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Review
September 7, 2021

Police Exposures and the Health and Well-being of Black Youth in the US: A Systematic Review

Author Affiliations
  • 1Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Office of Extramural Research, Education, and Priority Populations, Agency for Healthcare Research and Quality, Rockville, Maryland
  • 3Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 4Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 5Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Pediatr. Published online September 7, 2021. doi:10.1001/jamapediatrics.2021.2929
Key Points

Question  Is exposure to police associated with adverse health outcomes for Black youth in the US?

Findings  In this systematic review of 29 studies that included 19 954 participants, police exposure was associated with multiple health outcomes for Black youth, including adverse mental health, risk behaviors, and impaired safety.

Meaning  Police exposure should be considered a critical determinant of health.

Abstract

Importance  Black youth in the US experience disproportionate contact with police even when accounting for criminal or delinquent behavior, which some experts say is fueled by racism and discrimination. While the literature supports the link between racism and adverse health outcomes, less is known about the impact of policing on the well-being of Black youth.

Objective  To systematically review the literature describing the association between police exposure and health outcomes for Black youth 26 years and younger.

Evidence Review  A search of PubMed, Embase, Criminal Justice Abstracts, PsycInfo, and Web of Science was conducted. Eligible studies included original peer-reviewed research published from 1980 to December 2020, with a participant population of Black youth, a focus on police exposure, and health as the outcome. Additional articles were identified by hand-searching reference lists of included studies. Data extraction was performed, followed by critical appraisal of all included studies using a convergent segregated approach in which quantitative and qualitative studies were synthesized separately followed by an overarching synthesis across methods.

Findings  A total of 16 quantitative studies including 19 493 participants were included in the review and demonstrated an association between police exposure and adverse mental health, sexual risk behaviors, and substance use. A total of 13 qualitative studies including 461 participants were included in the review, which corroborated and contextualized the quantitative evidence and provided additional health outcomes, such as fear for life or hopelessness.

Conclusions and Relevance  Evidence shows that police exposures are associated with adverse health outcomes for Black youth. Clinicians, scientists, public health practitioners, and policy makers can partner with local governments to enact reforms that mitigate the health impact of policing on youth.

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