The policing and public health interface: insights from the COVID-19 pandemic

KEYWORDS:

• Policing
• public health
• regulation
• COVID-19

Introduction

The term ‘interface’ has at least two meanings. It refers to ‘the place at which interdependent and often unrelated systems meet and act on or communicate with each other’ and it also denotes the act of joining, as in ‘to connect by means of an interface’ (Merriam-Webster 2021). In both senses, the interface between policing and public health is steadily gaining attention as the subject of study, scrutiny, and innovation. A new collection of essays (Bartkowiak-Théron et al. in press) signals global interest in this topic, as have a series of articles designed to encourage shared thinking and practice in the many spaces where these systems meet (Burris and Koester 2013, Wood et al. 2015, Anderson and Burris 2017, Bartkowiak-Théron and Asquith 2017, Punch and James 2017, Van Dijk and Crofts 2017, van Dijk et al. 2019, Goulka et al. 2021).

This special issue on the policing and public health interface is meant to propel our journey toward better inter-disciplinary understanding and deeper normative engagement, with an emphasis on views from around the world, complementary theoretical ideas, and shared points of action. Taken together, the papers in the collection provide insight into the nature of vulnerability and harm and the ways in which policing functions on landscapes of plural regulation.

The policing and public health interface: some signposts

Examining the policing and public health interface is important because it is well known that our most prevalent social problems, including violence, mental illness, substance abuse, and infectious diseases defy institutional boundaries (see Punch 2019). The fields of public safety and public health find themselves in crisis response mode far too often (Anderson and Burris 2017) – reacting when people are shot by guns, experiencing a mental health crisis, suffering from the grips of addiction, or navigating the deadly risks of a global pandemic. No doubt, those working on the front lines wish such social ills could be prevented to forestall the harm and trauma experienced by people, those who care for them, and their communities. Tragically, the COVID-19 pandemic has laid bare the failures of prevention (Todorovic et al. 2020) and the urgency of finding better ways for policing and public health agents to work in harmony, both in strategy and in operations (Richards et al. 2006).

Strengthening the policing and public health interface has been a practical goal for the Global Law Enforcement and Public Health Association (GLEPHA), whose mission is to advance ‘research, understanding and practice at the intersection of law enforcement and public health’ (Global Law Enforcement and Public Health Association 2021). Foundational to this agenda is working across geographic, theoretical, methodological, and institutional vantage points. In Braithwaite’s terms, this agenda is concerned with fostering ‘hybridity’ (Braithwaite 2014a) – that is, forming bridges in pursuit of ‘theory and discovery’ (Braithwaite 2014a) that transcend our institutions and disciplines. By ‘discovery’ we refer both to empirical research that describes and explains phenomena as well as solutions-focused work devoted to practical, equitable and fair interventions.

In the spirit of hybridity, perspectives from across the disciplines have produced different theoretical lenses and framing language that help us make sense of the interface, and interfacing efforts, that have animated our work so far. One conceptual pillar of the LEPH agenda is the practice of ‘law enforcement’ in its varied institutional forms. A focus on law enforcement has several benefits. It is a broad term that encapsulates laws, law-making and the many institutions of law enforcement. To date, the concept has been applied in ways that foreground public police agencies but is inclusive of other ‘downstream’ criminal legal agents including prosecutors (Davis 2018, Fair and Just Prosecution 2018). The law enforcement pillar also connects naturally with the agenda of legal epidemiology (Burris 2002, Burris et al. 2016, Burris et al. 2018), devoted to ‘the scientific study and deployment of law as a factor in the cause, distribution, and prevention of disease and injury in a population’ (Burris et al. 2016). Of particular interest to the LEPH movement is the relationships between criminal laws, law enforcement practices and the public’s health. Although criminal laws are not explicitly designed to achieve public health benefits, there is no doubt that such laws, on the books, or in practice, can and do have consequences for the public’s health (Burris 2006). Criminal law is therefore recognised as an ‘incidental’ (Burris et al. 2010) form of public health law due to its effects on population health.

Public health researchers and practitioners, beyond those working in legal epidemiology, have long been concerned about the deleterious consequences of law enforcement practices on the public’s health (Simckes et al. 2021). For instance, it is now well documented that certain kinds of police encounters – especially ones that are aggressive or stigmatising – can result in bad outcomes for physical and mental health (Geller et al. 2014, Sewell and Jefferson 2016, Duarte et al. 2020). Like medicine, policing can have ‘iatrogenic’ effects (Anderson and Burris 2017, Goulka et al. 2021), producing harm and deepening inequalities (Rafla-Yuan et al. 2021). Police violence has been framed as a public health issue (American Public Health Association 2018).

Given that ‘law is a ubiquitous treatment’ (Burris et al. 2021), inquiries into the policing and public health interface are therefore strengthened by a lens that homes in on the direct and indirect effects of laws and law enforcement practices on population health. The power of this lens is even more apparent in the context of the COVID-19 pandemic. Across the globe, we have seen officers playing roles in the enforcement of laws and public health orders designed to stop the spread of the virus, such as stay-at-home orders, social distancing requirements, travel restrictions and mask-wearing mandates (Mazerolle and Ransley 2021). In this capacity, police agencies have stepped in, with varying degrees of apprehension (Chan 2020), as deliberate health interventionists rather than incidental ones.

As we continue to map both the direct and indirect roles of policing in shaping public health outcomes, a lens focused on the ‘regulatory craft’ (Sparrow 2000) is informative. This lens invites a broad of view of policing that considers the range of mechanisms and techniques designed to foster compliance with rules and directives. One part of the regulatory craft involves police in their role as ‘purveyors of force and law’ (Friedman 2020). Police do ‘govern through force’ (Wood and Shearing 2007), or ‘by command’ (Ayling and Grabosky 2006), and coercion in its many forms has generated the iatrogenic harms that have deeply troubled public health academics and practitioners. Thinking normatively, the prospect of strengthening the connections at the interface of policing and public health can therefore seem ill-advised and dangerous.

Current policy debates, especially in the United States, are fuelled by this worry about governing through force, expressed most powerfully by Kaba who regards policing as one of several ‘death-making institutions’ (in Taylor 2021). Some have argued for a ‘de-centring’ of the police institution (DC Police Reform Commission 2021), with a view that they ‘should serve as one force among many who provide and maintain public safety’ (DC Police Reform Commission 2021). In a similar vein, others argue for a ‘decoupling’ (Rafla-Yuan et al. 2021) of policing from public health, especially in responding to mental health (Rafla-Yuan et al. 2021).

This notion of decentring is not new to scholars of regulation (Black 2000), who have worked to describe and explain the plurality of institutions, mechanisms and techniques involved in shaping behaviours and fostering compliance – i.e. regulatory pluralism (Gunningham and Sinclai, 1999, Drahos 2017). Regulation, in the broadest sense, refers to ‘influencing the flow of events’ (Parker and Braithwaite 2003). Seeing policing in terms of a regulatory craft expands our view to a wider horizon of options for ‘influencing’ events, like shaming, education, moral suasion and other ways to ‘nudge’ (Thaler and Sunstein 2009) behaviours in furtherance of common goods like public safety and public health. Scholarship on regulation has been enriched by powerful literature in the social psychological tradition that proves compliance with the wishes of regulatory authorities is more likely to be successful when regulatory agents, like police, or doctors and other health authorities, behave in ways that are ‘procedurally just’ (Tyler and Mentovich 2013).

This broad view of regulation and plurality is consistent with the view – found in scholarship on the ‘policing web’ (Brodeur 2010), plural policing (Loader 2000, Crawford et al. 2005) and multilateral policing (Bayley and Shearing 2001) – that the public police are only one entity among many that work to influence the flow of events, and that the police need not, and do not, rely on coercion and enforcement of the law all of the time, even if that is what they have been trained and socialised to do (Friedman 2020). It could be said then that the conditions for de-centring the police and bringing other institutions into the centre of our lens already exist, but we fail to see them well. Certainly, the literature on the role of private policing entities in shaping health risk behaviours and environments has been scant (Wood 2020).

A view that emphasises regulatory pluralism is thus compatible with the normative agenda to ‘reduce altogether the footprint of force and law’ (Friedman 2020). It emphasises that the police, as one regulatory institution, can make use of other tools, beyond coercion and law enforcement, to influence health-risk behaviours. And if enforcement becomes necessary, it should be carried out in procedurally just ways to maintain the legitimacy of state authorities (Tyler 2004). In this light, the COVID-19 pandemic brought with it unique challenges to the performance of policing as a regulatory craft in shaping behaviours and environments in furtherance of public health. In unique ways, the papers in this special issue bring different lenses to the problems of vulnerability, harm, plural policing, and regulation. They illuminate ways in which agents of law enforcement and public policing have responded to the operational demands brought on by the pandemic. Most importantly, they provide us with conceptual tools for making sense of the policing and public health interface and elements of it that should worry us.

Vulnerability, harm, and the craft of policing: key insights from the papers

The papers in this issue help us further examine, scrutinise, and reimagine the policing and public health interface in the context of the COVID-19 pandemic. They provide contributions from different parts of the world – Nigeria, Pakistan, New Zealand, Australia, and the United Kingdom, places with unique economies, political traditions, cultures, and policing legacies.

The literature on policing and public health has to date been centrally concerned with what Brodeur depicts as ‘low policing’, that is, ‘everyday policing largely performed by agents in uniform’ (Brodeur 2007). In their piece, Ian Stanier and Jordan Nunan shine a light on one element of what Brodeur characterised as ‘high policing’ (Brodeur 1983, 2007) – i.e. the use and management of human sources - in the United Kingdom. Stanier and Nunan set out to understand how the national lockdown affected the work of English and Welsh Dedicated Source Units (DSUs) in their efforts to continue their intelligence operations and maintain relationships with their informants. They were particularly interested in how members of these little-known units adapted to an operational environment constrained by physical distancing requirements as well as adjusted to various aspects of their work to maintain flows of intelligence. Through survey-based data collection and thematic analysis of qualitative responses, Stanier and Nunan illuminate DSU members’ concerns about the wellbeing of their informants and the ways in which members of this intelligence community brought a health-oriented sensibility to their trade.

This article richly describes ways in which police agents were reflective and creative in responding to the conditions of the pandemic and found ways of aligning concerns about the health and wellbeing of their informants with their own operational imperatives to gather intelligence. DSU staff recognised not only that the health of informants was at risk, but that informants' economic security and mental health was threatened by lockdown requirements. Stanier and Nunan depict how DSU staff worked to be responsive to informants’ vulnerabilities such as through the provision of public health information and advice and finding alternative ways of paying informants protect their economic wellbeing. Stanier and Nunan’s study reveals that maintaining relationships with informants based on trust and rapport was a focal concern for handlers, and that matters of public health were not viewed as antithetical to matters of crime control and national security.

Picking up the theme of vulnerability, the article by Francesca Menichelli examines a multi-agency partnership designed to address the needs of people affected by ‘severe and multiple disadvantage’ (SMD). The notion of severe and multiple disadvantages makes an important conceptual advance in its treatment of vulnerability as structurally determined. It is a conception that resonates with an emphasis on the social determinants of health (Burris 2011, Compton and Shim 2015). A lens focused on SMD focuses on the many intersections between different forms of disadvantage, such as housing insecurity, mental illness, substance use and criminal legal involvement.

Engaging with the literature on plural policing, Menichelli draws from her first-hand experience of a partnership-based approach to support people experiencing severe and multiple disadvantage. She characterises the partnership in terms of ‘hybrid’ governance arrangements, within institutions, including the police, from across public, private and ‘third’ sectors leveraging their assets in addressing vulnerability. Notably, the partnership was established prior to the outbreak of COVID-19. Like Stanier and Nunan’s concern with the operational implications of the pandemic for informant handling, Menichelli focuses on the operational implications of the pandemic on the functioning of this partnership.

Menichelli’s central concern is a normative one, which is the effects of the pandemic on aspects of responsiveness, participation, and equity in the performance of the partnership. One of Menichelli’s findings is that local governance efforts to prioritise and address the ‘combination of needs’ (p. 536) of individuals was trumped by a national directive to focus on the single issue of housing, thereby undermining the responsiveness of the partnership to multiple forms of disadvantage. Due the requirement of working remotely, the partnership also experienced barriers in its efforts to foster participation on the part of people with lived experience, including peer mentors, who are meant to play central role in identifying needs and supporting people suffering from multiple disadvantage. Menichelli learned that people’s complex needs deepened during the pandemic, raising questions about how the partnership could provide intensive support equitably to all who needed it. Menichelli encourages us to engage with these normative concerns more broadly as we assess the functioning of hybrid and plural institutional arrangements at the interface of policing and public health.

In the Australian context, Alex Workman, Erin Kruger, and Tinashe Dune provide insight into issues of vulnerability, responsiveness, and equity in their analysis of how partner violence is framed in the grey literature, with an emphasis on how newspapers constructed victims and perpetrators during the pandemic. Their analysis focused on whether the construction of victim and perpetrator identity was inclusive of people with multiple identities in terms of gender identity, sexuality, race/ethnicity, cultural identity, disability status and religious status. They were interested in exploring whether the COVID-19 pandemic fostered a heightened awareness of the diversity of victims in contrast to what has traditionally been a heteronormative view of partner violence, centred on white women as victims and heterosexual white men as perpetrators.

While Menichelli is concerned with disadvantaged people falling through the cracks of service delivery systems, Workman, Kruger, and Dune are troubled by the prospect of victims, in all their diversity, ‘falling through the cracks of our awareness’ (p. 548). Their analysis is informed by ‘intersectionality’ theory which recognises the ‘interconnected parts and socially created categories which make up a person’s identity’ (p. 554) as well as people’s unique experiences of disadvantage. This view of intersectionality and disadvantage complements Menichelli’s conception of multiple disadvantage. Workman, Kruger, and Dune find that media constructions of partner violence, vulnerability and victimhood remain deeply problematic from an intersectionality perspective, and that ‘[i]t is critical that policymakers, policing agencies, and media institutions evolve to reflect on the diverse voices of the people they represent, protect, and advocate for all, rather than only a select type, of victims’ (p. 560).

Issues of vulnerability and responsiveness are touched on by Stanier and Nunan, Menichelli, and Workman, Kruger and Dune. Normative concerns drive the focus of the next paper on the Nigerian context. Here, we are brought back to our deepest worries about police violence as a public health problem. Richard Abayomi Aborisade and Dooshima Dorothy Gbahabo examine the treatment of frontline health workers by the Nigerian police during the period of the national lockdown. In contrast to Stanier and Nunan’s finding that the law enforcement sector can be responsive to the conditions of the pandemic and consider the health and wellbeing of institutional partners, Aborisade and Gbahabo provide qualitative evidence of police aggression and extortion in the handling of the lockdown, renewing longstanding concerns about institutional violence in the country.

Through interviews with healthcare workers, Aborisade and Gbahabo focused their analysis on the ways in which officers interacted with healthcare workers who, in the context of the lockdown were regarded as essential workers and therefore allowed by the government to travel to their work destinations and be exempt from curfews. In theory, the journey of healthcare workers through checkpoints was to be smooth and efficient, with minimal disruption to the work they did to help battle the COVID-19 pandemic. The interviews elicited worker’s experiences of police encounters at checkpoints and other areas they encountered the police. As part of the interviews, respondents were asked to report on any forms of aggression that they may have experienced. They were also asked to provide their perspective on why police were aggressive.

Participants reported various forms of aggression, from verbal acts such as shouting and taunting to different expressions of disrespect. Physical forms of aggression included acts such as kicking, beating, and pushing. Due to negative and prolonged encounters with police, some workers reported being late for work and paying bribes to get through checkpoints. Respondents furnished different explanations for the harmful behaviour of police, including inadequate training, stress, and a lack of resilience in the face of additional pressures brought about by the pandemic. Aborisade and Gbahabo suggest that ‘the hydra-headed problem of police corruption in Nigeria is attaining an ominous level, in threatening the country’s public health at a time of a pandemic with high fatality’ (p. 579). They advocate for continued efforts to listen to the voices of healthcare workers, whose views from the ground are revealing of the many functional and normative intersections between policing and public health in the handling of emergencies.

Shifting to Pakistan, the paper by Zoha Waseem asks a question that is relevant to Aborisade and Gbahabo Nigerian-based study: ‘How are public health emergencies policed in the global South, where some states are unable to guarantee the short – and long-term wellbeing of their citizens’ (p. 584)? As with the other countries examined in this special issue, Pakistan implemented strict public health measures including a national lockdown, to manage the spread of COVID-19. This resulted in increased public health enforcement burdens on the part of the police. In contrast to the findings of Aborisade and Gbahabo who point to failures of the police in being flexible and responsive to this public health role, Waseem illuminates creative, everyday practices by officers to meet these demands and cope with a lack of clarity in what they are being asked to do by different levels of government.

Waseem deploys the concept of ‘procedural informality’ to make sense of how Pakistani police navigate their roles and foster compliance in national efforts to disrupt COVID-19. Procedural informality is defined as ‘a condition in which policies (official and unofficial) are constructed by state institutions and conveyed to state officials (e.g. police officers), with the recognition that they will be implemented through informal practice’ (p. 584). This concept resonates with a plural view of regulation, whereby authorities at different levels of government work to pursue their policy goals through mixes of formal and informal procedures and compliance techniques.

Drawing from interviews and surveys with police officers, Waseem illuminates the many dimensions of procedural informality, such as acquiring personal protective equipment (PPE) with their own funds in the absence of other resources, allowing vendors to stay open in exchange for money and declining to arrest individuals in violation of lockdown restrictions. Through these, and many other examples, Waseem raises broader normative issues that merit greater attention and empirical study. Depending on the act, procedural informality may serve to enhance the legitimacy of police and authorities, and foster trust between officers and citizens. At its worst, it may enable police corruption (as seen in the bribery example) or unfair and discriminatory treatment of disadvantaged groupings. Notwithstanding, Waseem urges readers to be open to the possibility that procedural informality, if directed toward good ends, might be suitable to the conditions of certain countries in the global South.

Waseem’s analysis connects to larger debates about how best to regulate and foster compliance in different societies, recognising that formal and informal mechanisms co-exist and intermingle. Rules related to physical distancing, mask wearing and staying at home can conflict with people’s views of freedom and self-determination. The police role in fostering compliance with such rules is thus a unique regulatory challenge during a global pandemic. In addressing the problem of compliance, Molly McCarthy, Kristina Murphy, Elise Sargeant and Harley Williamson extend Valerie Braithwaite’s approach to the problem of defiance (Braithwaite 2014b) which is based on the view, explained by McCarthy and colleagues, that ‘individuals may hold a range of attitudinal positions towards authorities and their system of rules, which are shaped by their personal and vicarious experiences with authorities’ (p. 602). From this perspective, meeting the regulatory challenge of fostering compliance must address the range of ‘motivational postures’ people display in relation to laws and legal authorities. One question of interest to the authors is whether compliance among people with defiant attitudes toward police is facilitated by experiences of procedurally just policing.

Through surveys administered to Australian adults during the nation’s initial lockdown, the authors explore factors associated with compliance with physical distancing requirements. They focus their analysis on such factors among people who display defiant attitudes toward police in the form of two types of motivational postures – resistance and disengagement. Among many interesting results, they found strong correlations between these defiant postures and non-compliance with the restrictions, controlling for different factors such as demographics and risk perceptions of COVID-19. They also found that in terms of police-initiated contacts, people who had experienced such contacts during the pandemic and perceived them to be procedurally unjust were less likely to comply compared to people who did not have such contacts or had contacts perceived to be procedurally just.

Waseem, along with McCarthy, Murphy, Sargeant and Williamson illuminate different facets of regulation and regulatory pluralism. Together, these papers demonstrate the combined value of unique theoretical lenses, like procedural informality and procedural justice in making sense of how compliance is or could be fostered, especially during the period of a pandemic where police are centrally implicated in the enforcement of public health directives. In the New Zealand context, the theme of fostering compliance is addressed in a different, but complementary way through the lens of plural policing in the piece by Antje Deckert, Nicholas J. Long, Pounamu Jade Aikman, Nayantara Sheoran Appleton, Sharyn Graham Davies, Susanna Trnka, Edmond Fehoko, Eleanor Holroyd, Naseem Jivraj, Megan Laws, Nelly Martin-Anatias, Reegan Pukepuke, Michael Roguski, Nikita Simpson, Rogena Sterling and Laumua Tunufa’i. Like Menichelli, Deckert and colleagues make the case that explanatory and normative engagement at the interface of policing and public health must be attuned to the plurality of regulatory institutions and practices. Like Waseem’s paper, along with the piece by Aborisade and Gbahabo, the article by Deckert and colleagues demonstrates that context matters to how we assess the performance of policing and its responsiveness to the COVID-19 pandemic. They argue that in the context of New Zealand’s colonial history, the landscape of policing is best viewed as a plural landscape. At the outset of their paper, they state that ‘[t]he way in which a public health crisis such as the COVID-19 pandemic is experienced is heavily shaped not only by how it is policed, but also who it is policed by’ (p. 621).

Deckert and colleagues extend Loader’s framework of plural policing to identify the constellation of policing nodes, operating at the same time as the public police, that worked to foster compliance with pandemic control measures. In addition to the New Zealand Police, these include Indigenous-led community checkpoints as well as forms of ‘peer-to-peer’ policing and the regulatory tools they deployed, including enforcement, education, norm-setting, and surveillance. Echoing the scholarship on regulatory pluralism, the authors were interested in larger questions of how these co-existing forms of policing ‘affect each other’s functionality and legitimacy’ (p. 622). Their study findings are based on document analysis, surveys about people’s experiences of pandemic control measures, and depth interviews.

With respect to the public police, Deckert and colleagues noted that the NZP developed operational guidelines which emphasised the use of education and encouragement, with a view that enforcement, including arrest, be used a last resort. The authors found evidence that the NZP officers focused their enforcement practices on select situations, stopping people, for example, when they were travelling in their cars and thus assumed to be travelling far. There was less evidence of officers enforcing physical distancing rules or hygiene practices. Co-existing with NZP practices, Indigenous-led community checkpoints were set up to protect the health of Mãori communities that, historically, have experienced low levels of trust in the public police. The checkpoints allowed for the stopping of travellers in efforts to regulate ‘essential travel’, in line with Mãori values including ‘taking care of others, guardianship, and protection’ (p. 632). Theoretically, the authors characterise this type of policing as a form of ‘next-to-government’ policing, acknowledging Indigenous sovereignty rights and the critical need for NZP to recognise their legitimacy and cultivate true and equal partnerships with them.

The forms of ‘peer-to-peer’, ‘below-government’ policing observed by Deckert and colleagues made use of informal tools of social control including surveillance and threats of formal reporting to NZP, particularly in relation to behaviours deemed out of compliance with physical distancing and travel restrictions. The authors raise concerns about the authoritarian tone of such peer-focused practices, and their potential to foster resistance more than compliance. Deckert and colleagues suggest that future work should focus on the ‘synapses that connect individual policing nodes’ (p. 634) to ensure that the tools of enforcement and coercion are combined to good effect with the tools of education and encouragement. Like Menichelli, they provide evidence of the need to exert democratic control over plural policing arrangements. Without such efforts, issues of trust and legitimacy in regulatory authorities will remain ever-present. Pulling back the lens on all the papers in this collection, perhaps it is our shared concerns about trust and legitimacy that must propel future work on regulatory pluralism at the interface of policing and public health.

Disclosure statement

No potential conflict of interest was reported by the author(s).