In the wake of the Black Lives Matter protests, we zoom in on police violence as a leading cause of death among young Black men in the United States. This Special Feature looks at some of the ways in which police use of force affects the mental and physical health of Black Americans.

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Police use of force has dire consequences on the mental and physical health of young Black men in the U.S.

The authors of a 2018 study estimate that “[p]olice kill more than 300 [B]lack Americans — at least a quarter of them unarmed — each year in the USA.” Another paper estimates that 1 in 1,000 young Black men are likely to be killed by the police in the U.S. over the course of a lifetime.

The killing of George Floyd and the ensuing Black Lives Matter protests have brought police use of force into focus once again, with some people making the point that officials should regard police violence as a threat to public health.

The disproportionate rate of police-related deaths among Black Americans is a bitter reality with emotional implications that a medical news article cannot truthfully capture. In fact, examining the data behind these tragedies might seem callous or insensitive, particularly to those who live this reality daily.

However, data often provide a bird’s-eye view of a mass phenomenon, and looking at what the evidence shows can help inform better practices and policies on a wider social scale.

In this feature, we examine the evidence behind police violence as a public health concern.

We ask:

  • How many Black men die as a result of police violence in the U.S.?
  • Where does police violence rank as a cause of death among Black men compared with other causes of death?
  • What are some of the physical and mental health impacts that police violence has on Black men in the U.S.?

We turn to studies and researchers’ opinions in search of answers.

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In a study in the Proceedings of the National Academy of Sciences, Frank Edwards, Ph.D. — an assistant professor in the School of Criminal Justice at Rutgers University in New Jersey — and colleagues showed that police use of fatal force is a leading cause of death among young Black men.

Edwards and team found that over the course of one’s lifetime, about 1 in every 1,000 Black men are likely to be killed by the police. This risk is at its highest between the ages of 20 and 35 — a peak that is otherwise the same for men and women of all racial and ethnic groups.

The researchers used data from an impartial, journalist-led initiative aiming to create a national database of deaths that involved interactions with the police. Edwards and team used this database for information on deaths that occurred between 2013 and 2018.

Additionally, the authors used data from the 2017 National Vital Statistics System. In total, they accounted for approximately 11,456 police encounters in their analysis.

The deaths the researchers accounted for in their analysis did not include deaths described by the police as a suicide, fall, overdose, or traffic accident. Their analysis looked at how age, race, and sex affected mortality risk.

The study found that “[t]he highest levels of inequality in mortality risk are experienced by [B]lack men,” with 1 in every 1,000 Black men being likely to die at the hands of police. By comparison, the lifetime risk of being killed by police is 1 in 2,000 for all men.

“Black men are about 2.5 times more likely to be killed by police over the life course than are white men.”

– Frank Edwards, Ph.D., et al.

The study also found that Black women were 1.4 times more likely to be killed by police than white women.

It is important to note that, overall, the risk of being killed by police was almost 20 times as high for men in general as it was for women of any ethnicity or race. Specifically, the risk was 1 in 2,000 for men in general, compared with 1 in 33,000 for women.

Furthermore, American Indian/Alaska Native men were 1.2 to 1.7 times more likely to be killed by police than white men, and American Indian women were anywhere between 1.1 and 2.1 times more likely to be killed by police than white women. (The authors recognize that the risks were harder to estimate with precision for American Indians/Alaskan Natives.)

Latino men were 1.3 to 1.4 times more likely to be killed by police than white men.

Edwards and team also calculated an average annual mortality rate as a result of police use of force for Black men aged 25–29. They worked this out to be 3.4.

To put this figure into context, Medical News Today looked at data released by the Centers for Disease Control and Prevention (CDC) on causes of death for Black males in that same age group for 2015.

These data indicate that police violence is a leading cause of death, trailing behind homicide, accidents, suicide, heart disease (which has an annual mortality rate of 13.1), HIV (which has a mortality rate of 6.4), and cancer (which has a mortality rate of 6).

However, more young Black males died as a result of police use of force than they did as a result of diabetes (annual mortality rate of 2.7), influenza and pneumonia (annual mortality rate of 2), chronic lower respiratory diseases (annual mortality rate of 1.9), and cerebrovascular diseases (annual mortality rate of 1.8) in 2015.

When looking at the same data for 2017, the ranking stays roughly the same, with diabetes overtaking the 3.4 police violence mortality rate that Edwards and team calculated. According to the CDC, the former was 3.7 for 2017.

According to CDC data for 2017, police violence would still account for more deaths annually than chronic lower respiratory diseases, cerebrovascular disease, influenza, and pneumonia.

Data such as these reinforce the notion that officials should regard aggressive policing as a matter of public health. As Edwards and colleagues say of their findings, “This study reinforces calls to treat police violence as a public health issue.”

“Racially unequal exposure to the risk of state violence has profound consequences for public health, democracy, and racial stratification.”

The lead author of the study also commented on the results of the study at the time. Although they made these comments in August 2019, they express a sentiment that rings all the more true now, in light of the George Floyd murder and the BLM protests that started at the end of May this year.

“The inequality is not surprising […]. All you have to do is turn on the news to see that people of color are at a much greater risk of police-related harm. What we lack in this country are the solid estimates of police-related deaths because there is no official database where this information is stored.”

– Frank Edwards, Ph.D.

“[I]f we are going to try and change police practices that aren’t working, we need to track this information better.”

Further reasons for treating police violence as a public health issue include the effects it has on the health of Black communities.

Research suggests that these effects are particularly heightened when police disproportionately apply use of force on Black men compared with white men in a community, and when people perceive this use of force as unfair.

For instance, a study by Abigail A. Sewell — an associate professor of sociology at Emory University in Atlanta, GA — found a link between “living in minority communities with a high concentration of use of force by police against pedestrians” and a higher risk of diabetes and obesity.

However, the use of force by police in these communities was also associated with a lower risk of “poor/fair health.” This was before the researcher accounted for the ethnoracial composition of the community.

Once they had accounted for ethnoracial composition, the analysis showed that:

“[L]iving in areas with a heavy presence of whites where there are large racial differences in police use of force is associated with an increased risk of poor/fair self‐rated health, high blood pressure, diabetes, and obesity.”

– Abigail A. Sewell

Other researchers have looked at the years of life lost (YLLs) as a result of police violence. YLLs estimate the number of years a person could have lived had they not died prematurely.

The authors of a 2018 report appearing in the BMJ explain that YLLs are a key metric for evaluating public health.

“YLLs are a useful metric for comparing the burden of diseases and injuries across different populations and health conditions, and for setting priorities and agendas in health policy,” they write.

The report found that 57,375 years of life were lost due to police violence in 2015, while 54,754 years of life were lost in 2016.

Importantly, people of color accounted for 51.5% of YLLs, despite making up only 38.5% of the population. The most affected age group was 25–34.

Anthony Bui, from the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues conclude that:

“YLLs highlight that police violence disproportionately impacts young people, and the young people affected are disproportionately people of color. Framing police violence as an important cause of deaths among young adults provides another valuable lens to motivate prevention efforts.”

Unsurprisingly, the fear of violent encounters with the police and the ensuing stress can have negative effects on the mental (and physical) health of those it affects. Some experts have referred to these stressors within the larger scheme of structural racism.

In a teleconference organized by public health philanthropic organization the Robert Wood Johnson Foundation, Prof. David R. Williams said, “Minorities experience higher levels of stress, most of the common stressors, and greater clustering of stress, [i.e.] if they have one, they have another.”

“In addition to the traditional stressors, minorities experience the stress of racial discrimination that has been shown to have negative effects on physical and mental health.”

– Prof. David R. Williams

Other authors point out that the “trauma, anxiety, hopelessness, and fear about future police encounters are all stressors.”

“Accordingly, exposure to police killings in the residential environment or through news reports can trigger acute stress” — a stress that may be amplified when those the police kill are unarmed and the killings are “perceived as unjustified.”

Existing data support the above statements. For instance, a 2014 survey of over 1,200 men aged 18–26 years, which appears in the American Journal of Public Health, found that “[p]articipants who reported more police contact also reported more trauma and anxiety symptoms.”

These associations were connected to how aggressive the police encounters were, as well as how intrusive and how fair the respondents perceived the police’s behavior to be.

At the time, the authors concluded, “The intensity of respondent experiences and their associated health risks raise serious concerns, suggesting a need to reevaluate officer interactions with the public.”

The adverse mental health impact may also have a “spillover” effect onto other members of the community who are not directly affected. In a study co-authored by Prof. Williams, researchers examined the effects that witnessing or hearing about the killing of a Black American have on white and Black Americans.

The study examined the mental health of 38,993 Black adults — out of an initial sample of 103,710 respondents — who had had exposure to one or more police killings of unarmed Black Americans in the 3 months leading up to the study.

The researchers used a mental health assessment score that counted “poor mental health days” among Black and white Americans. They found that with each additional police killing of an unarmed Black American, Black respondents were more likely to report additional “poor mental health days.”

This likelihood was reflected in “0.14 additional poor mental health days” for each killing among Black American respondents.

By contrast, “Mental health impacts were not observed among white respondents and resulted only from police killings of unarmed [B]lack Americans (not unarmed white Americans or armed [B]lack Americans).”

The authors concluded:

“Police killings of unarmed [B]lack Americans have adverse effects on mental health among [B]lack American adults in the general population. Programs should be implemented to decrease the frequency of police killings and to mitigate adverse mental health effects within communities when such killings do occur.”

In an exclusive interview for MNT, sociologist and health disparities expert Prof. John Eason referred to police violence as a situation where public “safety” becomes “detrimental” to public health.

This occurs “[w]hen the police are killing Black people at the rate they do [and] when police interactions cause you to feel wholly unsafe,” said Prof. Eason, emphasizing the adverse effects that such interactions have on health.

“Some groups of people now have higher hypertension and higher stress because they deal with the police more, not just through driving while [being] Black or brown, they also deal with aggressive policing. So it’s not only whether or not you deal with the police, it’s the type of police you deal with.”

“So the police are hostile, and not just mean or angry yelling at you, they’re cursing you out and threatening you and imposing physical violence on you and even killing you. [W]e care about these murders, the murder of George Floyd was tragic,” Prof. Eason told MNT.

“But in that same week where George Floyd was killed,” he continued, “there’s Amy calling the police on a Black birder, [so] you can have random white people calling the police on you, acting as an agent of the state, to impose physical violence on you.”

“Public safety and public health are often at odds in this country,” Prof. Eason stated, adding that education or a higher socioeconomic status does not protect Black Americans from these daily stressors.

“The Black birder went to Harvard,” he said. “A Harvard degree doesn’t protect you from the arm of the state if a white person calls the police on you.”

Speaking of his own situation as well as that of his colleagues at the University of Wisconsin-Madison, he said, “[W]e’re not living in a highly policed, heavily disadvantaged neighborhood.”

“We’re professors at a [major] university, and we felt no less safe the day before George Floyd was murdered than the day after. This is a reality for Black people in America.”

– Prof. John Eason