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The Health Outcomes of Direct and Witnessed Interactions With the Police: Do Race and Ethnicity Matter?

      See Related Article on p.248
      The Bureau of Justice Statistics indicates that 61.5 million Americans came into direct contact with the police during 2018. Almost 47% (28.9 million people) of those encounters were initiated by police themselves [
      • Bureau B.J.S.
      Of justice Statistics (BJS) - FAQ Detail.
      ]. Fortunately, the vast majority of those encounters were nonviolent. Violence, particularly lethal violence, is rare. For example, it is estimated that one out of 33,000 people die as the result of police violence. However, one out of 1,000 black men die because of direct encounters with the police, making these violent encounters a leading cause of death among this demographic (especially men between the ages of 20 and 35 years) [
      • Edwards F.
      • Lee H.
      • Esposito M.
      Risk of being killed by police use of force in the United States by age, race–ethnicity, and sex.
      ]. Moreover, Blacks are more likely than Whites to believe that violent encounters occur between police officers and citizens indicating that the interpretation of encounters might vary by race and ethnicity [
      • Reinka M.A.
      • Leach C.W.
      Race and reaction: Divergent views of police violence and protest against.
      ].
      While lethal violence is the most severe outcome of interactions with the police, even routine interactions with the police can have profound impacts on an individual. In fact, a burgeoning literature base suggests that encounters with the police can lead to various negative health and behavioral outcomes including psychological distress, depression, anxiety, and suicidal behavior [
      • Jackson D.B.
      • Fahmy C.
      • Vaughn M.G.
      • et al.
      Police stops among at-risk youth: Repercussions for mental health.
      ,
      • McLeod M.N.
      • Heller D.
      • Manze M.G.
      • et al.
      Police interactions and the mental health of black Americans: A systematic review.
      ]. These findings suggest that proactive policing strategies such as stop and frisk may end up having adverse—iatrogenic—consequences [
      • White M.D.
      • Fradella H.F.
      Stop and frisk: The use and abuse of a controversial policing tactic.
      ], even if such strategies were originally intended to keep communities safe.
      In addition to experiencing direct encounters, vicarious or indirect encounters are pervasive in the United States. These indirect encounters can be proximate to the individual and include family and friends or be collective exposures that include images and videos in the media. Far-reaching examples of lethal police violence have made their way into peoples' family rooms. On March 3, 1991, the nation was shocked witnessing the brutal beating of Rodney King by Los Angeles police officers. Nearly 30 years later, on May 25, 2020, the nation witnessed a police officer kneel on George Floyd's neck for over 9 minutes—several of those minutes after Floyd lay lifeless. Both men were Black. Just witnessing the murder of George Floyd on social media has been linked to posttraumatic stress disorder [
      • Klein E.J.
      • Lopez W.D.
      Trauma and police violence: Issues and implications for mental health professionals.
      ,
      • Tynes B.M.
      • Willis H.A.
      • Stewart A.M.
      • et al.
      Race-related traumatic events online and mental health among adolescents of color.
      ]. Jarring video evidence also exists for other recent cases including Eric Garner, Tamir Rice, Walter Scott, and Philandro Castile—all people of color.
      Existing research about police-citizen encounters suggests that negative or unwelcomed police encounters are a part of a shared community memory that is passed down from one generation of Black Americans to the next [
      • Brunson R.K.
      • Weitzer R.
      Negotiating unwelcome police encounters: The intergenerational transmission of conduct norms.
      ]. This has resulted in not only a toxic relationship between Black communities and the police but also cumulative trauma experienced by members of those communities [
      • Brunson R.K.
      “Police don’t like black people”: African-American young men’s accumulated police experiences.
      ]. Through this process, present-day cases of police violence invoke collective memories of past events which then inform future behaviors [
      • Cunningham D.
      • Nugent C.
      • Slodden C.
      The durability of collective memory: Reconciling the “Greensboro massacre.
      ]. In this sense, memories of prior events become cultural forces that are imbued with collective meaning. Often, Black people do not view these cases as isolated incidents or aberrations but as continuations of violence experienced by the whole community [].
      In this issue of the Journal of Adolescent Health, criminologist Dylan Jackson and coauthors push readers to refocus on the health impacts of interactions with police. Specifically, the authors consider witnessed interactions with police [
      • Jackson D.B.
      • Del Toro J.
      • Semenza D.C.
      • et al.
      Unpacking racial/ethnic disparities in emotional distress among adolescents during witnessed police stops.
      ]. This is an important aspect of police-community encounters to explore as both indirect and direct exposure to stressors lead to poor health and socio-behavioral sequelae [
      • Zimmerman G.M.
      • Posick C.
      Risk factors for and behavioral consequences of direct versus indirect exposure to violence.
      ] and indirect encounters with police through family and friends can have their own negative health impacts [
      • Bowleg L.
      • Maria del Río-González A.
      • Mbaba M.
      • et al.
      Negative police encounters and police avoidance as pathways to depressive symptoms among US Black men, 2015–2016.
      ,
      • DeVylder J.
      • Fedina L.
      • Link B.
      Impact of police violence on mental health: A theoretical framework.
      ,
      • Alang S.
      Police Brutality and the Institutional Patterning of stressors.
      ]. They highlight the need to use racially and ethnically sensitive research approaches to uncover variation in the outcomes of interaction experiences. They reveal that youth of color (i.e., Black, Hispanic, and multiracial youth) experience heightened emotional distress during a witnessed encounter with police compared with Whites. The link between race/ethnicity and distress among youth who had witnessed police encounters is partially attributable to officer intrusiveness (e.g., threats of force, use of force) and perceptions of procedural injustice.
      Importantly, as the authors note, the results of their study, and studies that preceded theirs, point toward policies and programs that can make policing fairer and more efficient while limiting the negative health consequences that stem from interactions with police. For example, screening for somatic symptoms ranging from headaches and stomachaches to more major mental health issues including major depressive and anxiety disorders by professionals who come into contact with youth—particularly school counselors, primary care doctors, and community organizations—may identify physical and mental health concerns early and provide a foundation for creating a comprehensive intervention plan. Police departments, for their part, must work alongside social service providers to provide trauma-informed training to all officers and establish strong connections to external services that can benefit people and communities by providing mental health services. Finally, broader societal shifts must take place that reduce overly intrusive policing practices. Overall, the least punitive and least restrictive action should be promoted at each step from police-community interactions to court processing and to judicial sanctioning.
      The work by Jackson et al. [
      • Jackson D.B.
      • Del Toro J.
      • Semenza D.C.
      • et al.
      Unpacking racial/ethnic disparities in emotional distress among adolescents during witnessed police stops.
      ] highlights the importance of continued research on the health outcomes related to witnessing interactions with police. Indeed, this research reveals just how much child health and behavior can be negatively shaped by contact with the criminal justice system and its actors—including vicarious contact. Still, there is much more to learn. As intersectionality grows as a research framework, there are other nuances in the interaction-outcome link worthy of investigation including the experiences of Black females compared with White females and Black males compared with White males. There may also be differences regarding the intersection of race and socioeconomic status. How do poor black men fair related to poor white men and how do they both do compared with their counterparts in higher socioeconomic groups? More data and analyses are clearly needed, and a transdisciplinary approach combining the tools and ideas of multiple disciplines has the potential to continue to refine theory and research on youth's encounters with the police.

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