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Policing Tactics Can Affect Health Inequity, Association Says

An attendee at the 2018 American Public Health Association conference in San ...

Credit: American Public Health Association

Above: An attendee at the 2018 American Public Health Association conference in San Diego holds up a T-shirt that says "Health Equity Now," Nov. 12, 2018.

The debate over police-community relations isn’t just a political concern but also a matter of public health. That’s according to the American Public Health Association, which unveiled new findings in San Diego during its annual conference focused on health equity. KPBS Reporter Tarryn Mento heard the details from Executive Director Dr. Georges Benjamin.

Q: You focused on health equity. Why is that important?

A: Well you know we brought 13,000 of — I jokingly say — my closest friends here to really explore the issue of equality versus equity, and to some degree of justice. Equality: where everyone gets the same thing; equity means where people get what they need, and trying to do it in a way where people get it in the right way, which is the justice component of that.

Q: Why does addressing this matter to public health?

A: We will never achieve our best health if we don’t deal with everyone, and do it in a way that accomplishes people getting their best outcomes...You can’t raise the boat unless you raise the boat for everyone and that means focusing like a laser on health equity.

Police violence and public health

Q: The association recently made a statement that police violence is a public health issue. What do you mean by that?

What The APHA 2018 Policy Statement On Police Violence Calls For

  • Congress to fund research on law enforcement violence
  • Review of law enforcement policies that can lead to violence disproportionately affecting certain communities
  • Funding for more community-based efforts, restorative justice programs

Source: American Public Health Association

A: Police violence creates both injury and death, inappropriately of course, and it creates an environment of fear. We know that that fear environment influences our children, their health and well-being, influences their mental health, influences their actual growth. It results in early childhood trauma for those children who live in these communities in which people are afraid, so it's a big issue.

Photo caption: American Public Health Association Executive Director Dr. Georges Benjamin sp...

Photo credit: American Public Health Association

American Public Health Association Executive Director Dr. Georges Benjamin speaks with KPBS Reporter Tarryn Mento, Nov, 14, 2018.

Q: What can be done to address that issue?

A: The police work very hard on community policing and we support that. We think that’s a good first step, but it’s important for police communities and community leaders to get together, for people to understand one another. We have to deal with stigma, we have to change things so that for me, as an African American without my tie on, I’m not afraid that I’ll get stopped because someone’s afraid that I have a gun because I’m going to hurt them. But you know the problem I have? Is that they feel that way anyway, because I’m a big African American guy even if I have a tie on, people feel threatened. And we have to change the environment so we’re not threatened by people who should not be threatening to you.

Q: Have you been stopped a time where you believe there was no reason to stop you?

A: I’ve had people stop me. I’ve had, you know, I go into a store and I’ve had them follow me around. I generally go out and come back in so I can enjoy the experience a second time. Yeah, I’ve had people look at me and I have perceived that they’re looking at me because I’m African American and they’re suspicious of what I’m doing. I think most African American men have had that experience.

Q: How does that feel?

A: Oh, it’s disheartening. I’m obviously a lot more knowledgeable about this, but I think we all feel a little threatened when that happens.

Q: How can that feeling be harmful to a person’s wellness?

A: One of the things we clearly know is that when you feel threatened, it changes a whole range of hormones in your body. Those hormones influence your weight, your growth, how you respond to others...You put people in a more stressful environment, their blood pressure goes up because of hormonal changes and so we know it has enormous changes.

Children — when these children are in these high stress environments, it changes a whole lot of things including brain development, other physiological development. We are increasingly learning a lot about early childhood trauma and how stress plays an enormous role in that. Fast-forward to when these kids are in pre-school, then elementary school, they have difficulty in school and then they get further stigmatized in school as bad kids or kids with (attention deficit disorder) and then you have psychological issues in addition to some of the physiological issues that you see with the stress.

Q: What is the goal of the association with the approval of this policy statement that police violence is a public health issue?

A: We hope that when we pass a policy like this, that it empowers our members to take the sense of these policies to work on their communities to improve it. In fact, it becomes empowering for our members to go to city councils and show up at public hearings and say, 'Yep, I should go to that public hearing and say police violence is a public health issue.' We’ve made that statement and so it helps drive people there.

Fear among students of color

Q: One of the last pieces of new information that the association revealed was about how college students of color experience fear of violence and crime at a higher rate than their white peers. Can you explain the significance of those findings?

Findings From Study On Feelings Of Fear Among Students Of Color

The survey asked 1,400 University of Francisco students to rank their fear on a scale of 0 (none) to 10 (maximum).

Fear of murder

Students of color: 2.29

White students: 1.23

Fear of hate speech

Students of color: 3.89

White students: 1.84

Fear (in general)

Students of color: 4.53

White students: 3.43

Source: American Public Health Association

A: It goes with all the other challenges we have for communities of color, feeling threatened, feeling targeted by others. When you feel threatened, when you feel targeted, you respond to that, to the extent that we just want people to feel equally safe. I think if we can create a society where we all feel equally safe, we’ll have much more prosperity.

Q: When you think of public health, many think of infectious diseases but not so much about the state of mind. How does mental health become a matter of public health?

A: The brain is connected to everything else and the mental health of a person determines a lot of their health and wellbeing. The World Health Organization has a definition of health that’s been around since about 1948 and it is a holistic definition of health and that includes mental health. When I was practicing in the emergency department, I can tell you the number of people who came in with quote-unquote somatic illness, meaning that they have abdominal pain or chest pain which turned out to have a mental health component to it. It wasn’t all in their heads, quote-unquote, but it always had a mental health component to it. We often disconnect the mental health part of healthcare from the physical part of healthcare, and you can’t do that. We have to treat people in a much more holistic manner. And public health tries to do that. We don’t necessarily do it individual by individual, we try to do it from a broad population perspective, so that means we deal with these things. If you don't think that it’s a big issue, the biggest problem -- I mean there’s many that occur after these big disasters -- but the biggest problem that lingers in every hurricane, tornado, these wildfires in California, the biggest lingering major problem is the mental health aspect.

Q: How are we doing on addressing that?

A: Not well. We’re not putting the resources in it, we’re not addressing it holistically. I mean there are efforts obviously, the federal government tries, the local health departments try. But I remember when I was a health officer in Maryland, we had a tornado that went through southern Maryland, the lingering impact on not just the local community but the elected leaders who all had to stand up and be strong for their community was profound. They were all under enormous stress, and we tried to help them through that.

Highlighting The Progress

Q: We talked about a number of concerning issues in public health, but where is the hope?

A: We are making progress in health in this country. We are seeing much more lower rates of cardiovascular disease, for example. We’re making tremendous progress in tobacco control for combustible tobacco; we’re having challenges now with e-cigarettes but we’re getting our hands around that or at least trying to get our hands around that problem.

You’re seeing some leveling off on things like obesity. We’re doing much better health education. I think overall the health of the public is getting better in general. We do have things to intervene like opioids, which has entered the community. And we have things like these new scooters, right, which is now going to be a major disruptor because we have people wearing seatbelts in their cars and helmets on their bikes but they’re all on scooters without helmets, going very quickly through the community, so we do have some challenges. But I think we‘re very good at identifying those challenges and I think the hope of improving the health of the public is very strong.

An association of public health officials unveiled policy and research announcements in San Diego during its annual conference.

This interview has been edited for brevity and clarity. Sponsors for the American Public Health Association conference include The California Endowment, which also supports City Heights reporting by KPBS.

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