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
- chlamydia trachomatis
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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.
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