In the weeks after George Floyd was killed by a Minneapolis police officer, dozens of city councils, mayors and governors approved resolutions condemning police violence and calling racism a public health crisis.
One of the most strongly worded statements, passed unanimously by the Goleta, California, City Council, proclaimed that "Black people in America continue to live in fear of losing their lives at the hands of law enforcement."
But long before these resolutions denounced racist policing practices, the largest organization of public health workers in the world was locked in a multiyear debate over a policy statement titled "Addressing Law Enforcement Violence as a Public Health Issue."
With more than 130 citations, the 14-page statement is a dense piece of academic work, but in some respects it's as impassioned as a message scrawled on a protest sign.
The story of what it took to get the 25,000-member American Public Health Association to explicitly state that systemic racism contributes to bad policing presages the conversations occurring across the country now.
"It was that same kind of exposure, awakening and awareness that we've seen in the past few months, but at APHA it happened on a slower scale because the times were different," said Nancy Krieger, a professor of social epidemiology at Harvard T.H. Chan School of Public Health, who contributed research to the statement.
Emma Rubin, one of the 12 authors of the statement, put it this way: "People had to go with us on a journey of critical dialogue and interrogating the evidence. It was a process, but we got there."
The origins of the statement technically date to 2015, but public health workers have been thinking about these issues for decades.
The disproportionate impact of policing on Black communities has been documented since at least the 1960s, and there is a long history of public health researchers examining the role racism plays in health differences among whites and Black and Latino communities.
More recently, the authors of the statement were inspired by activist groups, including Black Lives Matter, which formed in 2013, and the uprisings in Ferguson, Missouri, after police fatally shot Michael Brown in 2014. Also influential was the work by the Guardian newspaper, which compiled the most accurate count to date of killings at the hands of American police.