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Epidemiology
Short report
Police killings of Black people and rates of sexually transmitted infections: a cross-sectional analysis of 75 large US metropolitan areas, 2016
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  1. Umedjon Ibragimov1,
  2. Stephanie Beane1,
  3. Samuel R Friedman2,
  4. Justin C Smith1,
  5. Barbara Tempalski2,
  6. Leslie Williams2,
  7. Adaora A Adimora3,4,
  8. Gina M Wingood5,
  9. Sarah McKetta6,
  10. Ronald D Stall7,
  11. Hannah LF Cooper1
  1. 1 Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, Georgia, USA
  2. 2 National Development and Research Institutes, New York City, New York, USA
  3. 3 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  4. 4 Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  5. 5 Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA
  6. 6 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, United States
  7. 7 Department of Behavioral and Community Health Sciences and Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Umedjon Ibragimov, Emory University School of Public Health, Atlanta, GA 30322, USA; umed.ibragimov{at}emory.edu

Abstract

Objectives Emerging literature shows that racialised police brutality, a form of structural racism, significantly affects health and well-being of racial/ethnic minorities in the USA. While public health research suggests that structural racism is a distal determinant of sexually transmitted infections (STIs) among Black people, no studies have empirically linked police violence to STIs. To address this gap, our study measures associations between police killings and rates of STIs among Black residents of US metropolitan statistical areas (MSAs).

Methods This cross-sectional ecological analysis assessed associations between the number of Black people killed by police in 2015 and rates of primary and secondary syphilis, gonorrhoea and chlamydia per 100 000 Black residents of all ages in 2016 in 75 large MSAs. Multivariable models controlled for MSA-level demographic and socioeconomic characteristics, police expenditures, violent crime, arrest and incarceration rates, insurance rates and healthcare funding.

Results In 2015, the median number of Black people killed by police per MSA was 1.0. In multivariable models, police killings were positively and significantly associated with syphilis and gonorrhoea rates among Black residents. Each additional police killing in 2015 was associated with syphilis rates that were 7.5% higher and gonorrhoea rates that were 4.0% higher in 2016.

Conclusions Police killings of Black people may increase MSA-level risk of STI infections among Black residents. If future longitudinal analyses support these findings, efforts to reduce STIs among Black people should include reducing police brutality and addressing mechanisms linking this violence to STIs.

  • social science
  • syphilis
  • gonorrhoea
  • chlamydia trachomatis

https://doi.org/10.1136/sextrans-2019-054026

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    Footnotes

    • Handling editor Alec Miners

    • Contributors UI conceptualised the study, contributed to the study methodology and led the writing. SB conducted the analyses and contributed to writing. SF conceptualised the study, reviewed and edited the manuscript; JCS, BT, LW and GW contributed to the study methodology, reviewed and edited the manuscript. AA, SM and RS reviewed and edited the manuscript. HLFC conceived the study, contributed to the study methodology, cowrote the manuscript and supervised the study.

    • Funding The following grants supported this project: National Institute on Drug Abuse, National Institutes of Health (DA037568; PIs: Cooper, Friedman and Stall); Center for AIDS Research at Emory University (P30AI050409; PI: Del Rio) and Center for Drug Use and HIV Research (P30 DA11041; PI Sherry Deren).

    • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.