Rethinking Policing as a Public Health Issue

As a former college president and a university physician, we’ve been heartened by some medical researchers’ recent assertions that many issues involving policing -- gun deaths, sexual violence, domestic brutality, alcohol and drug use, among others -- can and should be framed as public health problems requiring research and study. For instance, in a commentary in The American Journal of Medicine, Leana S. Wen, at George Washington University, and Nakisa Sadeghi, at the University of North Carolina at Chapel Hill, cite a 2020 federal allocation of $25 million to the Centers for Disease Control and Prevention and the National Institutes of Health for research on gun violence. Wen and Sadeghi comment that this investment in research “represents an important opportunity to depoliticize the gun violence epidemic by using a public health approach.”

Such an approach is greatly needed. The Police Executive Research Forum recently noted in a letter to its members that, given the significant rise in homicides and violent crimes, public safety has become one of most pressing domestic challenges that America faces today. “Yet,” it added, “our investment in research on how to effectively combat crime is amazingly minuscule in comparison to the need. For example, there is very limited research on what works in training and whether various types of less-lethal equipment are effective. So police departments have no guidance.”

Viewing policing as a matter of public health has implications for universities and police departments working together at a crucial moment in American history. Such a perspective can alter the troubling status of law enforcement in communities across the nation, including on numerous campuses where activists are demanding closing of university police departments and/or severing collaboration with municipal police.

Instead of pursing current policing procedures, which often seem ineffective at best, a public health approach would apply numerous aspects of what is called “evidence-based medicine” to policing. This concept differs significantly from the historical practice of gaining knowledge solely by a physician’s clinical trial and error and passing down insights from generation to generation, mentor to student. Evidence-based medicine involves precisely defining and fully describing a problem, identifying relevant and diverse disciplines to aid investigation, collecting pertinent data, measuring the prevalence and incidence of various elements, identifying risk factors, revealing causes, and constructing controlled trials for possible treatments and prevention.

These are the kinds of efforts we commonly see from medical and public health schools working with affiliated hospitals. Like law enforcement with its 18,000 police departments around the country, American medicine is very decentralized, yet a network of medical school-hospital partnerships continually produces innovative research that has yielded superb evidence-based medical care. Methodologies, data and interpretation are shared with practitioners in hospitals, clinics and practices that deliver services to communities throughout the United States and, indeed, the world. Governmental agencies, especially the NIH and the CDC, as well as the private sector have been the drivers of this impactful research.

Could partnerships between universities and police departments be analogues to the collaborations between medical schools and hospitals that have yielded invaluable research and informed practice? The elements of such a system are already in place.

In fact, some police department are already moving toward evidence-based policing (EBP). Gary Cordner, academic director of the education and training section of the Baltimore Police Department, has written that EBP “identifies data that should be collected, analyses that should be conducted and research that should be carried out -- all for the purpose of making policing better.” And he has acknowledged the vital link between research and practice: “Improving policing depends on producing and then using the best available evidence when making decisions, developing policies, and designing programs and practices.”

Universities offer a research culture and multiple disciplines that could provide many vital insights on policing and crime. Those disciplines include not only the usual suspects: criminology, forensic medicine and criminal law, as well as pertinent science fields like biology, chemistry and physics. They also encompass technical fields newer to policing, such as epidemiology, statistics, computer science, engineering and management, along with sociology, psychology, social work, economics, political science, anthropology and communication science. Even the relationship of literature, the arts, foreign languages and music with policing -- currently far from explored -- could be sources of human narrative and insights about police practices and interactions.

To be most effective, any university-police department partnerships along these lines should be required to participate in a national network in which data, analyses and practical applications are regularly shared -- just as that occurs in the public health sphere. This network would form a logical structure for establishing national databases, investigator-initiated research and coalitions for large-scale research projects.

The Need for Funding

But while the need is great, as is the potential, we’ve seen little experimentation with these types of collaborations. A National Institute of Justice report by Geoffrey P. Alpert, Jeff Rojek and J. Andrew Hansen of the University of South Carolina surveyed the prevalence of such collaborations between police researchers and practitioners. The researchers included faculty members at higher education institutions and experts at research organizations like the Police Executive Research Forum and the Rand Corporation; the practitioners encompassed law enforcement agencies, like state, county, city and municipal police and sheriffs. Only 32 percent of responding practitioners in the survey said they had engaged in partnerships, a rate the authors judged as “low overall.” Formal, long-term collaborations between law enforcement agencies and researchers were even less common -- only about 10 percent reported they’d engaged in them.

The most common reason for not participating in these relationships is a lack of funding resources, according to Rojek, Alpert and Hayden P. Smith, another University of South Carolina scholar. It thus stands to reason that federal and private funding of university-police department collaborations would undoubtedly encourage more formal and longer-term partnerships. Such partnerships could also potentially be funded more robustly if police reform is considered a public health issue. Competitive funding for the best-designed research grants would be an effective use of resources.

When it comes to who would support such research, the obvious analogue to the NIH is the National Institute of Justice (NIJ), an arm of the U.S. Department of Justice. In fact, the institute already funds a strong research program on policing issues. But that said, the NIH’s annual budget is around $39 billion compared to only about $230 million for the NIJ. The imbalance is striking and calls for the NIJ to receive substantively more funding to pass on to research partnerships. In addition, the NIH and the CDC also have pertinent programs in drug abuse, violence and trauma that could also help support important research on policing issues if monies were directed toward it.

To support a particular university-police department partnership, the NIJ and other funders should look for evidence of the following:

• Collaboration. As judged by submission of a formal agreement for multiple years, commitment of leaderships and staffs, a plan for maintaining and strengthening relationships, and procedures for planning and publishing studies together issuing from the partnership.
• Personnel. As assessed by experience in relevant fields and commitment.
• Data. As judged by ability and willingness to collect both prospectively and retrospectively.
• Analysis. As assessed by quality and fit of past research work and access to adequate personnel, software and hardware.
• Reporting. As judged by intent to publish in ways accessible to both academe and law enforcement.
• Network. As assessed by a willingness to work with the other partnerships to achieve adequate representation of demographics and regions corresponding to the plurality of populations in the U.S. and sufficient numbers for statistical significance.
• Study design. As judged by submission initially of a full research proposal with the understanding that it would be reviewed for possible first-round funding.

Just imagine if we as a society had answers to questions like these gained by applying to police reform the full capacity and academic breadth of American higher education research thorough a national network of police department-university partnerships:

• Are there reliable methods to identify in advance police candidates who are prone to unnecessary violence and/or are biased against segments of the community?
• Does crisis intervention training or bias training make a difference?
• What are the most effective strategies for ensuring officers are both held accountable when appropriate and supported when they have operated in accordance with the law and policy?
• Is it possible to change police culture and still maintain an organization that can protect a community from violence?

It is time for far more college and university leaders to reach out to local police and invite sustained research partnerships while simultaneously partnering with each other to create a national network of higher education institutions dedicated to police reform. Higher education leaders must also collectively lobby for more robust, sustained funding from Congress and state legislatures as well as corporations and private foundations.

As with many advances in human knowledge and practice, progress is often achieved from where you least think it will arise. For police reform, this might be recourse to public health and university partnerships.