Krieger N. Police killings, political impunity, racism and the people’s health: issues for our times. Harvard Public Health Review. Winter 2015;3. 10.54111/0001/C2
These searing statements visibly appear on handwritten placards, on buttons, and on the shirts, hoodies, hats, and even bodies of hundreds of thousands of people who have been participating in protests across the United States, triggered by the recent round of police killings of unarmed black men and, in the case of Michael Brown and Eric Garner, the abject failures of grand juries to call for criminal prosecution for their deaths. Starkly revealing the profound links between racism and the people’s health, these statements also illuminate the flip side of this pain: the fundamental links between social justice and public health.
My impression, derived from being at and participating in these public expressions of anger and outrage – and also at last week’s “listening event” here at the Harvard T.H. Chan School of Public Health — is that they are also and equally about dignity, about affirming human rights and well-being, and about what each and all of us must do to create a world in which all can truly thrive. It is heartening to see so many young people stepping up, so many elders holding fast, the protesters so inclusive with regard to race/ethnicity, nativity, Indigenous status, social class, gender, sexual orientation, and disability status. It is encouraging to see the outrage cut through the cant that we live in a “post-racial” society, and to move beyond polite euphemisms about “diversity” and “cultural competency” to press instead for accountability and frank discussion about the complex realities, past and present, of racial injustice. At a time of growing economic inequality within and across racial/ethnic groups, the rise of an allied social movement seeking racial justice gives grounds for hope. It movingly affirms the progressive premise of public health and its focus on preventing harm, especially unjust harm – as it also vividly repudiates centuries of racism, including scientific racism, that are also part of our legacy in public health and society overall.
We in public health have the capacity — the analytic tools, the data, and the knowledge — to make the connections palpable – and actionable — between the many forms of racism, whether structural, everyday, gendered, or environmental, and the myriad ways they become embodied and manifest as health inequities. We likewise have the capacity to analyze — and promote – the social determination of health equity and illuminate how and why the intertwined work for social justice, racial justice, economic justice, environmental justice, community justice, and climate justice, is integral to our public health mission. We can and must carry out these dual lines of rigorous work in our research, our practice, and our pedagogy.
Police killings, impunity, and health inequities are not new – and neither is the struggle against them. Their newfound visibility, however, brought about by a swelling social movement, creates a critical moment in which to press for constructive change. The time for action is now: in our field, in our work, and here at school as well.
Nancy Krieger is Professor of Social Epidemiology, Department of Social and Behavioral Sciences, at the Harvard T.H. Chan School of Public Health and Director of the HSPH Interdisciplinary Concentration on Women, Gender, and Health. She has been a member of the School’s faculty since 1995. Dr. Krieger is an internationally recognized social epidemiologist (PhD, Epidemiology, UC Berkeley, 1989), with a background in biochemistry, philosophy of science, and history of public health, plus 30+ years of activism involving social justice, science, and health. In 2004, she became an ISI highly cited scientist, a group comprising “less than one-half of one percent of all publishing researchers, with her ranking reaffirmed in the 2015 update.” In 2013, she received the Wade Hampton Frost Award from the Epidemiology Section of the American Public Health Association, and in 2015, she was awarded the American Cancer Society Clinical Research Professorship, and re-awarded its renewal in 2020. In 2019, Dr. Krieger was ranked as being “in the top 0.01% of scientists based on your impact” for both total career and in 2017 by a new international standardized citations metrics author database, including as #1 among the 90 top scientists listed for 2017 with a primary field of public health and secondary field of epidemiology (https://doi.org/10.1371/journal.pbio.3000384). In 2020, she was awarded the American College of Epidemiology’s “Outstanding Contributions to Epidemiology” award, and she and her team received the 2020 American Journal of Epidemiology “Paper of the Year” award for their study on historical redlining and cancer stage at diagnosis (the first ever study on this issue). In 2021, she was appointed as member of the UNESCO International Scientific Committee for the Slave Route Project: Resistance, Liberty, Heritage.
Dr. Krieger’s work addresses three topics: (1) conceptual frameworks to understand, analyze, and improve the people’s health, including the ecosocial theory of disease distribution she first proposed in 1994 and its focus on embodiment and equity; (2) etiologic research on societal determinants of population health and health inequities; and (3) methodologic research on improving monitoring of health inequities. In April 2011, Dr. Krieger’s book, Epidemiology and the People’s Health: Theory and Context, was published by Oxford University Press. This book presents the argument for why epidemiologic theory matters. Tracing the history and contours of diverse epidemiologic theories of disease distribution from ancient societies on through the development of — and debates within — contemporary epidemiology worldwide, it considers their implications for improving population health and promoting health equity. She is also editor of Embodying Inequality: Epidemiologic Perspectives (Baywood Press, 2004) and co-editor, with Glen Margo, of AIDS: The Politics of Survival (Baywood Publishers, 1994), and, with Elizabeth Fee, of Women’s Health, Politics, and Power: Essays on Sex/Gender, Medicine, and Public Health (Baywood Publishers, 1994). In 1994 she co-founded, and still chairs, the Spirit of 1848 Caucus of the American Public Health Association, which is concerned with the links between social justice and public health.