Policing as a Public Health Crisis

The recent police shootings of unarmed black men, the lack of police indictment and the assassination two New York City police officers has caused tremendous unrest in communities across the country. As a public health nurse, I have been challenged to determine my role in supporting the vulnerable, as this is clearly a public health crisis. The New York City Commissioner of Health, Dr. Mary Bassett, posted a riveting piece in The New England Journal of Medicine entitled "#BlackLivesMatter -- A Challenge to the Medical and Public Health Communities." Dr. Bassett provides her perspective as a public health professional, physician and mother of black children. She calls for the steadfast commitment of public health professionals to the reduction of health disparities.

In public health, our work involves advocating for the vulnerable. Unarmed victims and their surviving families are unarguably vulnerable at the hands of law enforcement. In my quest to seek answers and determine my contribution to change, I attended a variety of events. "How to Improve Police-Community Relations," hosted by the Amadou Diallo Foundation, was transformative. If you don't recall, Diallo was a young man gunned down in the hallway of his Bronx apartment building in February 1999. At this event I sought insight from those affected by such violence. Heartfelt testimonies were given by the foundation's president, Mrs. Kadiatou Diallo, and members of Black and Hispanic communities speaking about the trauma of police brutality or the emotional and psychological effects of losing family members at the hands of police. These accounts were compelling and overwhelming. I realized that the impact of survivorship is not readily discussed. Major quality-of-life issues exist when families continue living in communities where their loved ones were gunned down. Some testimonies mirrored accounts of people living in war-torn countries. This is considered slow genocide, which is the physical and emotional harm to survivors of violence who continue living in communities plagued with violence. What I learned only scratched the surface and must be addressed in public health's efforts to support victims.

What I also found compelling were the perspectives of the speakers, including retired members of the NYPD. I desired to seek all perspectives, but I was surprised at the viewpoints of retired cops. I realized that the public health crisis continues into the lives of police officers as well. My realization was surprising. I had not perceived officers as victims in the traditional sense, but there are vulnerabilities that need to be addressed to improve policing.

From the public health prospective, we are taught to apply a sociocultural approach to our efforts in diverse communities. We come to understand through community-based participatory research that effective community-level health interventions cannot be determined by academic scientists sitting in some ivory tower. We learn about the community through the lens of the community. Our work must be community-based, community-driven and participatory for change to be realized. We take this approach very seriously.

I would think that police training would be socioculturally guided as well. Police officers should feel the same societal obligations that health professionals feel. Well, cadet training does not include an in-depth understanding of diversity in New York City, the melting pot. Time is not taken to ensure effective cultural-competency training. In fact, a criticism of cadet training by a retired sergeant was that six months is insufficient to ensure preparation for patrolling culturally diverse neighborhoods. From the retired sergeant's perspective, the outcome is overwhelming fear. Rookies are afraid to be on the street. The example put forth was that it's like putting a drunk behind the wheel of a car. Let's think about this: In such a scenario, would any of us be safe? Do we want to be protected by scared cops with loaded guns? Whether you are perceived to be privileged or underprivileged, I am confident that your answer is no. The retired sergeant suggested that scared rookies find different employment, but that's not the answer. The problem is two-fold. In our ongoing, exhaustive discussions of police-community relations, a more representative police force is always a suggested solution. With 24.5 percent of New York City's population being Black, the fact that only 7 percent of the recent graduating class of NYPD cadets is Black is unacceptable. Inappropriate assignments are also a problem; more seasoned officers should patrol more challenging neighborhoods.

So here is an awful scenario resulting from bias and stress: A scared rookie, investigating a building with an unlit staircase, shoots and kills an approaching young black man, Akai Gurley. What does the rookie say? He felt threatened for his life? As long as the rookie can maintain this claim, he may not be convicted for the senseless killing. Can we dispute his claim of fear? Most likely it's an honest account of his feelings. However, we can't continue down these destructive paths.

Some may say rookies are not the only ones shooting unarmed men of color. Seasoned officers commit such crimes, like the ones who riddled Amadou Diallo's body with bullets. However, I will tell you that post-traumatic stress is real. Dealing with the stress and emotional pain that is a part of the difficult job of being a cop plays out in policing. What is being done to support officers? I checked. The NYPD has an Early Intervention Unit with peer counselors and invites officers to utilize these services. But there is a problem with the voluntary utilization of such services: Not everyone at risk will perceive themselves to be at risk. In fact, they may believe themselves to be effectively coping, until challenged. The retired sergeant made an insightful point: Psychological examinations are done upon entry into the academy, but they're not conducted regularly -- another problem, as PTSD is said to affect many people working for several years in public safety. The retired sergeant also believes that officers should be given sabbatical, similar to academics. This will allow for rest and a temporary change of environment.

So the public health crisis is more pervasive than I once believed. I am now challenged to identify interventions -- essential to addressing all aspects of police-community relations. We clearly need to hold the NYPD accountable; we need to hold the administrators and decision makers accountable for needed improvements in police management. We are all victims, cops and citizens alike, at the hands of the decision makers. They should be prosecuted.