauma, detected among people of color not even directly involved). Given these racial inequities, does that mean that racism plays a part? The evidence says yes, and not just in the form of racist individuals or "bad apples." In fact, researchers have demonstrated that structural racism — the policies, practices, and norms that create and maintain white supremacy — is a predictor of police shootings of unarmed Black individuals. Police violence continues to occur because of oppressive and systemic inequities that are reinforced through policing and not addressed at the root cause, which is structural racism.
Structural racism impacts health by shaping the "social determinants" of health such as housing, education, income, employment, transportation and the physical environment (e.g., access to healthy foods or safe recreational settings). In the United States, structural racism results in inequitable access to opportunities at every level, and it is this inequity that places communities of color at higher risk for COVID-19 infection and its most severe outcomes. And much like COVID-19, structural racism is an unremitting, devastating public health crisis that requires fundamental changes at the systems level.
Inequities in all public health and safety issues continue to occur because of structural racism, and we must not be distracted by the current emphasis on police reform to the point that structural racism remains unaddressed. Instead, we can utilize public health tools to design and promote equitable, community-led solutions. Public health solutions are science-based, prevention-focused, and multi-level. They are rooted in equity and social justice and promote systems-level change. As in the fight against COVID-19, government leaders must partner with public health professionals for evidence-based guidance in confronting the health effects of structural racism and working to intervene on these oppressive, systemic forces.
Dr. Kathleen Carlson, Ph.D., is an injury and violence prevention researcher, associate professor at the OHSU-PSU School of Public Health, and chair of the OHSU Gun Violence as a Public Health Issue Advisory Committee. Dr. Dawn Richardson, Ph.D. is an associate professor of community health and a social epidemiologist in the OHSU-PSU School of Public Health, where she serves as Chair of the Diversity, Equity, and Inclusion Committee. The views expressed here do not necessarily represent those of OHSU or PSU.
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