Police brutality, medical mistrust and unmet need for medical care.

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.