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Race, Policing, and History — Remembering the Freedom House Ambulance Service [nejm.org]

 

By Matthew L. Edwards, The New England Journal of Medicine, April 10, 2021

Americans protesting violent policing of Black communities are calling for law-enforcement budgets to be reallocated to community health services. Although such proposals are sometimes dismissed as naive or unrealistic, history provides an example of a transfer of power and resources from police to health services that benefited Black communities enormously. Pittsburgh’s Freedom House Enterprises (FHE) Ambulance Service not only supplanted the police in a role in which law-enforcement officers were not effective, but also reimagined the role of Black citizens in improving the community’s health and helped establish national standards for emergency medical care.

Freedom House was a community-based sociomedical program that aspired to “encourage Black enterprise” during the 1960s and 1970s by training Black community members to provide emergency medical services (EMS) (see photo).1 At the time, police officers and morticians without medical training supplied most prehospital “care,” generally providing transportation without medical treatment. Even Pennsylvania Governor David Lawrence’s 1966 death, which was partially attributable to inadequate EMS care, failed to galvanize improvements in emergency care.2 Moreover, EMS quality was often worse in Black communities. In this bleak environment, Freedom House enabled a group of disadvantaged Black laypeople to establish a model for paramedic training that ultimately set the U.S. standard.

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