Police killings of unarmed black Americans have a negative impact on the mental health of black Americans in the general population, findings published in The Lancet revealed.
The estimates indicated that police killings of unarmed black Americans could contribute an additional 55 million poor mental health days per year among black American adults in the U.S.
“Police killings of unarmed black Americans have been interpreted by many as an expression of ‘structural racism,’” Jacob Bor, ScD, SM, assistant professor and Peter T. Paul Career Development Professor in the departments of global health and epidemiology at Boston University School of Public Health, and colleagues wrote. “Negative interactions with police have been associated with worse mental health among black men. However, the population-level health impacts of police killings have not been quantified in nationally representative data.”
Researchers conducted a population-based, quasi-experimental study using recently compiled data on police killings combined with individual-level data from the nationally representative 2013 to 2015 U.S. Behavioral Risk Factor Surveillance System (BRFSS) to determine the causal impact of police killings of unarmed black Americans on mental health reported by other black adults in the general U.S. population.
Study data revealed that police killings of unarmed black Americans have a negative impact on the mental health of black Americans in the general population.
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The primary exposure was the number of police killings in the 3 months before BRFSS interview within the same state, and primary outcome was the number of days the respondent reported poor mental health in the previous month. The investigators estimated difference-in-differences regression models after adjusting for state-month, month-year, and interview-day fixed effects, age, sex and educational attainment. They also examined the timing of effects, the specificity of the effects to black Americans and the robustness of the results.
In the 3 months before the survey, more than one-third of black American respondents (38,993 of 103,710) were exposed to one or more police killings of unarmed black Americans in the state where they lived.
Analysis revealed that every additional police killing of an unarmed black American was linked to 0.14 additional poor mental health days (95% CI, 0.07-0.22; P = .00047) among other black American respondents in the general population. At the population level, these estimates suggest that police killings of unarmed black Americans might cause 1.7 extra poor mental health days per person per year, or 55 million (95% CI, 27 million to 87 million) extra poor mental health days per year among black adults in the U.S.
The greatest effects on mental health occurred 1 to 2 months after exposure, according to the researchers. Bor and colleagues found no effect on the mental health of white respondents and no effects of police killings of armed black Americans.
“The results provide rare causal evidence about the impact of events widely perceived to reflect structural racism on the mental health of black Americans,” the researchers wrote. “These findings bolster calls to more accurately measure police killings and provide an additional public health rationale to better understand and address the potential pathogenic effects of police killings of unarmed black Americans and other manifestations of structural racism in the U.S.”
Although these data excluded incarcerated, hospitalized and young black Americans and did not report physical health outcomes, the findings presented by Bor and colleagues are important, Rhea W. Boyd, MD, of the Palo Alto Medical Foundation, wrote in a related comment.
“Their work to acknowledge and address the clinical impact of police killing black Americans sits within a broader clinical imperative to rigorously define and intervene in the relationship between structural racism and clinical outcomes,” she wrote. “This evidence should ignite inquiry into the broader health impacts of police violence and advance the challenge to confront racial health inequities as products of racism.” – by Savannah Demko
Disclosures: The authors report no relevant financial disclosures. Boyd reports no relevant financial disclosures.