Abstract

Excerpted From: Semir Bulle, We Cannot Police Systemic Racism and Systemic Poverty: Why Policing Is Not a Solution to Our Public Health Crisis, 2024 Utah Law Review 807 (2024) (94 Footnotes) (Full Document)

Health outcomes are profoundly influenced by the environmental conditions in which people live. The persistent legacy of structural injustices suffered by Indigenous and Black communities has had a detrimental effect on their current health status. These disparities are deeply troubling. In Canada, an individual's racial background is the primary determinant of their economic well-being, and income levels play a substantial role in predicting one's health. The imbalances experienced by Indigenous and Black communities are pervasive throughout our healthcare system, leading to significant gaps in life expectancy.

We must also acknowledge that the Canadian health-care system has its own history of racism and prejudice, similar to countries like the United States. It enables the discriminatory practice of other sectors, most notably police services, especially when it comes to caring for structurally vulnerable populations. These are experiences that many of us have lived and seen in our practice as health-care providers from these same communities.

As physicians, there is no denying that the current state of policing is a public health crisis. The recent deaths and stories of Regis Korchinski-Pacquet, Chantel Moore, Taresh Bobby Ramroop, and Ejaz Choudry, amongst many others, are painful reminders of rampant discrimination. The extent of anti-Indigenous and anti-Black racism cuts across the Canadian judicial and criminal systems. Indigenous and Black people are more likely to be stopped by police, criminalized, or killed. This contributes to a cycle of lateral violence and increased policing with detrimental outcomes.

For example, “[b]etween 2013 and 2017, a Black person was 20 times more likely than a white person to be fatally shot by police in Toronto.” Black and Indigenous people are also severely overrepresented in Canadian prisons. In fact, more than thirty percent of inmates in Canadian prisons are Indigenous, even though they make up just five percent of the country's population.

Decades of anemic reforms and stockpiled reports have failed our communities. We cannot police our way out of systemic racism and systemic poverty. The policy solutions are multifaceted, and we must finally begin addressing the pathologies of policing--not merely its symptoms.

As one of the co-founders of Doctors for Defunding Police, we were able to bring a group of more than 600 doctors and medical professionals together to sign onto a letter. Doctors for Defunding Police is as a group of physicians in Toronto and beyond who stand in solidarity with Black and Indigenous communities to advocate for defunding the police and reallocating funds to support response systems that are supported by public health research. The letter which was circulated and signed had three main demands.

First, it demanded for full transparency around Toronto's policing budget to the Toronto Police Services Board. The police budget has major implications on the well-being of many in the city, and Indigenous and Black communities must be engaged in the prioritizing of spending decisions with meaningful inclusion. The harm inflicted on Indigenous and Black communities by police continues to be very real, a fact clearly acknowledged by the Toronto Police Service (“TPS”). Systemic racism in policing is well documented in both Canada and the U.S. In Canada, Black and Indigenous people are also more likely to be victims of violent crime and more likely to be harmed by the police. Indigenous women face astonishing rates of violence, making up four percent of women in our population but more than twenty percent of women murdered.

In this discussion, we cannot forget the many police-involved deaths of unarmed Black and Indigenous people in our city. People who have not been given a choice but to involve the police when they needed help, given all alternative mental health and socioeconomic resources have been devastatingly underfunded and under-resourced by decision makers. Increasing the police budget does not keep these vulnerable groups safe. Multiple studies across have found that there is no consistent correlation between police spending and municipal crime rates across even our largest cities.

The second demand called for an immediate start to reducing the budget and number of police. We have an opportunity to create solutions-based approaches to building real safety, and this notion is neither novel nor radical. Defunding the police involves reallocating limited resources of our city's budget in an intentional manner to rebuild, redesign and reconcile. We currently spend almost $18.5 billion annually on policing in Canada, which has increased rapidly over the past couple of decades. In Toronto, seven percent of our municipal budget is allocated to the police, which is almost $1.1 billion annually. There was recently another nearly $50 million budget increase proposed for the upcoming annual Toronto police budget, that has passed. In fact, “Canadian cities' police spending ranges from one-10th to nearly a third of total municipal budgets.” We should invest in decent housing for all, education, childcare and secure employment. Our current approach is punishing communities on two fronts--it is underfunding evidence-informed investments for health promotion and then criminalizing the paucity of opportunities.

The final demand was to disallow the use of force by police and prohibit their ability to cause bodily harm when interacting with people. Armed officers should not respond to non-violent community calls, as the presence of weapons often exacerbates critical situations. A wellness check should never be a death sentence for people in crisis. When many of us work in the psychiatric emergency department or in the community, we are aware that the continued presence and use of weapons and deadly force further adds to the trauma in communities already adversely affected by over-policing. Instead, we must adequately fund community health outreach workers who are trained in de-escalation tactics and a trauma-informed approach, such as the services provided through the Toronto Community Crisis Service (“TCCS”).

In this Article, Part I provides background to the Canadian context and explores the roles of police, costs of policing, and policing and the mental health care system. Part II discusses why we cannot police our way out of systemic racism and poverty. Part III concludes with suggestions for reallocating resources.

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From drug addiction to issues with homelessness, the mental health crisis, community disputes, traffic violations and more, there does not seem to be any evidence that increased police budgets and spending are the best use of limited resources. Criminalization in substitution for measured and targeted interventions has not worked in structurally vulnerable and marginalized communities and it is far past the time to accept tangible alternatives, such as funding initiatives like TCCS. Instead of perpetually increasing our police budget, let's instead invest in healing our communities. Let's invest this money in education, recreation, childcare, housing, health; measures that are proven to dramatically improve public health and safety.

Semir Bulle, MD. Psychiatry resident at the University of Toronto and co-founder of Doctors for Defunding Police.