Aggressive Policing, Health, and Health Equity

Aggressive policing (or aggressive order maintenance policing) is prevalent throughout the United States, negatively affecting the health of those exposed to it. To address this public health issue, policymakers must promote greater data transparency and consider structural changes in the roles police institutions play in monitoring deviance.

What’s the Issue?

In the United States, law enforcement is a means by which officials maintain population welfare in its intention to ensure public safety, minimize disorder, and exert social control. However, since the 1990s, law enforcement agencies across the country have incorporated aggressive policing approaches into their regular operations. Emerging empirical literature suggests that aggressive policing can affect the mental and physical health of individuals and communities—even among people who have not had contact with police. More importantly, an overpolicing of Black and other communities of color serves to amplify health disparities.

In practice, aggressive police strategies include persistent neighborhood patrolling; frequent engagement of civilians who are considered suspicious (including stop-and-frisk tactics); and routine arrests of people for even low-level infractions (these accounting for 80% of all U.S. arrests). Although aggressive policing tactics are used across U.S. cities, they are—and historically have been—concentrated on communities of color, particularly in areas where greater densities of Black residents live.

Aggressive policing often elevates levels of involuntary contact between law enforcement officers and citizens. A frequency of unwilling contact can more easily become contentious, and thus elevate the risk for physical violence, injury, and even death of civilians. Residents of heavily surveilled neighborhoods are chronically vigilant against the possibility of being unfairly criminalized, causing them elevated levels of psychological distress and worse outcomes on several chronic health measures.

What’s Next?

The authors note that policy leaders have proposed that law enforcement agencies reevaluate their guidelines for “reasonable suspicion” to reduce the unfairness and arbitrariness of frequent police contact. A heavy reliance on arrest as a tool for controlling minor disorderly behavior can have further collateral consequences for health. More evidence is needed to understand how aggressive policing affects population welfare. Broad structural changes in policing methods and possible policy interventions may be needed to eliminate the population health harms that aggressive policing may be causing.

Additional research—perhaps exploring the variation across agencies in their policing approaches—is required to better understand how the use of aggressive policing contributes to the outsized risk for death and injury incurred by people exposed to them. Fundamental reforms to methods of policing—along with additional investments in housing, health care, and education—could prove essential in helping to reduce the negative population health consequences currently generated by law enforcement across the United States.

The brief reviews what is known about aggressive policing and its impacts on population health and health equity, including how it may be serving to diminish population welfare. It also discusses recurring research challenges that scholars face when trying to precisely identify associations between aggressive policing practices and health. It ends by discussing policy interventions that may help diminish the health harms that U.S. law enforcement may be causing—especially addressing disproportionate poor health outcomes for people of color.