Racialized police use of force and maternal health.

Introduction: There are large racial disparities in maternal health that cannot be explained by education, income, or other individual-level risk factors. This cross-sectional study estimated associations between racial inequity in police use of force (PUOF) at the community level and health outcomes of Black and White women.

Methods: Birth records were linked to maternal hospital discharge records and municipal police department data for 326,240 births occurring between 1/1/2012 and 12/31/2016 to Black and White women in New Jersey. Outcomes, identified using diagnosis and procedure codes, were substance use (any/tobacco/alcohol/other), mental health disorders (any/depression/anxiety/ other), asthma, obesity, hypertension (preexisting/gestational), diabetes (preexisting/gestational), severe maternal morbidity, other cardiovascular diseases, and preterm labor. Data were analyzed in 2024.

Results: For Black women, living in a community with 1% greater racially-disproportionate PUOF was associated with higher odds of any mental health disorder [by 0.18%; 95% CI: 0.08-0.28], depression [0.19%; 95% CI: 0.05-0.33], anxiety [0.25%; 95% CI: 0.09-0.41], other mental health disorder [0.17%; 95% CI: 0.07-0.27], any substance use [0.26%; 95% CI: 0.14-0.38], tobacco use [0.31%; 95% CI: 0.16-0.46], other substance use [0.17%; 95% CI: 0.04-0.30], asthma [0.12%; 95% CI: 0.04-0.21], and preterm labor [0.17%; 95% CI: 0.05-0.29] in adjusted models. There were no robust associations with the other outcomes for Black women or with any of the outcomes for White women.

Conclusions: Racially-disproportionate PUOF was significantly associated with mental illness, substance use, asthma, and preterm labor of Black women. Results underscore the potential importance of institutionalized racism as a fundamental cause of health disparities.