As protests over George Floyd's death continue nationwide, several doctors' groups -- the American Academy of Pediatrics, American Medical Association and American College of Physicians -- are emphasizing that racism is a public health issue and they're calling for police brutality to stop.
The American Academy of Pediatrics posted to Twitter on Sunday night that "racism is a public health issue," and the tweet linked to the AAP's 2019 policy statement about the impact of racism on child and adolescent health.
"The AAP condemns violence, especially when perpetrated by authorities, and calls for a deep examination of how to improve the role of policing," the academy tweeted. "Systemic violence requires systemic response."
The American Medical Association on Friday released a joint statement from its board chair Dr. Jesse Ehrenfeld and president Dr. Patrice Harris noting that "police brutality must stop."
"AMA policy recognizes that physical or verbal violence between law enforcement officers and the public, particularly among Black and Brown communities where these incidents are more prevalent and pervasive, is a critical determinant of health and supports research into the public health consequences of these violent interactions," Ehrenfeld and Harris said in the statement.
"Recognizing that many who serve in law enforcement are committed to justice, the violence inflicted by police in news headlines today must be understood in relation to larger social and economic arrangements that put individuals and populations in harm's way leading to premature illness and death," they wrote in part. "Police violence is a striking reflection of our American legacy of racism -- a system that assigns value and structures opportunity while unfairly advantaging some and disadvantaging others based on their skin color."
How racism puts the black community's health at risk
The statement went on to describe how both the coronavirus pandemic and police violence have disproportionately impacted communities of color, shedding light on stark health disparities in the United States.
"Racism as a driver of health inequity is also particularly evident in findings from a 2018 study showing that law enforcement-involved deaths of unarmed black individuals were associated with adverse mental health among Black American adults -- a spillover effect on the population, regardless of whether the individual affected had a personal relationship with the victim or the incident was experienced vicariously," Ehrenfeld and Harris wrote.
"The trauma of violence in a person's life course is associated with chronic stress, higher rates of comorbidities and lower life expectancy, all of which bear extensive care and economic burden on our healthcare system while sapping the strength of affected families and communities," they wrote. "The United States has a track record of historically and systemically disadvantaging certain racial groups -- in addition to ethnic, religious and other minoritized groups -- across the country."
Also on Friday, the American College of Physicians stressed in a statement that internists are "gravely concerned" about discrimination and violence against communities of color, whether by police or private individuals.
"It is evident that African-Americans in particular are at risk of being subjected to discrimination and violence against them because of their race, endangering them and even costing them their lives. This should never be acceptable and those responsible must be held accountable," Dr. Heather Gantzer, chair of the board of regents for the American College of Physicians said in the statement.
"ACP has long held that hate crimes, prejudice, discrimination, harassment and violence against any person based on race, ethnicity, religion, gender, gender identity, sex, sexual orientation, or country of origin is a public health issue," Gantzer said in part. "The issue of how to ensure that policing does not result in discriminatory enforcement and violence is a multifaceted and complex one."
'What has stood out to me is not so much the physical injuries ... but the psychological harm'
This isn't the first time that doctors and public health leaders have weighed in on how racism, whether intentional or implicit, hurts public health and can help drive racial disparities in health.
When a white nationalist rally in Charlottesville, Virginia, turned deadly in 2017, the American College of Physicians named hate crimes a public health issue in a position statement.
At that time, the American Psychological Association, the American Medical Association and the American Academy of Family Physicians also issued policy statements on hate crime as a public health concern, referencing how experiencing racism and discrimination can play a role in raising the risk of certain chronic health conditions in the black community.
Several studies suggest that experiences of racism or discrimination raise the risk of emotional and physical health problems, including depression, cardiovascular disease, hypertension -- more than 40% of black adults have high blood pressure -- and even death.
"By identifying discrimination and hate crimes as public health issues, the ACP not only acknowledges the impact these factors have on our patients but also our role and responsibility to address them as part of our professional dedication to the health of our patients and the public," Dr. Elizabeth Samuels, an emergency physician in New Haven, Connecticut, and Providence, Rhode Island, told CNN in 2017.
"When I have cared for patients assaulted because of their race, religion, gender, sexual orientation, age or disability, what has stood out to me is not so much the physical injuries inflicted -- which are not to be minimized -- but the psychological harm," she said. "Hate-based violence and systemic racism are detrimental to public health."