Public Health

11 beginning steps to reform policing and tackle racial injustices

Kevin B. O'Reilly , Senior News Editor

What’s the news: The AMA is urging Congress to “find common ground on a path forward on effective and equitable policing reforms” and has outlined a set of steps to address the long-standing problems of police brutality, systemic racism and racial injustice.

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In a letter to Democratic and Republican congressional leaders in the U.S. House and Senate, AMA Executive Vice President and CEO James L. Madara, MD, detailed physicians’ support for the following changes, among others:

  • Research into the public health consequences of violent police interactions.
  • States requiring the reporting of legal-intervention deaths and law-enforcement officer homicides to public health agencies.
  • For appropriate stakeholders, including law enforcement and public health communities, to define “serious injuries” for the purpose of systematically collecting data on law enforcement-related nonfatal injuries among civilians and officers.
  • Law-enforcement departments and agencies having in place specific guidelines, rigorous training and an accountability system for the use of conducted electrical devices, often called Tasers.
  • Research into the health impacts of conducted electrical device use and development of a standardized protocol developed with the input of the medical community for the evaluation, management and post-exposure monitoring of subjects exposed to these devices.
  • Increased use of body-worn cameras by law enforcement officers, as well as funding for the purchase of body-worn cameras, training for officers, and technical assistance for law enforcement agencies.
  • Training for law enforcement at all levels on implicit or unconscious bias and structural racism.
  • School discipline policies that permit reasonable discretion and consideration of mitigating circumstances when determining punishments rather than “zero tolerance” policies that mandate out-of-school suspension, expulsion or the referral of students to the juvenile or criminal justice system.
  • More research to identify programs and policies that are effective in reducing disproportionate minority contact across all decision points within the juvenile justice system.
  • Reauthorizing federal programs for juvenile justice and delinquency prevention, which should include incentives for community-based alternatives for youth who pose little risk to public safety, reentry and aftercare services to prevent recidivism, and policies that promote justice to reduce disparities.

The AMA also opposes “choke and sleeper holds as the use of deadly force with the potential to kill,” says Dr. Madara’s letter.

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“These are but a few of the necessary reforms to address the national disgrace of excessive use of violence against individuals who are part of minoritized and marginalized communities,” Dr. Madara wrote. “We are at a critical point in our nation’s reckoning with issues of police use of violence, racism, and discrimination. The use of excessive police force is a communal violence that significantly drives unnecessary and costly injury, and premature morbidity and death. Police brutality and racism must not be tolerated. We urge Congress to act now on meaningful and effective policing reform legislation.”



Why it’s important: Research shows that “racially marginalized communities are disproportionally subject to police force, and there is a correlation between policing and adverse health outcomes,” says the AMA’s letter. “An increased prevalence of police encounters is linked to elevated stress and anxiety levels, along with increased rates of high blood pressure, diabetes, and asthma—and fatal complications of those comorbid conditions.” 

Other medical research has found “that law enforcement-involved deaths of unarmed Black individuals were associated with adverse mental health consequences among Black American adults—regardless of whether the individual affected had a personal relationship with the victim or the incident was experienced vicariously,” Dr. Madara noted.

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“The trauma of violence in a person’s life course is associated with chronic stress, higher rates of comorbidities, and lower life expectancy, all of which bear extensive care and economic burden on our health care system while sapping the strength of affected families and communities,” he added.

Find out why police brutality is a matter of public health.

Learn more: The AMA Board of Trustees has pledged action to confront systemic racism and police brutality. In a joint AMA Leadership Viewpoints column, the AMA’s imediate past president and immediate past chair declared that “police brutality must stop.”

Systemwide bias and institutionalized racism also contribute to inequities across the U.S. health care system. The AMA is fighting for greater health equity by identifying and eliminating inequities through advocacy, community leadership and education.