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Riley T, Jahn JL, Sharif MZ, Enquobahrie DA, Hajat A. Neighbourhood-level policing as a racialised gendered stressor: multilevel analysis of police stops and preterm birth in Seattle, Washington. J Epidemiol Community Health 2024:jech-2024-222216. [PMID: 38782545 DOI: 10.1136/jech-2024-222216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Most studies capturing the health effects of police violence focus on directly impacted individuals, but a burgeoning field of study is capturing the indirect, community-level health effects of policing. Few empirical studies have examined neighbourhood-level policing, a contextual and racialised gendered stressor, in relation to preterm birth risk among Black and other racially minoritised people. METHODS We spatially linked individual birth records (2017-2019) in Seattle, Washington (n=25 909) with geocoded data on police stops for three exposure windows: year before pregnancy, first and second trimester. We fit race-stratified multilevel modified Poisson regression models predicting preterm birth (<37 gestational weeks) across tertiles of neighbourhood stop rates controlling for individual and neighbourhood-level covariates. For the second trimester exposure window, birth was operationalised as a time-to-event outcome using multilevel Cox proportional hazard models. RESULTS Neighbourhood stop rates of Black residents was higher compared with White residents, and Black and Asian pregnant people were exposed to the highest median neighbourhood-level stop rates. Black birthing people living in neighbourhoods with more frequent police stops had increased risk of preterm birth across all exposure windows including the year before pregnancy (adjusted risk ratio (aRR): 1.38, 95% CI 1.02 to 1.85), first trimester (aRR:1.74, 95% CI 1.17 to 2.57) and second trimester (aHR: 1.66, 95% CI 1.14 to 2.42). We found null or inverse associations among Asian, Hispanic and White people. CONCLUSION Our study adds to the growing evidence documenting associations of higher risk of preterm birth with neighbourhood police stops among Black birthing people. These findings suggest that routine police practices are one aspect of structural racism contributing to racialised perinatal health inequities.
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Affiliation(s)
- Taylor Riley
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Jaquelyn L Jahn
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
- Ubuntu Center on Racism, Global Movements, and Population Health Equity, Drexel Uiversity, Philadelphia, Pennsylvania, USA
| | - Mienah Z Sharif
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Center for the Study of Racism, Social Justice and Health, UCLA, Los Angeles, California, USA
| | - Daniel A Enquobahrie
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
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2
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Riley T, Schleimer JP, Jahn JL. Organized abandonment under racial capitalism: Measuring accountable actors of structural racism for public health research and action. Soc Sci Med 2024; 343:116576. [PMID: 38237286 DOI: 10.1016/j.socscimed.2024.116576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/14/2023] [Accepted: 01/05/2024] [Indexed: 02/10/2024]
Abstract
Understanding the shifting nature of structural racism historically and across institutions is vital for effective action towards racial health equity. While public health research on structural racism is rapidly increasing, most studies are missing the interdependence of policies and institutional practices over time that shape power imbalances and lead to entrenched health inequities. Here, we discuss Ruth Wilson Gilmore's concept of organized abandonment - the intentional disinvestment in communities which, in turn, creates opportunities for extraction, revenue generation, and carceral enforcement to fill the cracks of a compromised social infrastructure - to encourage action-oriented public health research that is grounded in history and an understanding of racial capitalism. We present a case example using publicly-available data on redlining, gentrification and policing in Seattle, Washington. We mapped the intersections of redlining and gentrification and estimated their neighborhood-level association with police activity using Bayesian spatial Poisson regression models. We found that histories of racist housing policies like redlining and processes of gentrification are interdependent and shape contemporary neighborhood racial and economic segregation and police activity. Compared to structurally advantaged neighborhoods, police stops were higher in neighborhoods that were 1) historically disinvested (i.e. redlined) and remain low-income and structurally disadvantaged and 2) formerly industrial and business districts that were not redlined and are now gentrified. Notably, we found that policing practices were significantly more intensive in neighborhoods that were both high redlined and gentrified. Together, these findings illustrate how the place-based racialized processes of dispossession, displacement and policing are deeply intertwined to maintain racial capitalism. Our findings also highlight the importance of examining multiple racialized processes simultaneously to fill critical gaps in the existing literature that are necessary for sustainable solutions to address structural racism.
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Affiliation(s)
- Taylor Riley
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA.
| | - Julia P Schleimer
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Jaquelyn L Jahn
- Ubuntu Center on Racism, Global Movements, and Population Health Equity, Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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3
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Alang S, Haile R, Mitsdarffer ML, VanHook C. Inequities in Anticipatory Stress of Police Brutality and Depressed Mood Among Women. J Racial Ethn Health Disparities 2023; 10:2104-2113. [PMID: 35976605 DOI: 10.1007/s40615-022-01390-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/14/2022] [Accepted: 08/03/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Police brutality towards racially minoritized populations is structural racism. Even though most of the research on the health impacts of police brutality centers the experiences of men, women are also harmed by this structural violence. OBJECTIVES We identify factors associated with the anticipatory stress of police brutality among women and examine its relationship with depressed mood across ethno-racial categories. METHODS Data came from the cross-sectional Survey of the Health of Urban Residents in the United States (N = 2796). Logistic regressions were used to identify factors associated with odds of always worrying about the possibility of becoming a victim of police brutality and to examine its association with depression among Latinas, Black, and White women. RESULTS Odds of always worrying about police brutality were greater among Black women and Latinas compared to White women. Household history of incarceration was associated with anticipation of police brutality among Black women and Latinas but not among White women. Black women and Latinas with constant anticipation of police brutality and history of incarceration of a household member during their childhood had elevated odds of depressed mood. CONCLUSION Although police brutality harms all women, the stressful anticipation of police brutality does not burden all women equally. Structural racism in communities of color continues to be associated with the anticipatory stress of police brutality and it harms the mental health of women of color. Developing policies to eliminate structural racism and for the allocation of resources to persons who are strongly impacted by these injustices is important.
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Affiliation(s)
- Sirry Alang
- Department of Sociology and Anthropology, Program in Health Medicine and Society and Institute for Critical Race and Ethnic Studies, Health Justice collaborative, Lehigh University, 31 Williams Drive #280, PA, Bethlehem, USA.
| | - Rahwa Haile
- Department of Public Health, State University of New York (SUNY) Old Westbury, Long Island, NY, USA
| | - Mary Louise Mitsdarffer
- Department of Sociology and Anthropology, Program in Health Medicine and Society and Institute for Critical Race and Ethnic Studies, Health Justice collaborative, Lehigh University, 31 Williams Drive #280, PA, Bethlehem, USA
| | - Cortney VanHook
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
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4
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Kerrison EMT, Hyatt JM. COVID-19 Vaccine Refusal and Medical Distrust Held by Correctional Officers. Vaccines (Basel) 2023; 11:1237. [PMID: 37515052 PMCID: PMC10384026 DOI: 10.3390/vaccines11071237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
This study explores COVID-19 vaccine acceptance among prison security staff and the extent to which they trust varied sources of information about the vaccines. Cross-sectional survey data were obtained from a state-wide sample of corrections officers (COs, hereafter; n = 1208) in February 2021. Group differences, disaggregated by demographic characteristics, were examined using F-tests and t-tests. Despite the comparatively limited risk of contracting the virus, non-security staff reported they would accept a COVID-19 vaccine at no cost (74%), compared to their more vulnerable CO counterparts (49%). We observed vaccine refusal correlations between COs' reported gender, age, and length of time working as a CO, but none with their self-reported race. Vaccine refusal was more prevalent among womxn officers, younger officers, and those who had spent less time working as prison security staff. Our findings also suggest that the only trusted source of information about vaccines were family members and only for officers who would refuse the vaccine; the quality of trust placed in those sources, however, was not substantially positive and did not vary greatly across CO racial groups. By highlighting characteristics of the observed gaps in COVID-19 vaccine acceptance between COs and their non-security staff coworkers, as well as between corrections officers of varied demographic backgrounds, these findings can inform the development of responsive and accepted occupational health policies for communities both inside and intrinsically linked to prisons.
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Affiliation(s)
| | - Jordan M Hyatt
- College of Arts and Sciences, Drexel University, Philadelphia, PA 19104, USA
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Das A, Bruckner TA. New York City's Stop, Question, and Frisk Policy and Psychiatric Emergencies among Black Americans. J Urban Health 2023; 100:255-268. [PMID: 36763179 PMCID: PMC10160307 DOI: 10.1007/s11524-022-00710-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 02/11/2023]
Abstract
Under the Stop, Question, and Frisk (SQF) policy, New York City (NYC) police stopped Black Americans at more than twice the rate of non-Hispanic whites, after controlling for arrests and precinct differences. We examined whether police stops of Black Americans during SQF correspond positively with psychiatric emergency department (ED) visits among Black residents in NYC. We utilized as the exposure all police stops, stops including frisking, and stops including use of force among Black Americans in NYC between 2006 and 2015 from the New York City Police Department's New York City-Stop, Question, and Frisk database. We examined 938,356 outpatient psychiatric ED visits among Black Americans in NYC between 2006 and 2015 from the Statewide Emergency Department Database (SEDD). We applied Box-Jenkins time-series methods to control for monthly temporal patterns. Results indicate that all stops, frisking, and use of force of Black residents correspond with increased psychiatric ED visits among Black Americans in NYC (all stops-coef = 0.024, 95%CI = 0.006, 0.043; frisking-coef = 0.048, 95%CI = 0.015, 0.080; use of force-coef = 0.109, 95%CI = 0.028, 0.190). Our findings indicate that a one standard deviation increase in police stops equates to a 2.72% increase in psychiatric ED visits among Black residents in NYC. Use of force may have the greatest mental health consequences due to perceived threats of physical violence or bodily harm to other members of the targeted group. Racially biased and unconstitutional police encounters may have acute mental health implications for the broader Black community not directly involved in the encounter itself.
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Affiliation(s)
- Abhery Das
- Program in Public Health, University of California, 653 East Peltason Drive, Irvine, CA, 92617, USA.
| | - Tim A Bruckner
- Program in Public Health, University of California, 653 East Peltason Drive, Irvine, CA, 92617, USA
- Center for Population, Inequality, and Policy, University of California, Irvine, USA
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Kaufman EJ, Richmond TS, Hoskins K. Youth Firearm Injury: A Review for Pediatric Critical Care Clinicians. Crit Care Clin 2023; 39:357-371. [PMID: 36898779 PMCID: PMC9662754 DOI: 10.1016/j.ccc.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Firearms are now the leading cause of death among youth in the United States, with rates of homicide and suicide rising even more steeply during the SARS-CoV-2 pandemic. These injuries and deaths have wide-ranging consequences for the physical and emotional health of youth and families. While pediatric critical care clinicians must treat the injured survivors, they can also play a role in prevention by understanding the risks and consequences of firearm injuries; taking a trauma-informed approach to the care of injured youth; counseling patients and families on firearm access; and advocating for youth safety policy and programming.
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Affiliation(s)
- Elinore J Kaufman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Penn Presbyterian Medical Center, MOB Suite 120, 51 North 39th Street, Philadelphia, PA 19104, USA
| | - Therese S Richmond
- University of Pennsylvania School of Nursing, Fagin Hall 330, 418 Curie Boulevard, Philadelphia, PA 19104, USA.
| | - Katelin Hoskins
- University of Pennsylvania School of Nursing, Fagin Hall 312, 418 Curie Boulevard, Philadelphia, PA 19104, USA
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7
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Haile R, Rowell-Cunsolo T, Hyacinthe MF, Alang S. "We (still) charge genocide": A systematic review and synthesis of the direct and indirect health consequences of police violence in the United States. Soc Sci Med 2023; 322:115784. [PMID: 36863215 DOI: 10.1016/j.socscimed.2023.115784] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
Building on historical and contemporary efforts to eliminate police and other forms of state violence, and on the understanding that police violence is a social determinant of health, we conducted a systematic review in which we synthesize the existing literature around 1) racial disparities in police violence; 2) health impacts of direct exposure to police violence; and 3) health impacts of indirect exposure to police violence. We screened 336 studies and excluded 246, due to not meeting our inclusion criteria. Forty-eight additional studies were excluded during the full text review, resulting in a study sample size of 42 studies. Our review showed that Black people in the US are far more likely than white people to experience a range of forms of police violence: from fatal and nonfatal shootings, to assault and psychological violence. Exposure to police violence increases risk of multiple adverse health outcomes. Moreover, police violence may operate as a vicarious and ecological exposure, producing consequences beyond those directly assaulted. In order to successfully eliminate police violence, scholars must work in alignment with social justice movements.
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Affiliation(s)
- Rahwa Haile
- SUNY Old Westbury, Department of Public Health, Old Westbury, NY, USA.
| | | | | | - Sirry Alang
- University of Pittsburgh, Department of Health and Human Development, Pittsburgh, PA, USA
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8
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Darby A, Cleveland Manchanda EC, Janeway H, Samra S, Hicks MN, Long R, Gipson KA, Chary AN, Adjei BA, Khanna K, Pierce A, Kaltiso SAO, Spadafore S, Tsai J, Dekker A, Thiessen ME, Foster J, Diaz R, Mizuno M, Schoenfeld E. Race, racism, and antiracism in emergency medicine: A scoping review of the literature and research agenda for the future. Acad Emerg Med 2022; 29:1383-1398. [PMID: 36200540 DOI: 10.1111/acem.14601] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The objective was to conduct a scoping review of the literature and develop consensus-derived research priorities for future research inquiry in an effort to (1) identify and summarize existing research related to race, racism, and antiracism in emergency medicine (EM) and adjacent fields and (2) set the agenda for EM research in these topic areas. METHODS A scoping review of the literature using PubMed and EMBASE databases, as well as review of citations from included articles, formed the basis for discussions with community stakeholders, who in turn helped to inform and shape the discussion and recommendations of participants in the Society for Academic Emergency Medicine (SAEM) consensus conference. Through electronic surveys and two virtual meetings held in April 2021, consensus was reached on terminology, language, and priority research questions, which were rated on importance or impact (highest, medium, lower) and feasibility or ease of answering (easiest, moderate, difficult). RESULTS A total of 344 articles were identified through the literature search, of which 187 met inclusion criteria; an additional 34 were identified through citation review. Findings of racial inequities in EM and related fields were grouped in 28 topic areas, from which emerged 44 key research questions. A dearth of evidence for interventions to address manifestations of racism in EM was noted throughout. CONCLUSIONS Evidence of racism in EM emerged in nearly every facet of our literature. Key research priorities identified through consensus processes provide a roadmap for addressing and eliminating racism and other systems of oppression in EM.
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Affiliation(s)
- Anna Darby
- Department of Emergency Medicine, Los Angeles County and University of Southern California Medical Center, Los Angeles, California, USA
| | | | - Hannah Janeway
- Department of EM, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Shamsher Samra
- Department of EM, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Marquita Norman Hicks
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ruby Long
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Katrina A Gipson
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Anita N Chary
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Brenda A Adjei
- National Cancer Institute Division of Cancer Control and Population Sciences, Bethesda, Maryland, USA
| | - Kajal Khanna
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Ava Pierce
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sheri-Ann O Kaltiso
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sophia Spadafore
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jennifer Tsai
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Annette Dekker
- Department of EM, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Molly E Thiessen
- Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Jordan Foster
- Department of Emergency Medicine, Columbia University Medical Center, New York, New York, USA
| | - Rose Diaz
- Department of EM, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Mikaela Mizuno
- University of California, Riverside School of Medicine, Riverside, California, USA
| | - Elizabeth Schoenfeld
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts, USA
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Bailey JA, Jacoby SF, Hall EC, Khatri U, Whitehorn G, Kaufman EJ. Compounding Trauma: the Intersections of Racism, Law Enforcement, and Injury. CURRENT TRAUMA REPORTS 2022; 8:105-112. [PMID: 35578594 PMCID: PMC9096065 DOI: 10.1007/s40719-022-00231-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/24/2022]
Abstract
Purpose of Review
Traumatic injury sits at the nexus of law enforcement and structural racism. This narrative review aims to explore the major impacts of law enforcement on health, its intersections with US structural racism, and their joint impacts on traumatic injury and injury care. Recent Findings Many of the same forces of systemic disadvantage that put Black people, other people of color, and other marginalized groups at risk for violent injury also expose these same individuals and communities to intensive policing. Recent evidence speaks to the broad impact of police exposure and police violence on individual and community physical and mental health. Moreover, injured patients who are exposed to law enforcement during their care are at risk for erosion of trust in and relationships with their healthcare providers. To optimize the role of law enforcement agencies in injury prevention, collaboration across sectors and with communities is essential. Summary A broad approach to the prevention of injury and violence must incorporate an understanding of the intersecting impacts of law enforcement and structural racism on health and traumatic injury. Clinicians who seek to provide trauma-informed injury care should incorporate an understanding of the role of law enforcement in individual and community health.
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Affiliation(s)
- Joanelle A. Bailey
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Sara F. Jacoby
- University of Pennsylvania School of Nursing, Philadelphia, PA USA
| | - Erin C. Hall
- Trauma Surgery and Critical Care Medicine, MedStar Health, Washington, DC USA
| | - Utsha Khatri
- Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Gregory Whitehorn
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Elinore J. Kaufman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
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10
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Willis DE, Andersen JA, Montgomery BEE, Selig JP, Shah SK, Zaller N, Bryant-Moore K, Scott AJ, Williams M, McElfish PA. COVID-19 Vaccine Hesitancy and Experiences of Discrimination Among Black Adults. J Racial Ethn Health Disparities 2022; 10:1025-1034. [PMID: 35391714 PMCID: PMC8989097 DOI: 10.1007/s40615-022-01290-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/03/2022] [Accepted: 03/18/2022] [Indexed: 01/12/2023]
Abstract
Early in the COVID-19 vaccine rollout, Black adults consistently reported more hesitancy than White adults, but few studies have examined variation in hesitancy among Black adults or its associations with racial discrimination. Data were collected from Black Arkansas residents age 18 and older (n = 350) between July 12th and July 30th, 2021, as part of a larger survey of Arkansans (N = 1500). Participants were recruited through random digit dialing of both landline and cell phones, with oversampling of Black and Hispanic residents. Respondents reported COVID-19 vaccine hesitancy, sociodemographic information, influenza vaccination history, pandemic-related experiences, and experiences of racial discrimination. Almost half (48.9%) of Black adults in Arkansas were not hesitant towards COVID-19 vaccines, while the remainder reported some level of hesitancy. Nearly a quarter were very hesitant (22.4%), while fewer reported being somewhat (14.0%) and a little (14.7%) hesitant. Using an ordered logistic regression with partial proportional odds, we find odds of COVID-19 vaccine hesitancy decreased as age and influenza vaccination increased. Odds of COVID-19 vaccine hesitancy were 1.70 times greater for Black adults who experienced the death of a close friend/family member due to COVID-19 and 2.61 times greater for individuals reporting discrimination with police or in the courts. Within-group analysis revealed nearly half of Black adults did not report any COVID-19 vaccine hesitancy and heterogeneity among those who were hesitant. Findings suggest there may be an important link between racial discrimination in the criminal justice system and COVID-19 vaccine hesitancy among Black adults.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Brooke E E Montgomery
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72205, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Sumit K Shah
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Nickolas Zaller
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72205, USA
| | - Keneshia Bryant-Moore
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72205, USA
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Mark Williams
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR, 72205, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA.
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Freedman AA, Papachristos AV, Smart BP, Keenan-Devlin LS, Khan SS, Borders A, Kershaw KN, Miller GE. Complaints about excessive use of police force in women's neighborhoods and subsequent perinatal and cardiovascular health. SCIENCE ADVANCES 2022; 8:eabl5417. [PMID: 35044830 PMCID: PMC8769548 DOI: 10.1126/sciadv.abl5417] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/19/2021] [Indexed: 05/17/2023]
Abstract
There are substantial, unexplained racial disparities in women’s health. Some of the most pronounced involve elevated rates of preterm delivery (PTD) and cardiovascular disease (CVD) among Black women. We hypothesized that stress associated with excessive use of force by police may contribute to these disparities. In two prospective cohorts derived from electronic health records (pregnancy cohort, N = 67,976; CVD cohort, N = 6773), we linked formal complaints of excessive police force in patients’ neighborhoods with health outcomes. Exposed Black women were 1.19 times as likely to experience PTD [95% confidence interval (CI): 1.04 to 1.35] and 1.42 times as likely to develop CVD (95% CI: 1.12 to 1.79), even after adjustment for neighborhood disadvantage and homicide. The excess risks of PTD were also observed in maternal fixed-effects analyses comparing births to the same woman. These findings suggest police violence may be an unrecognized contributor to health inequity for Black women.
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Affiliation(s)
- Alexa A. Freedman
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Andrew V. Papachristos
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Sociology, Northwestern University, Evanston, IL, USA
| | - Britney P. Smart
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Lauren S. Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Sadiya S. Khan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ann Borders
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kiarri N. Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gregory E. Miller
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
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12
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Alang S, Rogers TB, Williamson LD, Green C, Bell AJ. Police brutality and unmet need for mental health care. Health Serv Res 2021; 56:1104-1113. [PMID: 34350595 PMCID: PMC8586484 DOI: 10.1111/1475-6773.13736] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE National movements have raised awareness of the adverse mental health effects of police brutality. This study examines the relationship between perceived police brutality and unmet need for mental health care. DATA SOURCES We used the 2018 Survey of the Health of Urban Residents (N = 4338), a quota sample survey of adults in urban areas in the contiguous United States. STUDY DESIGN Multivariate regressions were used to understand the association between police brutality and unmet need for mental health care. Unmet need was regressed on police brutality (the independent variable), controlling for sociodemographic and health status characteristics of respondents and access to care. We then stratified the sample by experiences of police brutality (no negative encounters with the police, encounters that were perceived as necessary, and encounters that were considered unnecessary) and described how medical mistrust and perceived respect within health care settings were associated with odds of unmet need for each subsample. DATA COLLECTION Data were collected online. PRINCIPAL FINDINGS Negative police encounters perceived as necessary were associated with greater odds of unmet need compared to no negative police encounters (odds ratio [OR] = 1.98, confidence interval [CI] = 1.30-2.65). Odds of unmet need were also higher among persons with negative and unnecessary police encounters (OR = 1.28, CI = 1.05-1.56). Greater respect was associated with lower odds of unmet need among persons who reported negative unnecessary encounters with the police (OR = 0.88, CI = 0.72-0.97). Medical mistrust was associated with greater odds of unmet need among those with negative unnecessary police encounters (OR = 1.52, CI = 1.12-1.93). CONCLUSIONS Persons who are exposed to police brutality are also likely to be those who experience unmet need for mental health care. Ensuring that they feel respected within medical settings and establishing conditions that build trust in medical institutions are important for eliminating unmet need for mental health care.
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Affiliation(s)
- Sirry Alang
- Department of Sociology, Program in Health, Medicine and Society, and Health Justice CollaborativeLehigh UniversityBethlehemPennsylvaniaUSA
| | - Taylor B. Rogers
- Department of Health Policy and Management, Fielding School of Public HealthUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Lillie D. Williamson
- Department of Communication ArtsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Cherrell Green
- Department of Criminology & Criminal JusticeUniversity of MissouriSt. LouisMissouriUSA
| | - April J. Bell
- California Preterm Birth Initiative, Obstetrics, Gynecology & Reproductive SciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
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Kerrison EM, Sewell AA. Negative illness feedbacks: High-frisk policing reduces civilian reliance on ED services. Health Serv Res 2021; 55 Suppl 2:787-796. [PMID: 32976631 PMCID: PMC7518820 DOI: 10.1111/1475-6773.13554] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This paper demonstrates that localized and chronic stop-question-and-frisk (SQF) practices are associated with community members' utilization of emergency department (ED) resources. To explain this relationship, we explore the empirical applicability of a legal epidemiological framework, or the study of legal institutional influences on the distribution of disease and injury. DATA AND STUDY DESIGN Analyses are derived from merging data from the Philadelphia Vehicle and Pedestrians Investigation, the National Historical Geographic Information System, and the Southeastern Philadelphia Community Health database to zip code identifiers common to all datasets. Weighted multilevel negative binomial regressions measure the influence that local SQF practices have on ED use for this population. Analytic methods incorporate patient demographic covariates including household size, health insurance status, and having a doctor as a usual source of care. PRINCIPAL FINDINGS Findings reveal that both tract-level frisking and poor health are linked to more frequent use of hospital EDs, per respondent report. Despite their health care needs, however, reporting poor/fair health status is associated with a substantial decrease in the rate of emergency department visits as neighborhood frisk concentration increases (IRR = 0.923; 95% CI: 0.891, 0.957). Moreover, more sickly people in high-frisk neighborhoods live in tracts that have greater racial disparities in frisking-a pattern that accounts for the moderating role of neighborhood frisking in sick people's usage of the emergency room. CONCLUSIONS Findings indicating the robust association reported above interrogate the chronic incompatibility of local health and human service system aims. The study also provides an interdisciplinary theoretical lens through which stakeholders can make sense of these challenges and their implications.
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Affiliation(s)
- Erin M Kerrison
- School of Social Welfare, University of California, Berkeley, Berkeley, California
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14
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Police brutality, medical mistrust and unmet need for medical care. Prev Med Rep 2021; 22:101361. [PMID: 33850697 PMCID: PMC8039814 DOI: 10.1016/j.pmedr.2021.101361] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 03/05/2021] [Accepted: 03/07/2021] [Indexed: 01/05/2023] Open
Abstract
Police brutality can shape health by limiting access to health care. Police brutality is associated with greater odds of unmet need for medical care. This association is partly explained by medical mistrust.
Police brutality is a social determinant of health that can directly impact health status. Social determinants of health can also impact health indirectly by shaping how people access health care. In this study, we describe the relationship between perceived police brutality and an indicator of access to care, unmet need. We also examine medical mistrust as a potential mechanism through which perceived police brutality affects unmet need. Using data from the 2018 Survey of the Health of Urban Residents (N = 4,345), direct effects of perceived police brutality on unmet need and indirect effects through medical mistrust were obtained using the Karlson-Holm-Breen method of effect decomposition. Experiencing police brutality was associated with greater odds of unmet need. Controlling for covariates, 18 percent of the total effect of perceived police brutality on unmet need was explained by medical mistrust. Experiences outside of the health care system matter for access to care. Given the association between police brutality and unmet need for medical care, addressing unmet need among marginalized populations requires public health leaders to engage in conversations about reform of police departments. The coronavirus pandemic makes this even more critical as both COVID-19 and police brutality disproportionately impact Black, Indigenous, Latinx and other communities of color.
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