University of California, Irvine 653 E. Peltason Drive, Irvine, CA, 92617, USA.
University of California, Irvine 653 E. Peltason Drive, Irvine, CA, 92617, USA.
Soc Sci Med. 2021 Jan;269:113561. doi: 10.1016/j.socscimed.2020.113561. Epub 2020 Nov 28.
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.
先前关于种族主义和不良心理健康的文献主要关注个体层面的暴露。我们调查了结构性种族主义（以美国警察枪杀手无寸铁的非裔美国人来衡量）是否以及在何种程度上会影响非裔美国人的一种严重和急性心理健康后果：与抑郁相关的急诊部（ED）就诊。我们将美国警察枪杀手无寸铁的非裔美国人作为暴露因素，将与抑郁相关的 ED 就诊（每 10 万人）作为结果。我们考察了 2013 年至 2015 年间五个美国州的 75 个县之间的关系（2700 个县月）。线性固定效应分析控制了时间不变的县因素以及每 10 万人的医院数量和暴力犯罪逮捕率（每 10 万人）。与非裔美国人相关的抑郁相关 ED 就诊每月增加 11%，与同期和暴露后三个月每 10 万人中的非裔美国人 ED 就诊相关（p<0.05）。研究人员和政策制定者可能希望考虑采取预防措施来减少警察执法中的种族偏见，并对致命警察遭遇进行监测。此外，这些遭遇可能会恶化非裔美国人在 ED 中的心理健康和寻求帮助的情况，而与遭遇本身没有直接关系。
