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American Journal of Law & Medicine, 43 (2017): 279-295American Society of Law & Medical Ethics, 2017 The Author(s)Boston University School of LawDOI: 10.1177/0098858817723665POLICE VIOLENCE, USE OF FORCEPOLICIES, AND PUBLIC HEALTHOsagie K. Obasogie & Zachary Newman†I. INTRODUCTIONRacialized police violence1 is a recurring issue.2 Recent social movements havere-centered police violence as a subject of public discourse,3 yet there has been littleprogress in reducing the number of people killed by police.4 Without further efforts inresearch and legal reform, this everyday crisis will continue. Thus, materialinterventions designed to fundamentally shift police practices away from deadlyengagements are greatly needed.5These interventions have the potential to disrupt current policing practices thatcontinue to determine which lives are valued—physically and discursively—and†Osagie K. Obasogie is Haas Distinguished Chair and Professor of Bioethics, University of California,Berkeley. B.A., Yale University; J.D., Columbia Law School; Ph.D., University of California, Berkeley.Zachary Newman is a Visiting Scholar at the Haas Institute for a Fair and Inclusive Society, University ofCalifornia, Berkeley. B.A. University of California, Santa Cruz; J.D. University of California, HastingsCollege of the Law.1We employ the term “police violence,” as opposed to police brutality or another similar term, becausewe believe this to be a systemic, generalized problem, not one that is individuated and momentary. Inaddition, by “violence,” we mean the “intentional use of physical force or power, threatened or actual,against oneself, another person, or against a group or community, that either results in or has a highlikelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation.” WORLDHEALTH ORGANIZATION [WHO], WORLD REPORT ON VIOLENCE AND HEALTH, at 4 (2002),http://www.who.int/violence injury prevention/violence/world report/en/summary en.pdf.2See, e.g., Nancy Krieger et al., Trends in US Deaths Due to Legal Intervention Among Black andWhite Men, Age 15-34 Years, by County Income Level: 1960-2010, 3 HARV. PUB. HEALTH REV. 1 (2015).3See Alicia Garza, A Herstory of the #BlackLivesMatter Movement, THE FEMINIST WIRE (Oct. 7,2014), atter-2/; see generally JEFF CHANG, WE GON’BE ALRIGHT 3 (2016) (“Race makes itself known in crisis, in the singular event that captures a larger patternof abuse and pain. We react to crisis with a flurry of words and, sometimes, actions. . . . The cycle turns nexttoward exhaustion, complacency, and paralysis. And before long, we find ourselves back in crisis.”).4Kimbriell Kelly, Fatal Shootings by Police Remain Relatively Unchanged After Two Years, WASH.POST (Dec. 30, 2016), 054287507db story.html?utm term .a1ad32c1ba53.5Nancy Marcus, From Edward to Eric Garner and Beyond: The Importance of ConstitutionalLimitations on Lethal Use of Force in Police Reform, 12 DUKE J. CONST. L. & PUB. POL’Y 53, 106 (2016)(“The collective conscience of this nation has driven a nationwide policing-reform movement to remedy theabuses, excesses, and systemic discriminatory practices in American policing. . . . It can no longer be acommon or acceptable practice in this country for police to gun down or otherwise use deadly force againstunarmed civilians . . . .”).

280AMERICAN JOURNAL OF LAW & MEDICINEwhich can be lost to incessant police violence.6 While many strategies for addressingpolice violence have been proposed, existing discussions do not fully engage a primaryfactor in police violence and major barrier to accountability: use of force policies.These are the policies that codify the rules that govern the levels and types of forcethat police are permitted to use against citizens, including deadly force.7 These rulesare important because they are not only used to train police and guide theirengagements with the community, but are also used as benchmarks when evaluatingwhether their use of force is excessive.8This Article examines use of force policies that often precipitate and absolvepolice violence as not only a legal or moral issue, but distinctively as a public healthissue with widespread health impacts for individuals and communities. 9 This publichealth framing can disrupt the sterile legal and policy discourse of police violence inrelation to communities of color (where conversations often focus on limited queriessuch as reasonableness) by drawing attention to the health impacts of state-sanctionedpolice violence. This approach allows us to shift the focus from the individual actionsof police and citizens to a more holistic assessment of how certain policy preferencesput police in the position to not treat certain civilians’ lives as carefully as they should.In sum, we seek to (1) develop an empirical understanding of the substance of existinguse of force policies and (2) discuss how these policies relate to police violence ingeneral and public health in particular.Not unlike seat belt laws or mandatory vaccinations, we see use of force policyreform as a site where a public health law sensibility can create the conditions forincreasing survivability and decreasing adverse health outcomes by minimizing thelikelihood of police force use and its severity. Accordingly, our research questions areaimed at understanding how use of force policies, police violence, and public healthintersect. We pursue this by conducting a content analysis of use of force polices fromthe twenty largest U.S. cities by population. Unlike previous use of force analyses, thisqualitative assessment takes a “deep” look at the language used to confer and restrainpolice power, which provides a basis from which to think through the link betweentextual articulation, police practice, and community health outcomes. This contentanalysis is then put in conversation with existing literature to explore and hypothesizethis link and opportunities for disruption in the name of improving health outcomes.II. LITERATURE REVIEWThis Article attempts to connect literatures on use of force polices, policeviolence, and public health in order to note their intersection and to contextualize thisresearch project. We briefly describe these literatures below.6See Osagie Obasogie & Zach Newman, Black Lives Matter and Respectability Politics in LocalNews Accounts of Officer-Involved Civilian Deaths: An Early Empirical Assessment, 2016 WIS. L. REV.541, 544 (discussing the representative politics of police violence, specifically in terms of respectability as avaluating process).7The National Institute of Justice notes “there is no single, universally agreed upon definition of use offorce. The International Association of Chiefs of Police has described use of force as ‘the amount of effortrequired by police to compel compliance by an unwilling subject.’ Officers receive guidance from theirindividual agencies, but no universal set of rules governs when officers should use force and how much.”Police Use of Force, NAT’L INST. JUSTICE (Nov. 29, 2016), -safety/use-of-force/pages/welcome.aspx.8Id.9When we use the term “public health,” we are referring to that which “promotes and protects thehealth of people and the communities where they live, learn, work and play.” What is Public Health? AM.PUB. HEALTH ASS’N, http://apha.org/what-is-public-health.

POLICE VIOLENCE, USE OF FORCE POLICIES, AND PUBLIC HEALTH281A. POLICE VIOLENCE AND USE OF FORCE POLICIESThe literature on the relationship between police violence and use of force policiesis relatively sparse.10 Existing scholarship largely focuses on the doctrinal relationshipbetween U.S. Supreme Court Fourth Amendment jurisprudence and use of forcepolicies.11 Scholars have called this case law “deeply impoverished” 12 and stated that itrequires an “overhaul.”13 Recently, the non-profit advocacy group Campaign Zeromade advances in this area by producing significant work that empirically examinesthe relationship between use of force policies and police violence.14First, Campaign Zero’s “Police Use of Force Project” consists of reviewing theuse of force policies of the largest urban police departments across the country todetermine what rules police must abide by and whether these policies prevent policeviolence.15 The authors empirically evaluate how many of the departments incorporateeight particular policies on use of force.16 The eight policies include rules that establishforce continuums and require officers to intervene and prevent other officers fromusing excessive force.17 With data tracking how often these eight approaches appear indepartment policies, the researchers examine the connection between how restrictivedepartment policies are (i.e. how many of the eight policies are in place) and thelikelihood that officers in those departments kill civilians.18 They found that eachadditional restriction was associated with a 15% reduction in killings and that anaverage department (that had already incorporated three policies) would see a 54%reduction in killings if they implemented all eight policies.19 Their findings ultimatelysuggest that a department with all eight would kill 72% fewer people than one withzero.20In another assessment, law professors Brandon Garrett (University of Virginia)and Seth Stoughton (University of South Carolina) wrote A Tactical FourthAmendment, which was recently published in the Virginia Law Review.21 The articleprimarily focuses on understanding the relationship between U.S. Supreme Court caselaw and use of force policies.22 As part of their discussion of doctrine, the authorsinclude an empirical analysis of the use of force policies at the fifty largest police10See e.g., DERAY MCKESSON ET AL., CAMPAIGN ZERO, POLICE USE OF FORCE POLICY ANALYSIS(2016), available at 6835/Police Use of Force Report.pdf; Samuel Sinyangwe, Examining the Role ofUse of Force Policies in Ending Police Violence (2016), 9581/Use of Force Study.pdf;BrandonGarrett & Seth Stoughton, A Tactical Fourth Amendment, 103 VA. L. REV. 211 (2017); WILLIAM TERRILL ETAL., FINAL TECHNICAL REPORT DRAFT: ASSESSING POLICE USE OF FORCE POLICY AND OUTCOMES 237794.pdf.11See Garrett & Stoughton, supra note 10; Rachel Harmon, When is Police Violence Justified?, 102NW. U. L. REV. 1119 (2008); see also Marcus, supra note 5; John P. Gross, Judge, Jury, and Executioner:The Excessive Use of Deadly Force by Police Officer, 21 TEXAS J. ON CIV. LIBERTIES & CIV. RTS 155(2016).12Harmon, supra note 11, at 1119.13Garrett & Stoughton, supra note 10, at 52.14See Police Use of Force Project, CAMPAIGN ZERO (Mar. 30 2016), http://useofforceproject.org/#project.15See id.; Sinyangwe, supra note 10, at 2; MCKESSON ET AL., supra note 10, at 3.16MCKESSON ET AL., supra note 10, at 11-13.17Id. at 3.18Id. at 8-9.19Id. at 9.20Id.21See Garrett & Stoughton, supra note 10.22See id.