Columns share an author’s personal perspective.
When I was working at Memorial Sloan Kettering Cancer Center in New York as a pediatric and internal medicine resident, I would sit in the kids’ playroom whenever I got a chance to take a break. I was there one day when two little boys and their moms came in. The first boy was in the hospital because of a relapse of his leukemia and had lost all his hair from his chemotherapy; the second had his arm amputated because of a recurrence of his Ewing’s sarcoma.
The first boy turned to the second and said, “You don’t have an arm.” His mom looked abashed and started to stand; I took her hand and influenced her back into her seat. The second boy responded, “You don’t have any hair,” and his mom started to stand until I looked at her and signaled for her to sit back down. The first boy then said, “Want to play trucks?” The second boy enthusiastically nodded and with both boys smiling their laughter soon filled the room.
I looked at the first mom and said, “Your son doesn’t have any hair” and I turned to the second mom and said, “And your son only has one arm.” I continued, “Your sons were making observations, not judgments or ridicule.” Prejudice is learned, and to their parents’ credit, these boys had not been taught to hate. It never came up that one boy was white and the other black.
Why have so many of us forgotten the important acceptance and love for our fellow human beings that we naturally have as small children? The racism, hatred and us versus them attitude that continues in our country, and that is manipulated for political gain by some who lead us, is a significant public health issue. Racism fuels the socioeconomic divide that pushes us apart instead of bringing us together. It adds to the health inequality that pervades our communities, and is at least partly responsible for the increased toll the COVID-19 pandemic has taken on people of color.
Yet another manifestation of this hatred is the shootings that occur all too frequently in the U.S. The overall homicide rate in the U.S. is over 5 per 100,000 people, much higher than in other developed countries. For example, the homicide rate in European countries is three to seven times lower than in the U.S. Over a third of all mass shootings worldwide, where four or more people are killed or wounded, occur in the U.S.; there were over 400 mass shootings in the U.S. in 2019, leading to over 500 deaths and almost 2,000 wounded people.
The police who put their lives on the line to serve and protect us are not spared from being victims of this violence. There are almost 100 police officers killed in the line of duty every year.
But none of this justifies the hundreds of people who die in arrest-related deaths (ARDs) or in police custody every year, a very disproportionate number of these being people of color. It is unconscionable that we do not accurately track this issue nationally, despite the fact that a law enacted in December of 2014 (which renewed and expanded on a law passed eight years earlier) requires this data to be collected and monitored.
Over the last 20 years, the Bureau of Justice Statistics reported that about 700 people died in police custody each year (estimates are that less than half of the actual number of deaths are reported and tracked), with almost two-thirds of these being identified as homicide by law enforcement (the majority of which are categorized as justifiable homicide from the law enforcement agent using lethal force to protect themselves or someone else in response to a violent situation), 10-15% being suicides, 10% due to intoxication, and the rest due to natural or unknown causes.
However, as we have recently been reminded, there are way too many cases where excessive force, out of proportion to the situation, is used. These should be categorized as “never events.” “Never events” are something we have in medicine where certain complications/errors/events are identified as ones that we strive to prevent from ever happening (for example, surgery on the wrong body part).
We need to address these important health issues at all levels, starting from the racism and hatred that underlie too many of these behaviors and following through to tracking, monitoring and addressing the specifics of what is occurring. We should not rest until these “never events” never occur.
Jeff Hersh, Ph.D., M.D., can be reached at DrHersh@juno.com.