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    Original Investigation
    Public Health
    November 21, 2018

    Association of Exposure to Police Violence With Prevalence of Mental Health Symptoms Among Urban Residents in the United States

    Author Affiliations
    • 1Graduate School of Social Service, Fordham University, New York, New York
    • 2School of Social Work, University of Maryland, Baltimore
    • 3School of Social Work, University of Michigan, Ann Arbor
    • 4Graduate Center, City College of New York, New York
    • 5School of Social Work, Columbia University, New York, New York
    • 6School of Public Policy, University of California Riverside, Riverside
    JAMA Netw Open. 2018;1(7):e184945. doi:10.1001/jamanetworkopen.2018.4945
    Key Points español 中文 (chinese)

    Question  What is the prevalence of police violence exposure in cities in the United States, and what is the association of police violence exposure with adverse mental health outcomes independent of other forms of trauma exposure and crime involvement?

    Findings  In this cross-sectional, general population survey study of 1000 adults residing in Baltimore, Maryland, and New York City, New York, police violence exposure was reported at a prevalence ranging from 3% for sexual violence to 15% for neglect, inequitably distributed across demographic groups, and was associated with concurrent mental health symptoms.

    Meaning  The findings suggest that police violence is experienced by many urban residents in the United States and may be associated with mental health disparities.


    Importance  Police violence is reportedly widespread in the United States and may pose a significant risk to public mental health.

    Objective  To examine the association between 12-month exposure to police violence and concurrent mental health symptoms independent of trauma history, crime involvement, and other forms of interpersonal violence exposure.

    Design, Setting, and Participants  This cross-sectional, general population survey study of 1221 eligible adults was conducted in Baltimore, Maryland, and New York City, New York, from October through December 2017. Participants were identified through Qualtrics panels, an internet-based survey administration service using quota sampling.

    Exposures  Past 12-month exposure to police violence, assessed using the Police Practices Inventory. Subtypes of violence exposure were coded according to the World Health Organization domains of violence (ie, physical, sexual, psychological, and neglectful).

    Main Outcomes and Measures  Current Kessler Screening Scale for Psychological Distress (K6) score, past 12-month psychotic experiences (World Health Organization Composite International Diagnostic Interview), and past 12-month suicidal ideation and attempts.

    Results  Of 1221 eligible participants, there were 1000 respondents (81.9% participation rate). The sample matched the adult population of included cities on race/ethnicity (non-Hispanic white, 339 [33.9%]; non-Hispanic black/African American, 390 [39.0%]; Hispanic/Latino, 178 [17.8%]; other, 93 [9.3%]), age (mean [SD], 39.8 [15.2] years), and gender (women, 600 [60.0%]; men, 394 [39.4%]; transgender, 6 [0.6%]) within 10% above or beyond 2010 census distributions. Twelve-month prevalence of police violence was 3.2% for sexual violence, 7.5% for physical violence without a weapon, 4.6% for physical violence with a weapon, 13.2% for psychological violence, and 14.9% for neglect. Police violence exposures were higher among men, people of color, and those identified as homosexual or transgender. Respondents reported suicidal ideation (9.1%), suicide attempts (3.1%), and psychotic experiences (20.6%). The mean (SD) K6 score was 5.8 (6.1). All mental health outcomes were associated with police violence exposure in adjusted logistic regression analyses. Physical violence with a weapon and sexual violence were associated with greater odds of psychotic experiences (odds ratio [95% CI]: 4.34 [2.05-9.18] for physical violence with a weapon; 6.61 [2.52-17.36] for sexual violence), suicide attempts (odds ratio [95% CI]: 7.30 [2.94-18.14] for physical violence with a weapon; 6.63 [2.64-16.64] for sexual violence), and suicidal ideation (odds ratio [95% CI]: 2.72 [1.30-5.68] for physical violence with a weapon; 3.76 [1.72-8.20] for sexual violence).

    Conclusions and Relevance  Police violence was commonly reported, especially among racial/ethnic and sexual minorities. Associations between violence and mental health outcomes did not appear to be explained by confounding factors and appeared to be especially pronounced for assaultive forms of violence.