Freedman Alexa A, Papachristos Andrew V, Smart Britney P, Keenan-Devlin Lauren S, Khan Sadiya S, Borders Ann, Kershaw Kiarri N, Miller Gregory E
Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL, USA.
Institute for Policy Research, Northwestern University, Evanston, IL, USA.
Sci Adv. 2022 Jan 21;8(3):eabl5417. doi: 10.1126/sciadv.abl5417. Epub 2022 Jan 19.
There are substantial, unexplained racial disparities in women’s health. Some of the most pronounced involve elevated rates of preterm delivery (PTD) and cardiovascular disease (CVD) among Black women. We hypothesized that stress associated with excessive use of force by police may contribute to these disparities. In two prospective cohorts derived from electronic health records (pregnancy cohort, = 67,976; CVD cohort, = 6773), we linked formal complaints of excessive police force in patients’ neighborhoods with health outcomes. Exposed Black women were 1.19 times as likely to experience PTD [95% confidence interval (CI): 1.04 to 1.35] and 1.42 times as likely to develop CVD (95% CI: 1.12 to 1.79), even after adjustment for neighborhood disadvantage and homicide. The excess risks of PTD were also observed in maternal fixed-effects analyses comparing births to the same woman. These findings suggest police violence may be an unrecognized contributor to health inequity for Black women.
女性健康方面存在显著的、无法解释的种族差异。其中一些最明显的差异包括黑人女性早产(PTD)和心血管疾病(CVD)的发病率较高。我们推测,与警察过度使用武力相关的压力可能导致了这些差异。在两个源自电子健康记录的前瞻性队列中(妊娠队列,n = 67,976;CVD队列,n = 6773),我们将患者所在社区对警察过度使用武力的正式投诉与健康结果联系起来。即使在对社区劣势和凶杀案进行调整之后,暴露于相关情况的黑人女性发生早产的可能性仍是未暴露者的1.19倍[95%置信区间(CI):1.04至1.35],患心血管疾病的可能性是未暴露者的1.42倍(95%CI:1.12至1.79)。在对同一女性的分娩情况进行比较的孕产妇固定效应分析中,也观察到了早产的额外风险。这些发现表明,警察暴力可能是黑人女性健康不平等的一个未被认识到的因素。