Overview
Communities affected by racism and state violence have long sought truth, accountability, and repair. Truth commissions and reparations, two core mechanisms of transitional justice, offer local governments formal ways to respond. Despite differences in structure, scope, and community context, a Network survey of various commissions reveals several common themes, three of which are especially relevant for local governments and public health practitioners.
Governments at every level have contributed to creating and sustaining racism through the policies they adopt and the ways they carry them out. Municipal and county governments have played a significant role in creating and perpetuating racial inequities through decisions related to housing, land use, education, and economic opportunity. State violence, including police violence, is an enduring manifestation of systemic racism in the United States, with lasting consequences for physical and mental health. Addressing these harms is both a government responsibility and a public health imperative.
Communities affected by racism and state violence have long sought truth, accountability, and repair. Truth commissions and reparations, two core mechanisms of transitional justice, offer local governments formal ways to respond. Truth commissions document harm, facilitate truth-telling, and develop recommendations for accountability and repair, while reparations can put those commitments into practice through concrete actions. To support this work, the Network has developed two issue briefs:
The Work of Reckoning: Local Truth Commissions as a Public Health Strategy examines municipal truth and reconciliation commissions established to address racism and racial injustice, with a particular focus on how they are established and implemented, their relevance to public health, and the approaches, challenges, outcomes, and lessons that emerge from their work.
Public Health and Reparations for State Violence examines reparations for state violence in the form of police violence and makes the public health case for reparations, with examples of reparations in action, drawing primarily on local examples.
Both briefs grew out of the Network’s Racial Health Equity Legal and Policy Cohort through technical assistance provided to a local health department and nonprofit partner who were laying the groundwork for a Commission on Truth, Racial Healing, and Transformation. They build on the Network’s broader work on community healing and redress, including community partnerships and resources on racism as a public health crisis, racial equity impact assessments laws, race-based and race-neutral policy strategies, intergenerational trauma, and cultural healing.
Lessons from five local truth commissions
Truth commissions are official, temporary, nonjudicial bodies that investigate injustice and recommend ways to address it. The Work of Reckoning reviews five commissions established by municipal governments in Carlisle, Pennsylvania; Charleston, South Carolina; Iowa City, Iowa; Salisbury, Maryland; and Williamsburg, Virginia between 2020 and 2023 to examine and address racism and racial injustice in their communities. These commissions addressed historical and ongoing racism across multiple systems, including housing, policing, employment, education, and health care. Despite differences in structure, scope, and community context, several common themes emerged. Three are especially relevant for local governments and public health practitioners.
Truth-telling surfaces the health impacts of racism. Community testimony and commission findings frequently highlighted barriers to health care, trauma, mental health challenges, and other health impacts of racism, leading commissions to recommend expanded supports, improved access to care, and other measures to advance health equity. In Williamsburg, health was not part of the committee’s charge. Nevertheless, community interviews surfaced barriers to accessing health care and community resources. In response, the committee developed recommendations to expand mental and social health services and partner with local health providers.
Those most affected must shape the work. People and communities most affected by harm should help shape truth-telling and repair efforts, including how they are designed, led, and resourced. Doing so requires intentional, sustained engagement that builds trust and creates safe, accessible opportunities for participation. Carlisle’s commission grew out of a community town hall on racial equity that drew more than 100 residents. Commissioners later sought dialogue through public events and community conversations such as “Thinking About Race Thursdays.”
Even so, the commission concluded that residents most affected by systemic racism participated less than it had hoped. In retrospect, commissioners recognized that asking some of the community’s most vulnerable residents to publicly share painful experiences with racism was “a monumental ask.” Similar challenges emerged across the commissions reviewed, as each sought to build trust and engage people affected by systemic racism.
Act on what is learned. Truth-telling and repair efforts ask residents to revisit painful experiences with the expectation that their participation will lead to change. When recommendations or commitments go unimplemented, communities may view the process as yet another broken promise, deepening distrust and making future engagement more difficult.
Local governments should consider how the work will continue after a commission issues its final report. In Williamsburg, city leaders publicly committed to acting on at least two of the Truth and Reconciliation Committee’s recommendations, demonstrating an early commitment to carrying the work forward. One of those recommendations was the Williamsburg Descendants Scholarship Program for descendants of African American residents whose families lived in Williamsburg before the Civil Rights Act was enacted in 1964. It was created with the committee’s urging and input to address disparities caused by the generational effects of racism. In 2024, the City Council voted unanimously to approve the program and provided $250,000 in seed funding. The following year, the city and City Council received a Table Builders Award for Outstanding Government Agency at a local National Day of Racial Healing event for establishing the scholarship program. This effort illustrates how truth-seeking can be translated into action that earns community recognition.
Looking ahead
Truth-telling and reparations can address harm as it happens, not only past injustice. Recent federal immigration enforcement actions under the Trump administration offer a current example. In addition to being a direct and harmful—sometimes deadly—form of state violence, these actions have also led families to avoid medical care and other essential services. The accompanying fear and trauma can have lasting health consequences. The experiences of individuals, families, and communities subjected to these actions matter and should inform action and accountability at the local, state, and federal levels.
Policymakers are already turning to these tools in response. In Minnesota, the Governor’s Council to Record the Truth of Operation Metro Surge and Operation PARRIS on Minnesotans (“Minnesota Truth Council“) is documenting residents’ experiences of those operations and partnering with a locally based international human rights advocacy group to collect community stories and inform law and policy reform. Its preliminary report was released last month. Federal lawmakers have also proposed the Make ICE Pay Act, which would support truth-telling and reparations for affected communities.
Local governments do not have to start from scratch. Communities across the country have already used truth commissions and reparations to document harm, address its health effects, and begin repair, and their experiences offer lessons for those that follow. Because these harms shape health, they demand a public health response. To learn more, read The Work of Reckoning: Local Truth Commissions as a Public Health Strategy and Public Health and Reparations for State Violence.
This post was written by Sara Rogers M.P.H., C.P.H., Senior Policy Analyst, Health Equity, Network for Public Health Law. The Network promotes public health and health equity through non-partisan educational resources and technical assistance. These materials provided are provided solely for educational purposes and do not constitute legal advice. The Network’s provision of these materials does not create an attorney-client relationship with you or any other person and is subject to the Network’s Disclaimer.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.
