“Police kill more than 300 black Americans — at least a quarter of them unarmed — each year in the USA. These events might have spillover effects on the mental health of people not directly…
“Police kill more than 300 black Americans — at least a quarter of them unarmed — each year in the USA. These events might have spillover effects on the mental health of people not directly affected.”
That was the premise behind a study released in June in the Lancet, and its author says it’s the first to look at “institutional racism.”
Dr. Atheendar Venkataramani is an assistant professor in the department of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania and a board-certified general internist at the Penn Presbyterian Medical Center. The idea for the study, he says, came from personal experience. “Friends and patients of mine would often make statements that belied the trauma they had felt every time one of these incidents happened,” he says. “More colloquially, people would make statements about how their anxiety rose or they had PTSD, how they felt incredibly defeated or depressed after one of these events happened.”
Venkataramani wanted to understand the mental health burden of police shootings on people who weren’t directly victims. There is research showing that personal experiences of racism correlate to an array of poor health outcomes, he says. “I was looking for a window into understanding how structural racism causes poor health for a population as a whole. People had not gotten into the weeds on this.” So he did.
Venkataramani analyzed data collected between 2013 and 2016 from 103,710 black adults. They were interviewed in a national survey that asked if the interviewee felt his or her mental health was good that day. He then drilled down to the interviews taken just before or just after a police shooting of an African-American. The results: The shootings were shown to add 1.7 days of poor mental health annually per person. “That may not seem like a lot per person, but this is at the population level,” he says. “The real number is there are about 55 million poor mental health days per year nationally among African-Americans” related to these events. “That is more than half as large as the burden on mental health from chronic physical diseases like diabetes.”
This decline in mental health was seen in all black Americans, regardless of whether there was a relationship with the victim, and it revealed itself in many ways, including “reactions of anger, activation of prior traumas and communal bereavement,” the study says. White Americans were also part of the study; for them, “mental health impacts were not observed,” the study notes dryly. In other words, although they often reported being upset by the events, their experiences did not devolve into mental illness. “We can say that moderate to severe mental distress went up for African-Americans after a police killing,” Venkataramani says more emphatically.
Institutional violence, sadly, is nothing new. African-Americans and other minorities have lived with it since the land was settled by whites centuries ago. What is new, however, is the easily accessed and ubiquitous records of these events on TV, social media and cellphone videos.
“People are traumatized by watching these videos because you are watching somebody who looks like you have violence against you by the police, which is state-sanctioned by default, and there are no consequences for it,” says Dr. Ruth White, a clinical associate professor in the Department of Social Change and Innovation at the University of Southern California. “If you feel you are also vulnerable for this treatment and there will be no consequences, that is a total set up for trauma. Not necessarily expecting it every day, but not knowing if it could happen to you.” Such ongoing stress is a known risk factor for mental illness, including depression and anxiety.
The lack of consequence for officers is arguably the most troubling aspect of institutional violence, White says. In the predigital past, there was often no hard evidence to corroborate the stories that minorities knew to be true. “But now, even with evidence, it hasn’t changed the outcome,” she says. “We have a consciousness of it in ways we never did before. Social media can share what happens in your neighborhood with the rest of the world. That level of consciousness makes it even more traumatizing, even if the actual risk hasn’t increased where you live, because our world is not just about where we live anymore.”
Venkataramani is digging even deeper into these weeds, collecting data on, for example, how institutional racism affects children and whether killings recorded by police body cameras are more salient than other killings. He stresses that his research has no anti-police bias. “It is not obvious that all [these events] are malicious or that all cops are racist,” Venkataramani says. “But we know from decades of work that society can be unfair even when individuals are not unfair themselves. This research was thought to be some kind of liberal paper, but it doesn’t imply anything about the competence or intent of police, only that societal structures can have negative impacts that change lives in detrimental ways.”