Over the past 24 years, there have been a combined 55 fatal civilian shootings at the hands of British and Welsh police officers. Cops in the United States topped that figure within the first 24 days of 2015. As of this writing, 935 people have been fatally shot this year by police officers in the U.S., 205 of whom were unarmed. These statistics come courtesy of the Guardian's the Counted project, which trawls the Internet for news on law enforcement-related deaths and compiles them into an online database.*
If it strikes you as odd that a newspaper in the United Kingdom is leading the charge in tracking American law enforcement-related deaths, you're not alone. When the site first launched in June, it quickly caught the attention of Nancy Krieger, a professor of social epidemiology at Harvard University. In an essay published today in PLoS Medicine, she and her colleagues argue that these deaths should be treated and recorded not just as a matter of criminal justice, but also as a public health concern. "Just as epidemic outbreaks can threaten the public’s health, so too can police violence and impunity imperil communities’ social and economic well-being, especially if civil unrest ensues," Krieger writes in her essay. "It is time that public health agencies exercise their ability to report to the public."
In an interview with Pacific Standard, Krieger explains how existing networks of public health surveillance could be used to record when and where these civilian deaths are occurring, and how better surveillance might help solve the problem.
What prompted this essay? What gave you the idea to start thinking about law enforcement-related deaths as a matter of public health?
I've devoted my career to examining how social inequality harms health, and how health equity is a good thing, meaning that there's not unfair, avoidable, preventable, unjust differences in health between social groups.
When the Guardian started the Counted, it showed that it really was possible to count the number of people killed by the police in the U.S. As someone who has spent a lot of my career coming up with better measure to monitor the health of the population, it really disturbed me. Public health counts people who are dead and figures out what the mortality rates are. It made no sense to me that we didn't have good, timely mortality data available to help us understand where the problems are so that we can prevent them.
What makes law enforcement-related deaths a matter of public health?
These kinds of deaths trigger social consequences on par with disease epidemics. I think right now it's extremely timely to think about what's happening in Baltimore in relation to the death of Freddie Gray—to think about what happened with the civil unrest that occurred between the time of his death and when the six police officers were charged. During those six days of civil unrest, there were effectively the consequences of what you see during an epidemic outbreak in terms of disturbances to the mental health of the population, in terms of access to medical supplies, because of what happened with the pharmacies, and much else.
How would the reporting process work?
In public health, we have had timely reporting through a very particular mechanism known as "notifiable conditions" that get reported on a real-time basis nationally—on a weekly basis. We already have a world class public health system in the U.S., but it hasn't been geared for counting law enforcement-related deaths, in part because the notifiable condition has been typically about epidemic diseases, but it's not restricted to epidemic outbreaks.
What happens with notifiable conditions is that they get reported through the public health department, and they're reported typically by public health people. This kind of report can be triggered by a public health person who, for example, reads a newspaper article saying that such a fatality has occurred. It doesn't have to be a direct eye witness or a direct care provider. The data then goes into this system of notifiable reports, and once a week those reports are sent off to the Centers for Disease Control and Prevention and they become part of what is the weekly report with the very cheerful title "Morbidity and Mortality Weekly Report."
And we don't need Congress to pass any new legislation or the cooperation of police departments to make this happen?
The data collection process occurs at the state level, through each state's health department. To have one database that includes all these deaths in a systematic, fair manner would help to alleviate concerns about bias or political intrigue, and would make this a straightforward, transparent reporting of the deaths. Determining the conditions of the deaths—whether it was a just or an unjust act or use of force—that's outside the realm of public health to offer opinion. We provide data. We count deaths.
What could we do if we knew when and where these law enforcement-related deaths were happening?
We don't have a lot of experience with having these kinds of data, but what is suggested is that if the communities [involved]—the people who are policing and the people who are being policed—have a common set of shared figures with transparency, it starts the basis of a discussion because there's no magic wand to wave and there's no simple policy to enact. It starts with understanding what the truth is.
My colleagues and I can help provide the data that are necessary to have informed policy and informed action that leads to justice. It would've shown, for example, some areas—including the one where Michael Brown had lived—had unusually high rates of these kinds of mortality at different points. You would see that there are problems. It would help detect those problems, and it would show that if there are certain areas that are having an unusual number of cases, something needs to change. It's the same principles that are used looking for hotspots of other kinds of disease or epidemic outbreaks. What's going on in those communities? What's different about them compared to other communities? What can be done? How can we learn from each other to reduce this kind of tragic loss of life?
When you start to see a public health treatment-oriented approach to what is a social and public health problem, as opposed to treating it solely as a criminal justice problem, you actually end up with possibilities for rehabilitation in a totally different way, and for prevention in a totally different way.
The interview has been edited for length and clarity.
*UPDATE — December 8, 2015: This article has been updated to more accurately reflect the number of people who have been fatally shot by police officers in the United States.