Hot Spots and Public Health Beat Intro Voiceover 00:00 This is the Beat – a podcast series that keeps you in the know about the latest community policing topics facing our nation. Interview TeNeane Bradford 00:08 Hello and welcome. My name is TeNeane Bradford, and on behalf of the COPS Office I’d like to introduce you to Dr. Anthony Iton. Anthony is a senior vice president of health communities at the California Endowment. He is here to talk with us today about partnering with public health departments. You’ve done a great deal of work looking at “hot spots,” geographical locations with a high density of calls for service. What did you learn when you ran your analysis of data focusing on high-poverty and high-crime areas? Dr. Anthony Iton 00:34 Well, one of the things that we found fascinating by looking at the geographical distribution of both things like calls for service for public health, calls for service for policing, calls for service from a whole host of government services like social services and the like, is that there were these clusters, these concentrated areas, where there was a high demand for these services. Simultaneously, when you look at the health status of people in those populations, they have higher levels of disease—things like heart disease and stroke and cancer—and [they] also die younger. As you look at the patterns across the whole community, you see this correlation between high demands for services and the worst outcomes. TeNeane 01:26 The health inequity you described, you controlled for a number of factors including low infant mortality, HIV/AIDS, and, most importantly for our audience, homicides. Even without taking these factors into consideration, the data still show that people in poor neighborhoods are going to die younger than people in wealthy neighborhoods. What does this suggest about how quality of life really affects the community members in these high-poverty, high-crime neighborhoods? Anthony 01:50 Well, that was one of the most fascinating things that we saw. We saw this difference in how long people lived between high-income communities and low- income communities. The first thing that people were concerned about was, “Well, that’s probably due to homicides ‘cause that’s what we see on the news. Or maybe it’s drug use and HIV/AIDS ‘cause that’s what we see on the news.” And so we actually factored out homicide and HIV/AIDS and found that they contribute a tiny little bit to the difference in life expectancy in these communities, but they’re really not all that significant. The big drivers of early death in low-income communities are the things that kill everybody: heart disease, cancer, stroke. They’re just killing people in low-income communities earlier in their lives and forcing them to live longer with the burden of these diseases. So they weren’t exotic, rare phenomena. They are the same phenomena that are essentially responsible for killing all people in the United States disproportionately. In these low-income communities, you just see them affecting people’s lives much earlier. That was surprising because we thought that it was something easy to explain, like gun violence or drug abuse, but in reality there are forces that are creating even higher burdens of routine disease in low-income communities that we need to understand. Presumably those same forces are responsible, in part, for the gun violence and the drug use. TeNeane 03:20 Interesting. While you were the public health director in Alameda County, you collaborated a bit with the police departments in that area. Can you tell me a little bit about the partnership and how it was received? Anthony 03:31 Our greatest interest was, I mean, one of the first things we did is we went and did ride-alongs with the Oakland Police Department to just sort of get an understanding of what their day-to-day shifts looked like. It was very eye- opening for all of us, myself in particular. The police officers were just running from call to call. There was no real time to do deliberative kind of work or even kind of more analytical work. It was really just responding, responding, reacting, reacting for the entirety of the shift. I thought, well, how are you really going to get to the root of some of the issues if you’re just constantly responding? It reminded me of being in an emergency room where you’re essentially just dealing with things rolling through the door and just trying to patch them up, to move them onto something else so you can get onto the next case. In order for us to be able to be helpful to the police department, we had to understand what the front- line police officer was experiencing, and then be able to interact up the chain to try to look at the systems for training and resourcing those police officers so that they would be better able to understand that they were seeing the tip of the problem but also that what we were proposing for them was relevant to what they were doing on a day-to-day basis. TeNeane 04:55 Very very interesting. What public health data out there do you think is under- utilized by public safety professionals? How can law enforcement make better efforts to coordinate with their public health departments? Anthony 05:07 One of the first things that is obvious to me is that, when you look at public health data, like premature death, and you see that these hot spots of premature death are clustering. Then you look at other data overlays, which we’ve done, we’ve looked at causes of death, we’ve looked at, essentially, hospitalizations, we’ve looked at very specific diseases, and you see the sort of overlapping patterns, you have to understand why that’s happening. A lot of what is causing that is, essentially, this environmental stress that people are living under. Once you understand those environmental stressors, you start to recognize that those things also produce some of those behaviors that are leading to criminality, like violence and the criminal reactivity that people have when someone disses them over a pair of shoes or what have you. Trying to understand the conditions that people are living under and that reactivity is really important to try and manage that. You can spend your whole life essentially in a damage control mode just trying to mitigate the harm, minimize the adverse consequences of that reality. Or you can actually start to figure out, simultaneously, how do I essentially invest in a way that makes it less likely that these people will be experiencing all this stress. Now when I say that, I think it’s important to say that if you walk into a community and there are fires burning, the first thing you do is put out the fires. But if you come back the next day and there are fires burning in the same places, well, you put the fires out again but you start to think, “Why are there fires burning in the same places?” If it’s the third day, the fourth day, the fifth day, at some point you have to think, “What can I do to prevent these fires?” That’s what this data allows us to start doing, is to start thinking about ways to prevent some of the inevitable outcomes that we can predict, based on the geographic concentration and the stressors that are incubating in these communities that are manmade. We can undo these stressors through policy, through investing in young people and their opportunities, and through helping people understand what they’re experiencing. TeNeane 07:28 A lot of valuable information. A lot of notes to be well taken. Thank you so much, Dr. Iton, for providing us with your expertise and your time, and we look forward to the next conversation. Anthony 07:40 Sure. Thanks for having me. Beat Exit Voiceover: 07:42 The Beat was brought to you by the United States Department of Justice COPS Office. The COPS Office helps to keep our nation’s communities safe by giving grants to law enforcement agencies, developing community policing publications, developing partnerships, and solving problems. ####END OF TRANSCRIPT####