Racialized Police Use of Force and Maternal Health

There are large racial disparities in maternal health that cannot be explained by education, income, or other individual-level risk factors. This cross-sectional study estimated associations between racial inequity in police use of force at the community level and health outcomes of Black and White women.

Birth records were linked to maternal hospital discharge records and municipal police department data for 326,240 births occurring between January 1, 2012, and December 31, 2016, to Black and White women in the state of New Jersey. Outcomes, identified using diagnosis and procedure codes, were substance use (any/tobacco/alcohol/other), mental health disorders (any/depression/anxiety/other), asthma, obesity, hypertension (pre-existing/gestational), diabetes (pre-existing/gestational), severe maternal morbidity, other cardiovascular diseases, and preterm labor. Data were analyzed in 2024.

For Black women, living in a community with 1% greater racially-disproportionate police use of force was associated with higher odds of any mental health disorder (by 0.18%; 95% CI=0.08, 0.28), depression (0.19%; 95% CI=0.05, 0.33), anxiety (0.25%; 95% CI=0.09, 0.41), other mental health disorder (0.17%; 95% CI=0.07, 0.27), any substance use (0.26%; 95% CI=0.14, 0.38), tobacco use (0.31%; 95% CI=0.16, 0.46), other substance use (0.17%; 95% CI=0.04, 0.30), asthma (0.12%; 95% CI=0.04, 0.21), and preterm labor (0.17%; 95% CI=0.05, 0.29) in adjusted models. There were no robust associations with the other outcomes for Black women or with any of the outcomes for White women.

Racially-disproportionate police use of force was significantly associated with mental illness, substance use, asthma, and preterm labor of Black women. Results underscore the potential importance of institutionalized racism as a fundamental cause of health disparities.