The Physical and Mental Impact of Contact With Police

The story of state-sanctioned violence in America, particularly toward non-white communities, is as old as America itself. But its devastating effects have long been obscured for lack of one thing: comprehensive, reliable data.

That story—the one of cold, hard data—begins shortly after the August 9, 2014, killing of Michael Brown by a police officer in Ferguson, Missouri.

Like many researchers and others reacting to the event, Bloomberg Distinguished Professor Odis Johnson, PhD, had burning questions about just how common fatal interactions with police are in terms of race, residence, socioeconomic status, and other social factors. At the time, little data existed and what did was inadequate.

Since 1949, the CDC has included deaths from law enforcement in its National Vital Statistics System, but Johnson explains that federal data remain incomplete and unreliable. One reason: They are based on reports from officers who are themselves processing their own trauma from the homicide—a recipe for incomplete or fuzzy reporting.

In 2015, Johnson and his team at Washington University in St. Louis merged reports from publicly available data sets, including those compiled by Fatal Encounters and Killed by Police, cross-referenced and fact-checked them, and created the first Fatal Interactions with Police Study, or FIPS.

The results were disturbing.

In the period covered by FIPS, May 2013 to January 2015, approximately 1,700 people—about three per day—were killed by police. Of those, people of color were about 2.4 times more likely to have been unarmed at the time of death than white people. Additionally, although 93% of the deceased were male, Black women represented the only subgroup of race and gender in which the majority—57.2%—were unarmed when killed by police, Johnson says.

“This suggests that gender as a shield theory—[that] somehow gender makes women appear less threatening and therefore less likely to receive deadly force—does not apply to racial groups equally. It might apply to white women but does not apply to Black women to the same extent.”

“This is clearly a prominent issue for public health, that police homicides would be one of the leading causes of death.”

FIPS also revealed a surprise about body cameras: It’s not enough to require officers to wear them. Johnson says policymakers must ensure that cameras are turned on, the footage reviewed, and consequences issued for inappropriate behaviors.

While the data have led to myriad, more granular findings, Johnson says perhaps the most important result is the indisputable proof that racial justice and systemic racism are public health issues. In a single fact: Being killed by police now ranks in the top six causes of death of young Black men. “This is clearly a prominent issue for public health, that police homicides would be one of the leading causes of death,” Johnson says.

FIPS was one of the first studies to calculate the odds of fatal interactions with police. Today, Johnson says “an avalanche” of studies exists, making use of the many crowdsourced databases that arose to fill the gaps still left by federal reporting. They examine not only fatal interactions, but the impact of other aggressive, intrusive, or violent police encounters on a variety of public health outcomes.

That’s the type of research Dylan Jackson, PhD, MS, an assistant professor in Population, Family and Reproductive Health, conducts. Jackson studies the effect of any adverse police interaction—including trauma from witnessing police violence—on urban youth.

“In many respects, police aggression is not like other sources of trauma,” Jackson says. “It’s constantly besieging some groups more than others. It is part of state-sanctioned violence in the name of public safety that’s disparate by race in terms of exposure, and there’s very little recourse for healing or justice if you are victimized by an officer.”

Students of color also report more distress than white students when witnessing police stops in their schools and communities, regardless of whether those stops resulted in arrests or were perceived as just. Moreover, the mothers of youth who are stopped by police are twice as likely as their counterparts to report worse sleep and health, Jackson says, which “intimates that even family members of the youth are being impacted vicariously.”

The repercussions are significant. As their number of encounters with police increase, youth experience physical effects of posttraumatic stress: uncontrollable thoughts with sweaty palms, rapid heart rates, and lower quality sleep. In a study of youth in the UK, Jackson and Bloomberg School colleagues Rebecca Fix, PhD, MS, and Tamar Mendelson, PhD, MA, found rates of self-harm and suicide attempts also increase.

The effects are so pervasive, Jackson adds, that over time, police encounters can also undermine youths’ confidence that they will attend college or obtain a well-paying job later in life.

In addition to the trauma itself, many affected youths experience shame around police encounters. That keeps one-third of them from telling anyone what happened, even a parent or friend. In turn, those youths are even less likely to be connected to counseling or other resources that could help them.

Jackson says this speaks to a broader issue in understanding the health of young people: “We are overlooking [police encounters] as a source of trauma, particularly racialized trauma, among youth.”

An immediate way to begin addressing this is to include police encounters as part of health screenings—for example, in the Adverse Childhood Experiences inventory, a questionnaire about childhood exposure to abuse and neglect used to predict future health outcomes. Still, Jackson cautions that, given the unique nature of this type of trauma, more work needs to be done to determine whether existing therapies for more generalized traumas will be optimally effective, or if new methods will be needed to help youth experiencing trauma from police encounters specifically.

Either way, “it all has to come down to what the youth say they need,” Jackson says. “The only way to do that systematically is if it’s driven by a process where youth are being supported by people in their social circle—peers, teachers, parents, etc.—who have a real, meaningful knowledge of what it means to be the subject of racially motivated police aggression.”