What Schistosomiasis Tells Us About Police Violence

A special issue of Journal of Urban Health co-edited by Mindy Fullilove charts a path for public health researchers to address the problem.

March 22, 2016

As the Black Lives Matter movement spotlights a growing list of police assaults and killings of African-Americans, many figures in public health, including public health students, have struggled with the limited amount of research into the consequences of this violence and possible solutions. A new special issue of the Journal of Urban Health edited by Mindy Fullilove, professor of Sociomedical Sciences, and Hannah Cooper, an associate professor at the Rollins School of Public Health at Emory University, attempts to help fill this gap.

Nine articles explore police violence from a variety of angles: among them, the connection between aggressive policing and poor health outcomes in affected communities in New York City and Baltimore; dehumanizing narratives of black male aggression, such as Ferguson, Missouri officer Darren Wilson’s testimony about the death of Michael Brown; historical analyses of efforts to reduce police violence in Newark, New Jersey, and in Prince George’s County, Maryland, including recent challenges; and a proposal to measure non-fatal police shootings in a hospital setting.

“They point out that we face a problem that is rooted in the use of violence to enforce centuries of oppression against black adults and children in the U.S.,” Fullilove and Cooper write in an editorial. “At the present time, the violence is an obvious and hurtful part of daily life in poor ghettoes. Finally, we learn that efforts to change these patterns have been fiercely resisted and quickly undone.”

Because the problem of police violence is complex, they argue efforts to understand and address it must account for the “ecosystem” in which the behavior thrives. Police don’t act in isolation, explains Fullilove, a psychiatrist who studies ways to dismantle boundaries been race and class in the urban environment. “They are the arm of the state. When we declare war on drugs, we as a society led by policymakers, are saying how we want crime managed. Police are carrying out our orders.”

The editorial makes the analogy of schistosomiasis, a disease caused by parasitic worms that have a complex lifecycle involving passage through fresh water, snails, and humans. While drugs are effective, experience has shown that a combination of killing snails, protecting the water supply, and using medication is the best way to control it. In a similar fashion, it explains, there is no silver bullet to end excessive police violence, whether sensitivity trainings or video cameras.

Fullilove argues that we must transform the culture of policing from intimidation and control to listening and community accountability. At the same time, the government must commit to end the war on drugs and shift from punitive policies that fuel mass incarceration to restorative justice practices that fight crime through investments in education, housing, and jobs. “We need to think of the five or six places that support this behavior and intervene in all of them at the same time,” she says. “Doing this will be vastly more effective and more likely to be sustained than any one intervention alone.”

But in order for fruitful research into solutions to happen, data sources are badly needed. Currently there is no surveillance data on fatal or non-fatal injuries at the hands of the police in the U.S. As one corrective, the editors argue that a mandatory federal monitoring program should be accompanied by survey measures to account for the various forms this violence takes—physical, sexual, psychological, and neglectful—and to understand when force is excessive. “The line between necessary and excessive force is hotly contested, and has historically been decided overwhelmingly in favor of officers,” they write.

Included in the special issue is a study by Abigail Sewell and Kevin Jefferson at Emory University and the University of Pennsylvania that used stop-and-frisk data from the New York Police Department to uncover neighborhood-level associations between the use of the tactic and elevated rates of diabetes, high blood pressure, and asthma for people living there, including those not directly subject to a stop and frisk. With better data, scientists could go further, exploring links between more violent police encounters and community health.

Continued research into the topic would be very much in the public health wheelhouse, says Fullilove, building off a wealth of existing scholarship on violence, injury prevention, and the social determinants of health. Yet so far, while the field hasn’t shied away from related topics like mass incarceration and inequality, there is almost no research into police violence. “This is an opportunity to start the research off on the right foot,” she adds. “We have a lot of work to do.”