Krieger N. Police killings, political impunity, racism and the people’s health: issues for our times. Harvard Public Health Review. Winter 2015;3.
“Black lives matter.” “I can’t breathe.” “Racism kills.”
These searing statements visibly appear on handwritten placards, on buttons, and on the shirts, hoodies, hats, and even bodies of hundreds of thousands of people who have been participating in protests across the United States, triggered by the recent round of police killings of unarmed black men and, in the case of Michael Brown and Eric Garner, the abject failures of grand juries to call for criminal prosecution for their deaths. [1. Steinhauer J, Schneider E. Thousands march in Washington to protest police violence. New York Times, December 13, 2014. Available at: http://www.nytimes.com/2014/12/14/us/thousands-march-in-washington-to-protest-deaths-by-police.html; accessed: December 17, 2014.] [2. Laughland O, Epstein K, Glenza J. Eric Garner protests continue in cities across America through second night. The Guardian, December 5, 2014. Available at: http://www.theguardian.com/us-news/2014/dec/05/eric-garner-case-new-york-protests-continue-through-second-night; accessed: December 17, 2014.] [3. Reuters in Geneva. UN calls on US police to end racial profiling and review rules on lethal force. The Guardian, December 5, 2014. Available at: http://www.theguardian.com/us-news/2014/dec/05/un-human-rights-experts-end-racial-profiling; accessed: December 17, 2014.] [4. Thousands protest against police violence across the US – video. The Guardian, December 14, 2014. Available at: http://www.theguardian.com/us-news/video/2014/dec/14/thousands-protest-police-violence-us-michael-brown-eric-garner-video; accessed: December 17, 2014.] [5. Los Angeles lawyers stage die-in in protest against police – video. The Guardian, December 17, 2014. Available at: http://www.theguardian.com/us-news/video/2014/dec/17/los-angeles-lawyers-die-in-protest-police-video; accessed: December 17, 2014.] [6. Associated Press. Defense lawyers march to protest police killings. New York Times, December 17, 2014. Available at: http://www.nytimes.com/aponline/2014/12/17/us/ap-us-killings-by-police-lawyers-protest.html; accessed: December 17, 2014.] [7. Ogletree CJ, Harris DJ. More than “enough is enough.” Boston Globe, December 17, 2014. Available at: http://www.bostonglobe.com/opinion/2014/12/16/blacklivesmatter-protests-are-demand-for-more/kd9N3vyTP7Yu7oooacMJWP/story.html; accessed: December 17, 2014.] Starkly revealing the profound links between racism and the people’s health, these statements also illuminate the flip side of this pain: the fundamental links between social justice and public health. [8. WHO Commission on the Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report. Available at: http://www.who.int/social_determinants/thecommission/finalreport/en/; accessed: December 17, 2014.] [9. Krieger N, Birn AE. A vision of social justice as the foundation of public health: commemorating 150 years of the Spirit of 1848. Am J Public Health 1998; 88:1603-1606.]
My impression, derived from being at and participating in these public expressions of anger and outrage – and also at last week’s “listening event” here at the Harvard T.H. Chan School of Public Health — is that they are also and equally about dignity, about affirming human rights and well-being, and about what each and all of us must do to create a world in which all can truly thrive. It is heartening to see so many young people stepping up, so many elders holding fast, the protesters so inclusive with regard to race/ethnicity, nativity, Indigenous status, social class, gender, sexual orientation, and disability status. [10. Black Lives Matter. Available at: http://blacklivesmatter.com/; accessed: December 17, 2014.] It is encouraging to see the outrage cut through the cant that we live in a “post-racial” society, [11. Wise T. Colorblind: The Rise of Post-Racial Politics and the Retreat from Racial Equity. San Francisco, CA: City Light Books, 2010.] and to move beyond polite euphemisms about “diversity” and “cultural competency” to press instead for accountability and frank discussion about the complex realities, past and present, of racial injustice. [12. Zinn H. A People’s History of the United States: 1492-Present. (Perennial Modern Classics Deluxe Edition). New York: HarperPerennial, 2010.] [13. Rothenberg PS (ed). Race, Class, and Gender Inequality in the United States: An Integrated Study. 7th ed. New York: Worth Publishers, 2007.] [14. Weinberg, M (ed). W.E.B. DuBois: a reader. New York: Harper & Row, 1970.] At a time of growing economic inequality within and across racial/ethnic groups, [15. Kochhar R, Fry R. Wealth inequality has widened along racial, ethnic lines since end of Great Recession. Pew Research Center, December 12, 2014. Available at: http://www.pewresearch.org/fact-tank/2014/12/12/racial-wealth-gaps-great-recession/; accessed: December 17, 2014.] [16. Fry R, Kochhar R. America’s wealth gap between middle-income and upper-income families is widest on record. Pew Research Center, December 17, 2014. Available at: http://www.pewresearch.org/fact-tank/2014/12/17/wealth-gap-upper-middle-income/; accessed: December 17, 2014.] the rise of an allied social movement seeking racial justice gives grounds for hope. It movingly affirms the progressive premise of public health and its focus on preventing harm, especially unjust harm – as it also vividly repudiates centuries of racism, including scientific racism, that are also part of our legacy in public health and society overall. [17. Krieger N. Epidemiology and The People’s Health: Theory and Context. New York: Oxford University Press, 2011.]
We in public health have the capacity — the analytic tools, the data, and the knowledge — to make the connections palpable – and actionable — between the many forms of racism, whether structural, everyday, gendered, or environmental, and the myriad ways they become embodied and manifest as health inequities. [18. Krieger N. Discrimination and health inequities. In: Berkman LF, Kawachi I, Glymour M (eds). Social Epidemiology. 2nd ed. New York: Oxford University Press, 2014; 63-125.] [19. Krieger N. Methods for the scientific study of discrimination and health: from societal injustice to embodied inequality – an ecosocial approach. Am J Public Health 2012; 102:936-945.] [20. Williams DR, Mohammed SA. Discrimination and racial disparities in health: evidence and needed research. J Behav Med 2009; 32:20-47.] We likewise have the capacity to analyze — and promote – the social determination of health equity and illuminate how and why the intertwined work for social justice, racial justice, economic justice, environmental justice, community justice, and climate justice, is integral to our public health mission. We can and must carry out these dual lines of rigorous work in our research, our practice, and our pedagogy.
Police killings, impunity, and health inequities are not new – and neither is the struggle against them. Their newfound visibility, however, brought about by a swelling social movement, creates a critical moment in which to press for constructive change. The time for action is now: in our field, in our work, and here at school as well.