Summary	Evidence	APHA Action Step No.
Improvements to data collection and research	In the United States, data on deaths and injury caused by legal intervention are not reliably or comprehensively collected. As with the CDC’s National Violent Death Reporting System, this is partly attributable to the voluntary nature of agency reporting. This approach poses a challenge for estimating the prevalence of law enforcement violence and related health outcomes. For example, in 2015, the US National Vital Statistics System underestimated deaths by law enforcement by as much as 55%. By contrast, nongovernmental, Web-based social media data sources, such as The Guardian’s The Counted, captured 93% of deaths by law enforcement in 2015, demonstrating that a comprehensive data collection mechanism is feasible.	1–3
Reallocation of resources and reversal of militarization	Government spending on social services has decreased since the 1980s while spending on policing has increased. By contrast, the literature suggests that increasing access to housing, education, employment, mental health, and substance use treatment; addressing structural factors that contribute to experiences of discrimination; and facilitating community-based, trauma-informed approaches to interpersonal harm and crisis response are associated with reduced community trauma and interpersonal harm, improved health, and cost savings. Similarly, implementation of a health-in-all-policies approach, inclusive of rolling back legislation promoting militarization, has been linked to harm reduction.	4, 7, 8
Decriminalization	Mass criminalization is a mechanism through which structurally marginalized communities experience increased risk of law enforcement violence. Notably, law enforcement intervention has not been shown to reduce criminalized activities. Decriminalizing stigmatized activities, such as drug use, and investing in public health alternatives have been linked to reductions in encounters with law enforcement and improvements in health outcomes.	5
Structural changes to law enforcement policies and procedures	Structural components of the law enforcement system may impede meaningful action toward accountability or reform. For example, local police union contracts and state-based Law Enforcement Officers’ Bills of Rights enforce suppression of data related to deaths and disciplinary records and promote investigative delays. Furthermore, procedural guidelines, such as stop and frisk and gang injunctions, have been linked to increased surveillance of marginalized groups.	6, 9, 10

Note. APHA = American Public Health Association; CDC = Centers for Disease Control and Prevention.

Source. APHA.¹