Alternatives to Policing

Illustration of a person opening a door that says "mental health professional."

​​Police violence is an area of concern for many communities. Establishing public health-informed, alternative response programs—separate from law enforcement agencies—is one approach to reduce police violence and give communities a more diverse set of tools with which to respond to crises and support community health and wellbeing. Such programs have the potential to improve health outcomes, especially for communities that are disproportionately harmed by the police.

This episode of the Population Healthy podcast provides a rationale for developing and implementing alternative response programs to policing informed by public health principles of care, equity and prevention. We talked to two researchers from the University of Michigan School of Public Health Department of Health Behavior and Health Education to understand the research and data on alternative response programs.

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Listen to "Alternatives to Policing" on Spreaker.

0:00:03.8 Paul Fleming: What creates safety in a community? What actually pushes safety? Is it armed police or is it other things? And so, if we start to reframe and ask different questions, if you were starting a community from scratch and thinking about how you are gonna address issues of safety? Having every instance of a public safety concern be responded with somebody with a gun that can throw you into jail, would probably not be how you would design that, that community. But it's the system that we have right now. And so everybody thinks it's really normal and accepted and the best way to do things. But if you actually kind of peel it back and think through, "Well, who is the best person to respond to an issue?" Oftentimes you would say, "Oh, well, probably a trained social worker, probably somebody with this type of support. Probably a supportive friend or a neighbor would be the best person to respond in that case."

0:00:55.0 PF: And so part of what I'm hoping for with this body of research is that we are helping people imagine a different future by exploring what is existing elsewhere in other communities. We can better imagine what could exist here but also by bringing together some of this evidence, we can see what are the harms and what are things that have an actual evidence base for better outcomes, and how do we integrate that into our community? 

0:01:24.4 Speaker 2: There's an old adage that says, if the only tool you have is a hammer, then you tend to see every problem as a nail. It's that concept that we'll be discussing today with two University of Michigan School of Public Health experts as it relates to community health needs and policing. Throughout this season, we've explored topics that are typically presented by the media as political. There are two entrenched sides at odds with each other. And political solutions come down to how many seats a party holds, not actual solutions. But when viewed through a public health lens with a focus on health, equity and data, we see public health solutions emerge as not only viable, but necessary. Police violence is one such public health issue. When a community only has a hammer, all the problems are nails. But if a community has a diverse set of tools in its toolbox, crisis response can be more precise and better support a community's health and wellbeing.

0:02:18.1 PF: This approach can keep police responses one option, but open up new avenues for responding to mental health crises, non-emergency medical care needs, and other societal issues. Hello, and welcome to Population Healthy, a podcast from the University of Michigan School of Public Health. Join us as we dig into important health topics, stuff that affects the health of all of us at a population level, from the microscopic to the macroeconomic, the social to the environmental, from cities to neighborhoods, states to countries and around the world.


0:03:00.1 S2: In this episode of Population Healthy, we'll dig into a public health rationale for developing and implementing non-police response programs, programs informed by public health, principles of care, equity, and prevention. We'll talk to two researchers from the University of Michigan School of Public Health.

0:03:16.3 Dr. William Lopez: Now, hi, I'm Dr. William Lopez. I go by Bill.

0:03:19.0 PF: I'm Paul Fleming.

0:03:20.4 S2: Lopez, is a clinical assistant professor of health, behavior, and health education, whose research examines the health impacts of law enforcement, especially on communities of color. Research that looks at both police violence and deportation. Fleming, is an assistant professor of health, behavior and health education whose research broadly focuses on root causes of health inequities, especially policies and structural issues that are shaping racial health inequities in the United States. Lopez and Fleming begin the conversation by sharing how their research brought them to explore today's police forces and interactions with the public. Here's Lopez.

0:03:54.8 DL: When I think about my research and my writing, I started out thinking about the harms specifically of deportation and of immigration enforcement. They're not only deportation, but also fear of the possibility of deportation. So kind of to summarize that, it's what kinda things do we do differently when we worry that we might be taken out of our community, right? When we worry that walking on the sidewalk or driving down the street can result in separation from our families. From there I kind of extended a similar frame to law enforcement. What do we do when we worry that we can't use our public spaces because we're worried about interactions with the police. And I think many public health folks are like this. We do wanna contribute to the empirical research and the knowledge about what we're finding and what we're describing, and especially when these are things that I like to say, communities may know these things in their bones.

0:04:42.9 DL: Folks may be well aware of, for example, racism and policing, but there may not be evidence. And part of what we wanna do is provide that evidence, right, to match the lived experience with what we see empirically. But I think also big component of that is engaging and organizing around these issues. And sometimes that might be policy level. Often it's also organizing at the community level, even if that means preaching to a choir and understanding that like choirs need to be amped up. We need to have the energy to do what we need to do to work against well funded systems that may be impacting our communities and our health.

0:05:16.7 PF: For me, at the end of the day, I wanna help create communities that allow people to thrive and don't exacerbate inequities. And I think the more I've done this work, the more I realize that a whole range of policies really need to be shifted. And so, that's where a lot of my work tries to think about what are the policies that actually are supportive and care-based and actually help people live healthy and happy lives, as opposed to policies that are more either punitive based or don't provide people the supports they need. And so this work really fits into that. And yes, absolutely, I think policy change is one of the concrete goals, but that policy change can exist at a lot of different levels, including institutionally. How do institutions think about this? How does city government think about it? How does county government think about it? And how does state or even federal policy think about it? I think some of our work is much more local.

0:06:11.8 DL: Public health is often thinking about the systems that result in particular health outcomes, right? So it's not thinking about necessarily what makes one person sick, but what makes a group of people sick or a community sick, and especially when a pattern emerges. That's what we wanna think about in policing, right? Who is injured? What is the pattern of that injury and death? Why is this burden upon particular racial groups? What are the systems that are at play here? A lot of it is the history of policing, and police were developed to maintain rights to your land and to maintain a particular labor pool and to fill our jails and prisons. So a public health perspective would think not only of that one officer interaction with one individual, but historically how did it result in this pattern? And the other aspect of public health is it's not solely about being physically and biologically healthy at one particular moment in your life.

0:07:02.3 DL: It's also about the potential to do well and to live long, healthy, happy, and fulfilling lives, not only by yourself, but with your blood or chosen family and with your community. So it's also about your potential as a human and your potential as a member of a community. And that's exactly what we're thinking about in policing. We don't wanna focus solely on injuries and killings, right? Although that's important and critical and we should continue to study it. We also want to think about how it shapes life in general. If you're scared of being killed, there may be no deaths, but you may be worried about leaving your house, which means you can't go to your church, your gym, your grocery store, your hospital, right? So the fear of this bodily injury and harm also just shapes daily life. So I think that's what we mean from a public health perspective.

0:07:46.2 S2: Lopez and Fleming have been involved in the coalition for re-envisioning our safety, a project looking to bring a non-police response team to Ann Arbor, Michigan. It's an initiative that has its roots in public health, one that prioritizes care, equity and safety.

0:08:02.6 PF: We've been involved in this coalition, which includes both of us, a few other researchers, but also people who are pastors, people who are involved as community members, part of the nonprofit space, etcetera. And that coalition, we've been kind of part of a core group that has really been advocating for a version of unarmed safety. And through that process, the Ann Arbor government has allocated $3.5 million to an unarmed non-police response program, that's still in progress. Bill and I are still involved in advocating that when it does finally take shape, it is gonna take shape in a form that's informed by some of our research and public health values.

0:08:44.8 S2: But to re-envision a system as complex as policing, we have to first understand how it took hold in society.

0:08:50.7 PF: When you look at the origins of policing, it really has its roots, both in colonial projects where a European nation is trying to colonize another area of the world, or in the US context, in slave patrols and trying to suppress slave revolts or enslaved people who are fleeing. If you trace back the origins of our current police institutions, that's where it comes from. It eventually evolves into... People who own businesses are using a version of a police force to squash kind of labor unions and labor revolts. And so over time, it's always been this case of kind of the powerful folks within a community or society are exercising that power through a police force. It's evolved into this place where every city has a police force. Both its origins come from that place of the powerful exercising their power over folks who are oppressed or who don't have as much power.

0:09:50.7 PF: Part of the reshifting that really needs to occur is something that's less oriented about the exercising of power and more about how do we provide support. In many ways, the institution of policing, because of this history, it's not exactly an institution that we can just tweak around the edges and shift, right? It's gonna be near impossible to garner that trust of the community because of the centuries of legacy that this institution holds. So we actually think it's a much more promising approach to really create a new institution, I don't wanna say from scratch, 'cause we can build on existing resources, but a new institution that is more driven by the community, led by the community, and has that trust from the outset. Because shifting the institution of policing in this country, we see time and time again. It just doesn't work. I don't know, Bill, what you would have to add to that.

0:10:43.8 DL: I think all of that is right. You covered a big history pretty quickly there. I think a lot about the history of policing and its roots and suppressing labor revolts. And part of that in the modern era is also making sure that jails and prisons are full because that's where a lot of our labor is coming from now, a lot of our very cheap labor and exploitative labor, and the same with immigrant labor. So in order to have our factories filled with folks and our meat packing plants filled with folks doing dangerous work and not getting healthcare and not getting insurance from the Affordable Care Act, there needs to be this threat of violence and incarceration. Police are really essential in that. If you break some law, then you can get detained. And for many folks you can get deported.

0:11:28.9 DL: What was once a history of stopping labor revolts now is, it's still working toward this same end goal, but it's providing folks to engage in this labor and also policing folks so that they continue to engage in labor and not rebel against the work that they're doing. And just to emphasize, Paul already said this, but why are police and firefighters doing all of these things that they're not really trained to do and perhaps don't even want to do, and are trained very well to respond to violent, aggressive escalating incidents. When you have a hammer, any problem you see is a nail, right? So when police are trained to respond with violence, then they'll tend to interpret their situation as violence. They're not going to interpret it as what is the care-based response that I need? What is the mental health emergency that I can address? It's how do I prevent this to escalating for escalating into violence.

0:12:17.4 DL: I think it's less a matter of diversifying our police force and more a matter of seeing how can we address all these other needs that typically the police address without training to do so.

0:12:28.9 S2: Within this history, the researchers say is a lot of data about policings impact on inequity, but it can be hard to understand what equity related to policing and violence would mean. In this case, Lopez and Fleming start by looking at the patterns.

0:12:42.6 DL: I think it comes in two parts. And the first is to establish how policing is done, if it's done equitably or inequitably and violence occurs in equitable or inequitable patterns. And it's always funny thinking about equity and police violence, right? So I always add that caveat that what we're going for is not an equal distribution of violence. What we're going for is stopping the violence. But nonetheless, it is important to establish the patterns. And what we do see is of course, that African-American folks, folks of color, indigenous folks, are more likely to experience police violence than their white counterparts. And this is especially the case for younger African-American men. We also know folks are more likely to go to jail, more likely to be convicted of a crime more, less likely to be let out on bond, et cetera. So we know there are these racial biases both in the criminal justice system and in the policing system.

0:13:34.1 DL: So, as I mentioned, it's I think kind of a two step process. The first is to establish the racial patterns in policing. And the second is also to look at what alternatives there are. Where have these alternatives been tried and what does the evidence show? And Paul knows that research better than I do.

0:13:50.9 PF: Really over the last decade, we've seen throughout society that people are paying more attention to police violence as an issue. Certainly in 2020, but in Ferguson, etcetera, these mass protest movements and really trying to think about police violence and how do we address it, and we see all these different proposals. But along the way, public health as a field has really stepped forward and framed this issue as a public health issue. If we look over the last five to 10 years, several different folks really framing and describing, "Look, this is the number of people that have died from this issue. These are the number of people that are injured." It's the sixth leading cause of death for young Black men is being killed by the police. There's over 50,000 people per year, young people, I mean, that are injured by the police and have to go to the emergency room.

0:14:41.1 PF: So public health folks really stepped in, in an epidemiological way to describe, here are the actual numbers of who's getting killed and hurt by policing. Alongside that, there was a movement of folks to ensure that APHA...

0:14:55.9 S2: The American Public Health Association.

0:14:58.0 PF: Took a stand on this issue. And I think that was some of the important groundwork for some of the work we're doing now. In I think it was 2018, APHA passed a policy statement that really not only said in really clear terms, police violence is a public health issue, it also recommended for things like unarmed non-police response programs where within communities people would have an alternative to policing to call in a time of need. And that these response programs would be led by folks like social workers, community members, neighbors, et cetera. So that's a really big part of the foundation.

0:15:33.9 S2: So how can researchers like Lopez and Fleming use public health efforts to offer solutions to a public health problem like police violence? 

0:15:42.9 PF: This unarmed non-police response that's community led has been a big part of how public health is thinking about what the solution is. And as part of our research project and what we're doing, we've looked at other cities across the country that have this type of program. So Eugene, Oregon, is one that has the CAHOOTS program.

0:16:01.8 S2: Which stands for Crisis Assistance Helping Out On The Streets.

0:16:05.8 PF: It's been around since the '80s and they've had incredible success, especially since 2020. And the kind of racial justice reckoning since the murder of George Floyd. A lot of cities are thinking more and more about these types of programs. Denver just initiated a program and they've done some thorough research on the program showing that not only does... Is their community acceptability and the community likes it, but it's actually been shown to reduce instances of crime that are recorded in the city and also better connect folks to supportive social services. So there's big successes in Denver. San Francisco is another example where they're actually operating it out of their department of public health. So another example of public health really taking the lead. And we see it sprouting up more and more. The Biden administration actually allocated a large amount of funding for cities to initiate these programs.

0:16:56.0 PF: So I think in the coming years we're gonna see more and more communities attempting this. And I think the key from our vantage point is that the devil's really in the details. There's a lot of different ways you could start a program like this. If it's just merely that the police are responding in a different way, or that there's really strong connections to police, a lot of the community members still won't trust it, still won't be willing to use it. And so, it's really important that these types of initiatives are completely separate from local policing, essentially, that there's kind of a firewall where people can trust calling this new service and not be worried that they're gonna be referred to the police for arrest and being jailed. Because in communities right now, we see a lot of folks don't trust calling 911. So if they're seeing a friend overdose, for example, or they're seeing an issue where somebody's being harassed or something like that, they simply will not call 911 will not call for help because they're worried about the violence that might happen or they're worried about being jailed. These alternative response programs are a way to potentially really improve health and connect folks to supportive social services.

0:18:04.4 S2: A non-police response can be difficult for many people to conceptualize, but Lopez and Fleming believe the data supports a move in that direction.

0:18:12.4 DL: Thinking about policing from a data-driven perspective is also very powerful in this time where people just see it as a political divide, as a political issue. And we're coming from the perspective of an issue maybe political, but it's because resources are usually driven by political decisions. And we need to think of the money that goes into policing, I should say, as a resource. What are the decisions that mean money goes into this resource and not another resource? So we're thinking about, yeah, resources, resource, distribution, and how we impact how those resources are distributed. So some of that is how do we organize, how do we work together? How do we change the outcomes that we wanna change? 

0:18:53.1 PF: One of the core tenets of public health is that you don't just force a program or a policy onto a community. You really try to have it be led by and informed by the community itself. And so, when I think about this issue of both police violence, but also what are some alternative solutions, we need to think about public safety from a lens of what is the community telling us, especially the folks who are most marginalized. What is it that they want? How do they wanna be responded to in a time of need in a time of emergency? And that is a really core principle. Your role as a public health professional is not to design some program and slap it into a community, but rather you are working alongside in working with communities. That's what the potential of these unarmed non-police response programs can be if they're developed in a way that are community led and community driven.

0:19:43.9 PF: And I want to pick up on the point that Bill was talking about, resources. At the end of the day, within public health, we often are trying to push resources to help promote community health. And when we see a situation where cities are spending 30%, 40%, sometimes 50% or 60% of their entire city budget on armed police, those are dollars that are not being spent on affordable housing. They're not being spent on other healthcare needs. They're not being spent on things that we know from a public health perspective, do help people thrive, do help them be healthy. And when alongside that we're studying the systems of policing and seeing that this many people die and this many people are injured. At the end of the day, we're talking about cities are spending 40% of their budget on something that our research is showing is harming the community in various ways.

0:20:39.9 PF: And that money could be going to things that our research is showing is helping people in vast number of ways. If you give somebody supportive housing, that's gonna have an impact on their health for sure and the health of their family. That issue of kind of resource allocation is so important in a really critical piece when we're thinking about public health of what are the resources that we put out into our community so that the entire community can be healthy and can thrive. I do think the issue of policing as a public health issue is a little bit newer to the field. And so, I think there still are a lot of folks trained within public health who haven't really thought about these issues in the same way that we have or some of our students have. So I think there's still room for growth within the field, but certainly more decision makers that have this framework of really understanding issues of the social determinants of health and just how critical it is to make sure that every person within a society has access to resources, basic resources like housing, like healthcare, a good education, that those are the pieces that are the fundamental building blocks for a community that thrives is such a critical perspective.

0:21:50.2 PF: We actually see the public health framing really resonating with people who don't have a public health background because when you put it in terms of health and wellbeing, people get it and they back away from some of their initial thoughts that are kind of based on just where our culture is at at this time.

0:22:09.2 DL: Thinking about an unarmed non-police response gives many people pause and they say they can't envision anything like that. "I don't know what you're talking about. I can't think of a world without police or without jails." And yeah, it's hard to think about something like that because we've had centuries in which this has been the norm. So thinking about non-police response in the same way we're thinking about a world without prisons and without jails and without cages, does take imagination. And it's something we wanna foster in public health, is not only how to tweak systems that have historically racially inequitable consequences, but how to think of systems that we've never envisioned before and how to confidently move toward our vision. And this can be tricky because we're both relying on data. We're data-driven field, but we also have to move toward a system that has never existed and never been researched. Then I think that's part of the beauty of public health, right? Is learning to lead with our heads and our hearts and learning how to use data on what's happened, but also boldly have a vision of what could happen and still go toward it anyway. And I see that most in the evolutionary stem and care-based responses to public health problems.

0:23:22.5 S2: Thanks for listening to this episode of Population Healthy from the University of Michigan School of Public Health. We're glad you decided to join us, and hope you learn something, they'll help you improve your own health or make the world a healthier place. If you enjoyed the show, please subscribe or follow this podcast on iTunes, Apple Podcast, Google Play, Stitcher, Spotify, or wherever you listen to podcasts. Be sure to follow us @umichsph on Twitter, Instagram, and Facebook so you can share your perspectives on the issues we discuss. Learn more from Michigan public health experts and share episodes of the podcast with your friends on social media. You're invited to subscribe to our weekly newsletter to get the latest research, news and analysis from the University of Michigan School public health. Visit to sign up. You can also check out the show notes on our website, For more resources on the topics discussed in this episode. We hope you can join us for our next edition, where we'll dig in further to public health topics that affect all of us at a population level.

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In This Episode

william lopezWilliam d. Lopez

Clinical Assistant Professor of Health Behavior and Health Education, University of Michigan School of Public Health 

Lopez's work and advocacy focus on the health impacts of law enforcement, including surveillance, arrest, incarceration, and deportation, in communities of color. He the author of the book, "Separated: Family and Community in the Aftermath of an Immigration Raid."

Lopez also teaches a variety of public health classes, including the Social Determinants of Health, Health Program Planning and Health Communication, both residentially and online.

Lopez has been fortunate to collaborate both in his research and advocacy with the Washtenaw Interfaith Coalition for Immigrant Rights and Synod Community Services, which operate the Washtenaw County ID Program.

paul flemingPaul fleming

Assistant Professor of Health Behavior and Health Education, University of Michigan School of Public Health

Fleming focuses his work on the root causes of racial health inequities and strategies to address them. He conducts community-based participatory research focused on the health needs of Latinx immigrants in Michigan and examines how to best integrate anti-racist principles into public health training and practice. He also is a member of Public Health Awakened and contributes to community organizing efforts to promote health through social change.