Police Killings Vicariously Impact Mental Health of Black Americans

Nationally-representative sample provides evidence that police killings of unarmed Black Americans cause worse mental health in Black Americans via vicarious racism


A new study, published in The Lancet, examines the spillover effects of police killings of unarmed Black Americans. The study was co-led by Jacob Bor, assistant professor at Boston University School of Public Health, and Atheendar Venkataramani, assistant professor at the University of Pennsylvania. Results of the quasi-experimental study, which analyzed data from over 100,000 Black Americans, suggest a causal link between police killings of unarmed Black Americans and poorer mental health in Black Americans.

“Beyond the immediate consequences for victims and their families, police killings might also affect the mental health of people not directly connected to the killings or to the people involved,” the researchers write. “Racism, like trauma, can be experienced vicariously.”

Photo Credit: Flickr

Black Americans are almost three times as likely to be killed by police as White Americans. That number increases to five times as likely when the person is unarmed. Research has shown that racism and discrimination are associated with poorer physical and mental health outcomes. Additionally, Black men who have negative interactions with police experience more mental health challenges.

Although there is substantial and increasing evidence of the association between structural racism and poorer mental health outcomes in people of color, it has been difficult to demonstrate a causal link between racism and health. Therefore, the authors conducted a population-level, quasi-experimental study to examine the effect of police killings on Black American’s mental health. The researchers collected data from over 100,000 Black Americans via the US Behavioral Risk Factor Surveillance System (BRFSS), a random, nationally representative survey.

They used the Mapping Police Violence database to calculate the number of police killings in the state the respondent was from during the three months before the survey, focusing on killings of unarmed Black Americans. The researchers used the number of days a respondent described their mental health as “not good” in the month prior to the survey as the study outcome measure.

The researchers were able to compare respondents who were exposed to police killings of unarmed Black Americans in their state during the previous three months to respondents who were not exposed to police killings over the last three months. They also explored the impact of police killings on the mental health of Black Americans compared to White Americans. This quasi-experimental design allowed the authors to make causal conclusions about how police killings of other Black Americans can impact Black American’s mental health.

Almost half (49%) of respondents were exposed to a police killing of an unarmed Black American in their state during the three months prior to the survey. On average, respondents were exposed to one police killing of an unarmed Black American in the previous three months, equating to four killings a year.

“Exposure to one or more police killings was associated with a 0.35 day (0.03-0.67; p=0.032) increase in poor mental health days.”

Results show that each additional police killing of an unarmed Black American results in a 0.14-day increase in poor mental health days in Black Americans. Psychological health appears to be worst about two months post-police killing. Police killings of unarmed Black Americans did not affect White American’s mental health, nor did police killings of armed Black Americans have an impact on Black American’s mental health.

The authors summarize their findings:

“Our estimates suggest that police killings of unarmed black Americans have a meaningful population-level impact on the mental health of black Americans. Specifically, our estimates imply that police killings of unarmed black Americans could contribute 1.7 additional poor mental health days per person per year, or 55 million… excess poor mental health days per year among black American adults in the USA.”

Given the findings, the authors support previous calls to “treat police killings as a public health issue” and reform the criminal justice system. They recommend more public health programs that provide mental health support to Black Americans vicariously affected by police killings. This call is especially important given recent research showing mental health counselors lack training in racial trauma.

The researchers point to the effect that these events have on the meaning-making of Black Americans. They suggest that “the meaning ascribed to police killings of unarmed black Americans, in light of the historical and institutional context in which they occur, probably mediates the adverse mental health effects of these events on black Americans.”



Bor, J., Venkataramani, A. S., Williams, D. R., & Tsai, A. C. (2018). Police killings and their spillover effects on the mental health of black Americans: A population-based, quasi-experimental study. The Lancet. Advance online publication. http://dx.doi.org/10.1016/S0140-6736(18)31130-9 (Link)


  1. The Brilliant Photograph appears to come from London in the UK, where 2nd/3rd generation Caribbean people are maybe 5 times more likely to be diagnosed with Severe Mental Illness than their non black counterparts, ending up dead many years before their time.

    Apologies for digressing – the ‘countries’ might be different but the issue is the same.

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  2. Good article Shannon. Be forewarned though. The title may get you in trouble.

    “You didn’t even put the term ‘mental illness’ in quotes.”

    Actually the term emotional well being would have worked. Being unjustly accused of crimes you haven’t committed is traumatic.

    Seek out “help” from quacks and you can experience it more than ever.

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  3. I don’t know about the use of the word “vicariously” here, in fact, I would think it should come as no surprise to anybody that police shootings are going to impact the health of black Americans across the board anyway. In some cases, terminally. I understand that police beatings can have a negative impact upon the health of black people being beaten as well, and that this negative impact may extend to those who merely read about it, or observe it taking place.

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  4. its worth noting that the legal system and the psychiatric system work together, as systems of control and punishment. shrinks “make examples” out of wayward patients, too, and they seem to be able to do so with even less fear of punishment than your average cop.

    maybe the fear, the violence, the sense of powerlessness…is not a dysfunction, but an integral part of how our system “really works” ?

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        • Right. It’s multiplicative. If a person is black, they’re worse off. If the person is poor, they’re worse off. If they are poor AND black, they’re a LOT worse off! Add in “drug user”, non-English speaker, having a “mental health” diagnosis, etc., and it gets more and more dangerous to be in contact with the police.

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        • The post by The Cat which sparked this conversation has been removed. I try to avoid commenting on moderation, but I suspect someone decided the post was racist because it raised oft-debated political positions regarding the relative significance of race vs. class in our current state of oppression, even though maybe it wasn’t phrased that way. Cat’s point — that all races need to unite to fight this oppression — is admirable for one coming from a “conservative” orientation (I think). It is not racist to discuss such seeming contradictions; it is more racist to ignore them. Obviously Cat made enough sense for people to respond to him with thoughtful posts. Not seeing the post that started this is weird. And I’d hate to see Cat driven away again by this sort of attitude, his perspective has always been refreshingly provocative.

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    • Frankly, just as I don’t trust psychiatrists I sure don’t trust the police in my city. “To protect and serve” may be their motto but dealing with them is a different matter altogether. In my city the police are equal opportunity haters of African Americans and Whites.

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      • Power corrupts. Sad fact of human nature. Without their political clout and pseudo-credibility shrinks would be as harmless as irridologists.

        Unlike racial differences a “mental illness” is not immediately apparent. If behaviors aren’t very eccentric police can’t tell. Calling police to check on a “mentally ill” “loved” one is a great way to get that person shot.

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    • Actually presenting it as a race issue is best. Black Lives Matter.

      If every “mentally ill” person on this planet died tomorrow and the public was informed a collective cheer would go up.

      “Yay! The cray crays are dead. No more crime, shootings, nasty relatives or parasites.”

      Only our psychiatric overlords would mourn. Like dictators without subjects.

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      • And when crimes, murders, and nastiness continued the psychiatrists could say, “Glory be! Somehow the SMI gene has spread despite the death of all who carried it.” Sane people are perfect angels who never do anything wrong dontchaknow.

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  5. I was reading…back in the day, psychiatry was openly based upon “non-injurious torture,” along with strong elements of -fear-. Of course, now its all “Evidence-based,” blah blah blah, but I got to thinking about it, and…

    given how even the high profile police brutality (and straight up murder, manslaughter) cases only rarely result in the “swift, certain, and severe” punishment that follows, say…hurting a cop…could one come to the conclusion that one of 21st century American police forces’ “latent functions” is, in fact, to instill fear in the masses, to keep us all in line?

    Just thinking (well…typing…) out loud.

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