Police cars.

Law as a Determinant of Police Violence

By Osagie K. Obasogie

One idea that distinguishes public health from medicine and other health sciences is the social determinants of health. This concept emphasizes the environmental conditions that give rise to health outcomes — poverty, lack of access to resources, exposures to contaminants, etc. — rather than locating disease solely in biological or physiological processes bounded by human bodies. Following this lead, public health interventions are often focused on community practices that can improve the spaces in which people live. The public health approach is refreshingly simple: healthy communities and environments produce healthy people.

A public health framework for understanding how police and policing impact community health outcomes is necessary as we continue to have wide-ranging conversations about excessive use of force. Improving the health of local communities involves rethinking the laws that govern how police interact with the people they serve.

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(Institute for the feeble-minded, Lincoln, Ill. / Library of Congress)

Why Buck v. Bell Still Matters

By Jasmine E. Harris

In 1927, Buck v. Bell upheld Virginia’s Eugenical Sterilization Act, authorizing the state of Virginia to forcibly sterilize Carrie Buck, a young, poor white woman the state determined to be unfit to procreate.

In less than 1,000 words, Justice Oliver Wendell Holmes, writing for all but one of the Justices of the Court, breathed new life into an otherwise fading public eugenics movement.

More than 70,000 people (predominantly women of color) were forcibly sterilized in the twentieth century.

Buck is most often cited for its shock value and repeatedly, for what is, perhaps, its most famous six words: “Three generations of imbeciles are enough.” While this may be the most provocative language in the opinion, it is not the most noteworthy.

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lady justice.

When Health Advice Is Hard to Come by, BIPOC Suffer the Consequences

By Claudia E. Haupt

The COVID-19 pandemic has highlighted the tradeoffs at stake for Black, Indigenous, and people of color (BIPOC) seeking reliable health advice.

While there are legal safeguards to ensure reliable health advice within the confines of the doctor-patient relationship, outside of that relationship, the First Amendment protects bad advice just as much as good advice.

Courts continue to interpret the First Amendment in an expanding, deregulatory manner and the health context is no exception. For example, one novel judicial interpretation challenges previously accepted applications of the police power in furthering public health. In a forthcoming article, “Public Health Originalism and the First Amendment,” my colleague Wendy Parmet and I explore some of the dangers associated with this deregulatory approach.

Overall, the beneficiaries of these recent developments tend to be powerful speakers. The costs have largely fallen on women, as seen for example in NIFLA v. Becerra, and those who lack access to reliable medical advice, who are disproportionately BIPOC. Current First Amendment doctrine thus has the dangerous potential to further exacerbate existing racial disparities in health.

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Empty classroom.

School Discipline is a Public Health Crisis

By Thalia González, Alexis Etow, and Cesar De La Vega

Education is well-accepted as a key social determinant of health. It serves as a strong predictor of chronic disease, social and economic instability, incarceration, and even life expectancy. For example, by age 25, individuals with a high school degree can expect to live 11 to 15 years longer than those without one. Despite such evidence, education policies and practices have not been public health priorities. Too often, policies and practices in schools that create and compound health inequities are narrated and re-narrated as falling outside health law and policy. This is a missed opportunity for collective action to positively impact the future health pathways of children and communities.

In the wake of national protests against racialized police violence and COVID-19’s disproportionate impact on communities of color, the time has come for the health community — from researchers, to public health organizations, to advocates, to health care professionals — to move from simply affirming that racism is a public health crisis, to actively exposing how structural discrimination in education has fueled disparities and deepened the persistence of health inequities.

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Woman holding sign that reads "I can't breathe."

Black Women Can’t Breathe

By Michele Goodwin

Years before George Floyd begged to be released from under the knee of Officer Derek Chauvin, Barbara Dawson, a fifty-seven year old Black woman, died begging a police officer, John Tadlock, not to remove her oxygen mask. Her death occurred right outside the Calhoun Liberty Hospital in Blountstown, Florida, shortly before Christmas in 2015.

Just before Officer Tadlock’s arrival, Ms. Dawson arrived at the hospital seeking oxygen. The hospital’s response to Ms. Dawson’s request was to call law enforcement. Photographs show Ms. Dawson slumped next to the police car. A police recording captures the tragic end of Ms. Dawson’s life. Officer Tadlock reprimands Ms. Dawson: “Falling down like this and laying down, that’s not going to stop you from going to jail.”

Ms. Dawson’s life ended on the pavement, feet away from the entrance of the hospital that phoned the police on their patient — because she refused to leave. She lay there nearly twenty minutes before being pronounced dead. It turns out she had a blood clot in her lungs.

In some sense, there is nothing extraordinary about the image of Ms. Dawson, or the interactions of the hospital and officer, which further complicates the deadly exchange. Indeed, the interaction was far too normal: Black women fear for their health and safety when they do not seek care and, troublingly, even when they do.

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Accomodating Racism in Hospitals

By Michele Goodwin

The Hurley Medical Center in Flint, Michigan is being sued for accommodating the request made by a parent that no African Americans tend to his newborn. The father, who allegedly sported a swastika tattoo, alerted a nurse that blacks were not to care for his baby.

To comply with the father’s request, nurse Tonya Battle, who was caring for the child in the Neonatal Intensive Care Unit (NICU) of the hospital was removed or reassigned from tending to the child.  A news video reporting on the incident can be found here. Battle is now suing the hospital.  According to her lawsuit, hospital staff complied with the father’s demand, posting a note next to the baby’s name on the assignment clipboard: “No African American nurse to take care of baby.”

Nurse Battle’s lawsuit claims that she was deeply shocked and offended–she’s worked for at the hospital for 25 years.  Professor Kimani Paul-Emile writes that such requests–based on race or ethnicity–are not unusual at U.S. hospitals and medical clinics.  See her article, Patients’ Racial Preferences and the Medical Culture of Accommodation, which is published in the U.C.L.A. Law Review here.  However, such instances of using racial preferences in the medical setting raise questions about the permissibility of such practices–not only as a legal matter, but also as matters of health and bioethics.  Some patients believe that the quality of their care is enhanced when provided by someone represented by their ethnic group; some even fear that their healthcare is compromised when delivered by medical staff outside of their ethnic group.  Should the law tolerate these forms of discrimination?  What about if racial perceptions have a positive placebo effect?  Post a comment.