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11 Beginning Steps to
Reform Policing and Tackle
Racial Injustices

T

he AMA is urging Congress
to "find common ground on
a path forward on effective
and equitable policing reforms" and
has outlined a set of steps to address
the long-standing problems of police
brutality, systemic racism and racial
injustice.

In a letter to Democratic and
Republican congressional leaders in
the U.S. House and Senate, AMA
Executive Vice President and CEO
James L. Madara, MD, detailed
physicians' support for the following changes, among others:
*	Research into the public health consequences of violent police
interactions.
*	States requiring the reporting of legal-intervention deaths and
law-enforcement officer homicides to public health agencies.
*	For appropriate stakeholders, including law enforcement and
public health communities, to define "serious injuries" for the
purpose of systematically collecting data on law enforcementrelated nonfatal injuries among civilians and officers.
*	Law-enforcement departments and agencies having in place
specific guidelines, rigorous training and an accountability
system for the use of conducted electrical devices, often called
Tasers.
*	Research into the health impacts of conducted electrical
device use and development of a standardized protocol
developed with the input of the medical community for the
evaluation, management and post-exposure monitoring of
subjects exposed to these devices.
*	Increased use of body-worn cameras by law enforcement
officers, as well as funding for the purchase of body-worn
cameras, training for officers, and technical assistance for law
enforcement agencies.
*	Training for law enforcement at all levels on implicit or
unconscious bias and structural racism.
*	School discipline policies that permit reasonable discretion
and consideration of mitigating circumstances when
determining punishments rather than "zero tolerance" policies

that mandate out-of-school suspension, expulsion or the
referral of students to the juvenile or criminal justice system.
*	More research to identify programs and policies that are
effective in reducing disproportionate minority contact across
all decision points within the juvenile justice system.
*	Reauthorizing federal programs for juvenile justice and
delinquency prevention, which should include incentives
for community-based alternatives for youth who pose little
risk to public safety, reentry and aftercare services to prevent
recidivism, and policies that promote justice to reduce
disparities.
The AMA also opposes "choke and sleeper holds as the use of
deadly force with the potential to kill," says Dr. Madara's letter.

Why police brutality is a matter of public health
"These are but a few of the necessary reforms to address the
national disgrace of excessive use of violence against individuals
who are part of minoritized and marginalized communities," Dr.
Madara wrote. "We are at a critical point in our nation's reckoning
with issues of police use of violence, racism, and discrimination.
The use of excessive police force is a communal violence that
significantly drives unnecessary and costly injury, and premature
morbidity and death. Police brutality and racism must not be
tolerated. We urge Congress to act now on meaningful and
effective policing reform legislation."

Why it's important
Research shows that "racially marginalized communities are
disproportionally subject to police force, and there is a correlation
between policing and adverse health outcomes," says the AMA's
letter. "An increased prevalence of police encounters is linked to
elevated stress and anxiety levels, along with increased rates of high
blood pressure, diabetes, and asthma-and fatal complications of
those comorbid conditions."
Other medical research has found "that law enforcementinvolved deaths of unarmed Black individuals were associated
with adverse mental health consequences among Black American
adults-regardless of whether the individual affected had
a personal relationship with the victim or the incident was
experienced vicariously," Dr. Madara noted.

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