10 Largest US Cities Will Spend More on Police Than Public Health This Year

Over 1,900 people have died from COVID-19 in Houston, Texas, the U.S.’s most diverse and fourth most populous city. Roughly 1.4 million people (19.7 percent of the city’s population) are without health insurance, and multiple hospitals’ ICUs have been at capacity for months. Yet, the city’s police department budget for 2021 is 10 times greater than the Houston Health Department’s budget, with the police allotted nearly $1 billion and the health department $100 million.

While the discrepancy in Houston’s budgeting priorities is particularly dramatic, a Truthout analysis found that all 10 of the U.S.’s largest cities will spend more on policing than public health during Fiscal Year 2021. Combined, these 10 cities’ policing budgets are 3.6 times greater than public health department budgets. Public health departments are generally tasked with aiding vaccine distribution, combating foodborne illnesses, homelessness and environmental toxins, and supporting addiction treatment, among other health-promoting activities.

City Police Budget Public Health / Health Budget
New York City $5,700,000,000 $901,000,000
Los Angeles $1,857,330,549 $1,200,000,000
Chicago $1,600,246,503 $57,344,506
Houston $965,146,748.00 $94,302,696
Phoenix $745,289,020 $470,028,800
Philly $757,235,715 $668,653,786
San Antonio $518,490,301 $45,816,390
San Diego $568,243,558 $182,070,000
Dallas $539,053,187 $117,000,000
San Jose $471,530,192 $127,503,405
$13,722,565,773 $3,863,719,583

The discrepancy between public health and policing budgets is underestimated. Phoenix, Arizona, for example, does not have its own health department. In this case, Truthout included the state’s entire health budget in its analysis. Still, Arizona’s health budget is just two-thirds of Phoenix’s police department budget. For the several cities without public health departments sectioned off in their budgets, Truthout counted the entire health department budget.

Additionally, police budgets don’t always reflect the full extent of a department’s power or presence. For instance, the Los Angeles Public Library reimburses the Los Angeles Police Department (LAPD) for millions of dollars in services, which is not reflected in the LAPD’s $1.9 billion budget. On the other side of the country, rather than cut the New York City Police Department’s (NYPD’s) budget following the Black liberation uprising of 2020, New York City transferred funds for school resource officers — school police — to the Department of Education budget, an act of subterfuge. Further, Truthout’s analysis does not include the billions spent on confining people in jails, prisons or on electronic monitoring.

Other studies have uncovered similar trends. Kaiser Health News found that “nearly two-thirds of Americans live in counties that spend more than twice as much on policing as they spend on nonhospital healthcare, which includes public health.” A new, in-depth report released by the Center for Community Alternatives found that New York State spent $18.2 billion on the carceral system in 2019, including policing, jails, prisons, prosecutors, parole and probation, compared to $6.2 billion on mental health services, public health, youth programs and services, recreation and elder services combined.

Policing and public health operate under antithetical frameworks. In an article published in the American Journal of Public Health, the authors explained, “A public health approach neither accepts harm as a given nor accepts punishment as prevention. Rather, a public health approach divests from a punishment framework and invests in a prevention framework, centering community-based and community-led efforts to public safety and well-being.” Although in the U.S., even health and social work systems are often bound up with the prison-industrial complex. At their best, public health practitioners target the structural inequities that may be responsible for criminalized behaviors. For example, a true public health approach to substance use would emphasize decriminalization, harm reduction and empathetic treatment, while a policing approach criminalizes marginalized groups who use illegal substances, disappears people and often tortures them with solitary confinement.

The United States government writ large has always prioritized the carceral system over public health, but this dynamic reached new heights during the ‘80s and ‘90s. The Federal 1994 Violent Crime Control and Law Enforcement Act, co-authored by Joe Biden and signed by then-President Bill Clinton, allocated $12 billion in state subsidies for prison construction, prioritizing states with the harshest sentencing laws.

Moreover, already underfunded public health departments have been increasingly under threat over the past decade. A dearth of funding set the stage for mass death from COVID-19 and, in some states, is contributing to snail-paced vaccine distribution. Georgia’s COVID data task force was disassembled due to a lack of funds, and the state slashed its Fiscal Year 2022 public health budget by $7 million. Meanwhile, district and county health departments in Alabama were operating at 65 percent capacity in 2019 relative to 2010. Some county health departments in North Carolina offer such low salaries that they are unable to fill vacancies for public health nursing positions. State budgets have been supplanted with federal COVID-19 funds, but the rollout has been slow and, in some cases, insufficient.

End Police Violence Collective (EPV), a group that writes about and generates support for the abolition of police and prisons in the public health field, has joined the chorus of rebellion-inspired voices who argue for the reallocation of funds from policing to social services, and ultimately for abolition. Omid Bagheri Garakani, a member of EPV, told Truthout that the collective formed in the process of developing and organizing a statement that addressed law enforcement violence as a public health issue for the American Public Health Association (APHA), which was permanently adopted in 2018. Last October, EPV and other activists drafted, garnered support for, and published an abolitionist statement for the APHA that emphasized decarceration during the pandemic. “While the health harms of incarceration in U.S. jails, prisons, and detention centers have long been a public health crisis,” the statement reads, “their coupling with the ongoing pandemic have made them simultaneously hyper-visible and unprecedentedly exacerbated.”

In response, signatories recommend:

  1. Urgently reducing the incarcerated population
  2. Divesting from carceral systems and investing in the societal determinants of health (e.g., housing, employment)
  3. Committing to non-carceral measures for accountability, safety and well-being
  4. Restoring voting rights to formerly and currently incarcerated people
  5. Funding research to evaluate policy determinants of exposure to the carceral system and proposed alternatives.

By mid-2020, for the first time since 2003, the U.S. prison population dipped below 2 million. A Vera Institute report found that a decline in local jail populations was initially responsible for the decrease, but many jails have since refilled. Prison populations declined in the summer and fall modestly. Still, the report says, “the decrease was neither substantial nor sustained enough to be considered an adequate response to the COVID-19 pandemic, and incarceration in the United States remains a global aberration.

Rather than putting faith in public officials to shift money away from prisons and policing, some advocates –including the Movement for Black Lives — offer participatory budgeting (PB), a model for community control over money with roots in Brazil, as a more robust route toward decarceration and defunding of police. “For PB to be truly equitable,” writes The Center for Popular Democracy, “it must center the voices of those most impacted, thus giving marginalized communities power over the pots of money that most affect their lives.”

The idea has been implemented in some U.S. cities, but on a relatively trivial scale. The “Measure U Committee” in Sacramento, California, recommended that the city allocate $15 million of its $1.3 billion budget toward participatory budgeting. On February 9, Sacramento City Council announced it would set aside $1 million, with one council member citing his belief in “representative democracy” as justification for the meager rationing.

Black liberation uprisings in Seattle, Washington, pushed the City Council to cut its police budget by 18 percent and to allocate $30 million of its $6.5 billion budget toward participatory budgeting. A 1,000-page report submitted to Seattle City Council from the Black Brilliance Research Project’s needs assessment focused on housing, mental health, youth, crisis and wellness, and economic development. A voting process is scheduled for mid-July to mid-August 2021.

Bagheri Garakani similarly emphasizes community empowerment as a pathway toward abolition, noting that the current public health system sometimes stands as a barrier. “Put simply, people most harmed by health harms and state violence must be shaping the ways we build and dismantle systems,” he told Truthout. “The system of public health is often complicit in the harm we are seeing — both with the pandemic and beyond.”

For example, HIV-related criminal prosecutions may rely on medical records provided by the public health department. Furthermore, Bagheri Garakani said, public health practitioners are often complicit by supporting community policing strategies.

“True community-based public health practice,” however, “will shift power to those who are closest to the problem and subsequently closer to the solution,” he said. “Throughout the pandemic, the enormous mutual aid efforts we’ve seen grow in communities across the country and the world are proof that communities know what is best and what is needed for our own health.”

CORRECTION: This article was updated to reflect the Los Angeles public health budget is $1,200,000,000, not $57,344,506.