Emergency Department visits for depression following police killings of unarmed African Americans

• Published in: Social science & medicine (1982) Vol. 269; p. 113561
• Main Authors: Das, Abhery, Singh, Parvati, Kulkarni, Anju K., Bruckner, Tim A.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2021; Pergamon Press Inc
• Subjects: African Americans; Arrests; Bias; Counties; Depression; Emergency department; Emergency services; Help seeking behavior; Hospitals; Individual differences; Mental depression; Mental health; Offenses; Police; Police community relations; Police killings; Policy making; Population growth; Prevention programs; Racial bias; Racial disparity; Racism; States; Surveillance; Systemic racism; Violent crime; Visits; Depression; Emergency department; Police killings; Racial disparity; Racism
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2020.113561

Previous literature on racism and adverse mental health largely focuses on individual-level exposures. We investigate whether and to what extent structural racism, as measured by police killings of unarmed African Americans, affect a severe and acute mental health outcome among African Americans: depression-related Emergency Department (ED) visits. We used police killings of unarmed African Americans as our exposure and depression-related ED visits (per 100,000 population) as our outcome. We examined the relation across 75 counties from five US states between 2013 and 2015 (2700 county-months). Linear fixed effect analyses controlled for time-invariant county-factors as well as the number of hospitals and arrests for violent crimes (per 100,000 population). Police killings of unarmed African Americans correspond with an 11% increase in ED visits per 100,000 population related to depression among African Americans in the concurrent month and three months following the exposure (p < 0.05). Researchers and policymakers may want to consider prevention efforts to reduce racial bias in policing and implement surveillance of fatal police encounters. These encounters, moreover, may worsen mental health and help-seeking in the ED among African Americans not directly connected to the encounter. •Police are almost 3.5 times more likely to kill Blacks than whites in the US.•We test whether these killings adversely affect mental health.•Police killings of unarmed Blacks precede increased ED visits for depression.