Each year, more than 300 black Americans are killed by police. Results of a study published in the Lancet1 suggest that these killings have adverse effects on the mental health of this population, and that programs should be implemented to mitigate the effects to mental health when shootings occur.

Atheendar S. Venkataramani, MD, PhD, of the Department of Medical Ethics and Health Policy at the University of Pennsylvania in Philadelphia, and colleagues, conducted a quasi-experimental, population-based study examining the effects of police killings on mental health in black American adults. Novel data on police shootings were compared with individual-level data from the 2013 through 2015 US Behavioral Risk Factor Surveillance System.

Primary study outcome was the number of days during the previous month in which survey respondent’s mental health was self-reported as “not good.”

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Data from more than 103,710 respondents were analyzed. A weighted sample of 49% were exposed to 1 or more police killings in their state of residence 3 months prior to being surveyed. Researchers found that each additional police shooting was associated with 0.14 additional poor days of mental health (95% CI, 0.07-0.22; P =.00047). The largest impacts on mental health were recorded 1 to 2 months following exposure. No mental health impacts were noted among white respondents.

The researchers noted that the quasi-experimental methodology, in conjunction with “empirical interrogation of potential violations to the unconfoundedness assumption,” allowed the data to be assessed with a causal interpretation.

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“Our estimates suggest that police killings of unarmed black Americans have a meaningful population-level impact on the mental health of black Americans,” the researchers wrote. “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 United States.”

“Our study demonstrates for the first time that police killings of unarmed black Americans can have corrosive effects on mental health in the black American community,” said Dr Venkataramani in a press release.2 “While the field has known for quite some time that personal experiences of racism can [have an] impact [on] health, establishing a link between structural racism — and events that lead to vicarious experiences of racism — and health has proved to be more difficult.”

Several study limitations were noted: geographic identifiers were limited to the state level, population heterogeneity was not captured, and the study does not focus on the other ways in which black Americans may be disproportionally targeted by the criminal justice system. The researchers emphasize that these limitations, among others, should motivate future research.

They concluded, “Our results point to the importance of structural racism as a driver of population health disparities… The results provide rare causal evidence about the impact of events widely perceived to reflect structural racism on the mental health of black Americans.”


  1. Bor J, Venkataramani AS, Williams DR, Tsai AC. Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study [published online June 21, 2018]. Lancet. doi:10.1016/ S0140-6736(18)31130-9
  2. The Lancet: Police killings of unarmed black Americans impact mental health of wider black American population [news release]. Published June 21, 2018. Accessed June 21, 2018