Private Policing and Public Health: A Neglected Relationship

Published date01 February 2020
Date01 February 2020
Subject MatterArticles
/tmp/tmp-17B7GeMKESIqOI/input 890191CCJXXX10.1177/1043986219890191Journal of Contemporary Criminal JusticeWood
Journal of Contemporary Criminal Justice
2020, Vol. 36(1) 19 –38
Private Policing and
© The Author(s) 2019
Article reuse guidelines:
Public Health: A
DOI: 10.1177/1043986219890191
Neglected Relationship
Jennifer D. Wood1
Policing, in its various forms and dimensions, has indelible and complex
connections to public health. The conventional functions of policing—promoting
social order, security, and crime prevention—are animated by many issues easily
framed by a public health lens (e.g., forms of violence, mental illnesses, drug
abuse, homelessness). Policing with a crime control focus can make public health
worse by criminalizing vulnerable people and undermining access to health and
harm reduction resources. Conversely, policing with a health focus can help link
vulnerable people to treatment and recovery-oriented resources. Recognizing
these connections, researchers have largely focused on the public health effects
of policing by the public police, and practitioners have worked to transform the
public police with population health in mind. This article suggests that although
this focus on transforming the public police is necessary to the advancement of
public health, it neglects to understand connections between private policing and
public health. This conceptual article argues for the need to widen our focus
beyond the public police when exploring policing’s relationship to public health.
This expanded view, I suggest, is important to discovering the ways in which
the health vulnerabilities of people and places may be compromised by different
policing mentalities and practices. At the same time, it may provide clues about
ways in which policing beyond the police might creatively and virtuously promote
public health.
police, private policing, public health, law enforcement
1Temple University, Philadelphia, PA, USA
Corresponding Author:
Jennifer D. Wood, Department of Criminal Justice, Temple University, Philadelphia, PA 19122, USA.

Journal of Contemporary Criminal Justice 36(1)
Issues of public health are inseparable from the functions of policing. It is hard to
conceive of a healthy population that is not an orderly society and free from victim-
ization, harm, and trauma. “Insecure places are rarely healthy places” (Anderson &
Burris, 2017, p. 300). Sadly, we are not short of examples that illustrate the health
dimensions of crime and insecurity. Exposure to violence increases risks for mental
health disturbance and risks for violent behavior among exposed people (Slovak &
Singer, 2001). Sustained exposure to violence can even result in neurological
changes (Leshem & Weisburd, 2019). Violence is now well recognized as an area of
“common ground” between policing and public health (van Dijk et al., 2019). A
framing of the violence problem that powerfully bridges the policing and public
health sectors is the conception advanced by Dr. Gary Slutkin (2013) that violence
contains all the core elements of a contagious disease; it clusters in space, it spreads,
and it transmits from person to person. From this perspective, effective policing is
epidemiologically informed.
Mental health is likewise an obvious area of intersection between policing and
public health (van Dijk et al., 2019). It is known from early sociological studies that
the public police routinely encounter individuals affected by mental illnesses and other
medical and social complexities, often in socially disadvantaged areas (Bittner, 1967).
Local jails in the United States house more people with serious mental illnesses than
psychiatric hospitals (Frank & McGuire, 2011). Recent estimates in America suggest
that 6% to 10% of public police encounters involve people affected by serious mental
illnesses (Livingston, 2016), and figures elsewhere are at least double (Parker et al.,
2018). Such estimates are conservative because many encounters occur in “gray zone”
situations (Wood et al., 2017), whereby people are not engaged in serious criminal
behavior, nor do they manifest a threat to themselves or others (the basic criteria for
transporting a person to an emergency department or designated psychiatric facility;
Wood et al., 2017). Although seen in some cases as threats to social order and public
safety, the behaviors driving such encounters are usually not violent or felonious in
nature (Draine et al., 2002).
A recent study in New Zealand found a significant increase in mental health–related
calls for service to the public police between the years 2009 and 2016 (Li et al., 2018).
As part of this trend, suicide-related calls (attempts/threats to commit) increased simi-
larly (Li et al., 2018). This study observed an increase in calls for service ultimately
deemed by police to be of low priority, including calls that did not merit police atten-
dance (Li et al., 2018). These findings are consistent with epidemiological research
challenging the lay view that people affected by serious mental illness are dispropor-
tionately responsible for serious or violent crimes (Swanson et al., 2015). Indeed,
mental illness is more likely to be linked to victimization and suicide (Baumann &
Teasdale, 2018; Cook & Goss, 2014). Other studies within and beyond the United
States reveal that mental health, public safety, and social order are connected, but in
complex ways that speak to issues of social vulnerability and structural disadvantage
(see Albers et al., 2018; Metzl & Macleish, 2015).

The problem of drug addiction and drug overdose also sits at the nexus between
policing and public health (Crofts et al., 2012). The opioid epidemic has afflicted
countries around the world. According to the U.S. Department of Health and Human
Services (2019), more than 130 people die each day in America from an opioid-
related overdose. In 2016, approximately 40% of opioid deaths were due to prescrip-
tion opioids and 81,000 people initiated heroin use. In 2017, about 68% of all 70,200
drug overdoses were related to an opioid (Centers for Disease Control and Prevention,
2019). The opioid epidemic has unfolded in three major waves, with the first wave
beginning in the 1990s when pharmaceutical companies misled the medical commu-
nity about the addictive potential of the pain relievers (Centers for Disease Control
and Prevention, 2019; U.S. Department of Health and Human Services, 2019). This
led to an increase in prescribing practices and ultimately an increase in deaths from
prescription opioids. The second wave, initiating around 2010, was a rise in heroin-
related deaths. A few years later, fentanyl and other deadly illicit opioids began to
infuse the products of street markets, leading to a steep uptick in overdose deaths
(Centers for Disease Control and Prevention, 2019). This public health crisis has
many obvious implications for public safety and social order—lives are lost or nearly
lost due to drug overdoses.
These and other issues (e.g., human trafficking) that cut across the domains of
policing and public health raise a complex question about how to reshape policing into
the future. Arguably, public health researchers have focused on this question more
than criminologists and policing scholars because policing practices are known to be
“iatrogenic”—that is, increasing the health risks of structurally vulnerable populations
(Anderson & Burris, 2017; Bohnert et al., 2011). For instance, studies have illumi-
nated the ways in which public police officers adversely shape the health risk environ-
ments of sex workers through activities that are stigmatizing, coercive, exclusionary,
and generally unprotective of their health (Kingston & Thomas, 2017; Klambauer,
2018; Platt et al., 2018). A similar consequence has manifested during targeted public
police crackdowns of urban drug markets. In efforts to avoid the gaze of officers,
injection drug users resort to a variety of avoidance tactics, such as rushing the needle
sanitization process, or choosing not to secure clean needles from needle exchange
facilities (Cooper et al., 2005; Maher & Dixon, 1999).
Policing scholars increasingly recognize the need to bridge disciplines and advance
theoretical frameworks, methods, and practices that align public health concerns with
practices for promoting order and security (see Zedner’s [2003] conception of secu-
rity). The journal Policing and Society recently released a special issue on law enforce-
ment and public health (Anderson & Burris, 2017; Bartkowiak-Théron & Asquith,
2017; Punch & James, 2017; van Dijk & Crofts, 2017; Wood & Watson, 2017). A
recent issue of the Lancet examined the nexus between public health and security at
both national and global levels (Michaud et al., 2019; Thomson et al., 2019; van Dijk
et al., 2019). There is now a Global Law Enforcement and Public Health Association
devoted to advancing research and practice at this nexus. These efforts are centrally
concerned with transforming the mentalities and practices of public police agents and
building new institutional arrangements across sectors that one might describe as

Journal of Contemporary Criminal Justice 36(1)
“referral bridges” between police and community health services. Referral bridges
help address the...

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