Racial Slurs by Police and Posttraumatic Stress Symptoms: Intrusive Policing and Perceived Injustice.

Using the Future of Families and Child Wellbeing Study (N = 785), this article considers the ramifications of police use of racial slurs, a type of intrusive behavior, toward minority youth for posttraumatic stress (PTS). We also examine whether other intrusive police behaviors exacerbate this relationship and test whether perceptions of injustice mediate it. Results indicated that hearing a police officer use a racial slur was positively associated with PTS after controlling for intrusive police behaviors and other covariates. Intrusive policing tended to co-occur with the use of racial slurs and was positively associated with PTS. The association between hearing a racial slur and PTS did not vary by the number of intrusive behaviors exhibited by police. The association between hearing a slur and PTS was partially mediated by perceived procedural injustice. Overall, the use of racial slurs by police may do harm to minority adolescents by putting them at risk for posttraumatic stress disorder. Our results are consistent with prior research that racial slurs may contribute to PTS by eroding the bounds of what is considered just and fair. Interestingly, the association between racial slurs and PTS was independent of other intrusive policing behaviors. Mental health screeners should ask not only about being stopped by police but the characteristics of that encounter as well - including those imbued with racial animus.

The adverse effects of policing on population health: A conceptual model.

While negative encounters between police and the community are not a new trend, recent high profile deaths of unarmed people of color have gained widespread national attention and ignited new movements demanding reform, accountability, and progress. Increasingly over the past few decades, researchers have examined the most extreme cases of lethal use of force, describing the context of these violent encounters, situational and personal characteristics, and underlying risk factors. More recent research has aimed to define the broader and more nuanced adverse effects that policing can have on population health. We propose a holistic and multidisciplinary model for the relationship between policing and population health in the U.S. that incorporates contextual, situational, and individual-level factors while also recognizing the direct and vicarious mechanisms by which policing exposures can negatively affect population health. The model captures the short and long term health effects of policing and the cyclic nature by which those effects at the individual, community, and systemic levels can influence each other. We consider the unique qualities of different communities that may influence these pathways, the historical trends of the criminal justice and policing systems, and recommend applications of the model in policing agencies, medicine, and research.

Postpartum Depressive Symptoms during the Beginning of the COVID-19 Pandemic: An Examination of Population Birth Data from Central New Jersey.

OBJECTIVES: To examine the mental health of women in the perinatal period prior to and during the COVID-19 pandemic. METHODS: We use provisional vital statistics data for births occurring in the central region of New Jersey. The Edinburgh Postnatal Depression Scale is employed to assess depressive symptoms. Our focal analysis uses linear regression models to test whether giving birth during the pandemic is associated with elevated depressive symptoms. All analyses are performed using time-matched (September 2019-April 2020; n = 18,531) and month-matched (January 2019-April 2019 and January 2020- April 2020; n = 18,346) samples. RESULTS: Women who gave birth in March and not in April reported higher levels of depressive symptoms than those who gave birth prior to the pandemic in our time-matched (b = 0.09) and month-matched (b = 0.09) samples. The magnitude of this association is approximately one-third the magnitude of the association between preterm birth and depressive symptoms. CONCLUSION: These findings suggest that researchers and practitioners should pay special attention to signs of postpartum depression and women's adaptive coping responses in the early stages of pandemics.

Multi-pronged approach to enhance education of children and adolescents with lupus, caregivers, and healthcare providers in New Jersey: Needs assessment, evaluation, and development of educational materials.

BACKGROUND: Childhood Systemic Lupus Erythematosus (cSLE) patients are younger at diagnosis and have a more severe disease course compared to adult onset SLE patients and develop significant complications related to disease and or immunosuppression. Moreover, female and minority populations experience higher rates of cSLE, with African American, Afro-Caribbean, and Hispanic populations being at greatest risk and having poor prognosis. METHODS: The Pediatric Alliance for Lupus initiative addressed the dearth in education and resources in a multi-stage process. First, we conducted a need assessment identifying knowledge gaps among healthcare providers (HCPs), and resources needed to care for cSLE patients and their families. Second, we educated HCPs about the diagnosis and treatment of cSLE by Continuing Medical Education (CME) sessions/webinars (presented here). Third, HCPs participated in a Quality Improvement (QI) program on cSLE approved by the American Board of Pediatrics Maintenance of Certification Part 4. Finally, patients and caregivers were educated through the development of appropriate, culturally and linguistically sensitive cSLE resources. PAL disseminated materials among HCPs and the community to improve the awareness of the availability of these materials. RESULTS: According to results from the statewide needs assessment (representative of every county throughout NJ), HCPs face significant challenges in providing care to cSLE patients and their families, in part due to the multi-systemic nature of the autoimmune disease. CONCLUSION: Based on this need, we developed educational sessions, with pre-post comparison data showing a significant increase in knowledge after HCP education. The 15 different materials developed as part of the endeavor is a major contribution to the cSLE community, HCPs and pediatric rheumatologists. Resources are available in multiple formats (PDF and web pages), and are accessible on the National Resource Center on Lupus, the latest web site of the Lupus Foundation of American that houses materials for SLE patients, their families, schools, HCPs, and the community at large.Improving cSLE knowledge will empower the children and adolescents and families by increasing their self-efficacy; and positively impact key health outcomes (transition readiness and HRQOL) that are not optimally addressed with current medical treatment alone.

Police contact and health among urban adolescents: The role of perceived injustice.

This research evaluates whether personal and vicarious police contact are related to self and caregiver-reports of teen health and to what extent these associations vary by perceptions of procedural injustice. We analyzed longitudinal health data collected from adolescents in the Fragile Families and Child Wellbeing Study (N = 3435), alongside teen self-reports of whether they were stopped by the police or experienced vicarious police contact, and if so, their perceptions of procedural injustice in these encounters. We estimated regression models with lagged dependent variables and a propensity score weighting approach. Our analysis yielded four important results. First, participants who reported personal or vicarious police stops had worse self-reported health in adolescence than their counterparts with no contact. Second, both types of police contact were unrelated to caregiver reports of adolescent health and inconsistently related to somatic symptoms. Third, procedural injustice exacerbated the relationship between both personal and vicarious contact and diminished self-reported health. Finally, the associations between police contact and self-reported health were stronger among black and Hispanic adolescents than white ones. Our results highlight personal and vicarious police contact, particularly instances viewed as procedurally unjust, as commonly experienced adverse health events among urban adolescents.

Gestational Weight Loss: Comparison Between the Birth Certificate and the Medical Record, Florida, 2012.

Objective Examine agreement with the medical record (MR) when gestational weight loss (GWL) on the Florida birth certificate (BC) is ≥ 0 pounds (lbs). Methods In 2012, 3923 Florida-resident women had a live, singleton birth where BC indicated GWL ≥ 0 lbs. Of these, we selected a stratified random sample of 2141 and abstracted from the MR prepregnancy and delivery weight data used to compute four estimates of GWL (delivery minus prepregnancy weight) from different sources found within the MR (first prenatal visit record, nursing admission record, labor/delivery records, BC worksheet). We assessed agreement between the BC and MR estimates for GWL categorized as 0, 1-10, 11-19, and ≥ 20 lbs. Results Prepregnancy or delivery weight was missing or source not in the MR for 23-81% of records. Overall agreement on GWL between the BC and the four MR estimates ranged from 39.1 to 57.2%. Agreement by GWL category ranged from 10.6 to 38.0% for 0 lbs, 47.6 to 64.3% for 1-10 lbs, 49.5 to 60.0% for 11-19 lbs, and 47.8 to 67.7% for ≥ 20 lbs. Conclusions Prepregnancy and delivery weight were frequently missing from the MR or inconsistently documented across the different sources. When the BC indicated GWL ≥ 0 lbs, agreement with different sources of the MR was moderate to poor revealing the need to reduce missing data and better understand the quality of weight data in the MR.

Perceived Unfair Treatment by Police, Race, and Telomere Length: A Nashville Community-based Sample of Black and White Men.

Police maltreatment, whether experienced personally or indirectly through one's family or friends, represents a structurally rooted public health problem that disproportionately affects minorities. Researchers, however, know little about the physiological mechanisms connecting unfair treatment by police (UTBP) to poor health. Shortened telomeres due to exposure to this stressor represent one plausible mechanism. Using data from a community sample of black (n = 262) and white (n = 252) men residing in Nashville-Davidson County, we test four hypotheses: (1) Black men will be more likely to report UTBP than white men, (2) those reporting UTBP will have shorter telomeres than those not reporting UTBP, (3) this association will be more pronounced among black men, and (4) these hypotheses will extend to those who report vicarious UTBP. Results reveal support for all hypotheses. The implications for our findings are discussed as they pertain to debates on policing practices and health disparities research.

Weighed down by discriminatory policing: Perceived unfair treatment and black-white disparities in waist circumference.

Police maltreatment, whether experienced personally or indirectly through one's family or friends, represents a potentially harmful stressor, particularly for minority populations. We address this issue by investigating: (1) how waist circumference (WC) varies by personal and vicarious exposure to unfair treatment by police (UTBP); and (2) to what extent exposure to UTBP explains the black-white disparity in WC. We employed data collected from a community-based sample of black (n = 601) and white (n = 608) adults living in Nashville-Davidson county Tennessee to address these questions. Results from our final linear regression model showed that those who reported vicarious UTBP had WCs that were approximately 2 in. greater than those who did not (b = 2.03; p = 0.003). While personal UTBP was not linked to higher WC, a post-hoc analysis suggested that our ability to detect an association was complicated by selection. Binary mediation analysis revealed that differential exposure to vicarious UTBP accounted for approximately 12% of the black-white WC disparity among women. We found no black-white differences in WC among men. The association between vicarious UTBP and WC did not vary by age, race, or gender. Overall, our findings point toward the role of discriminatory policing as a potential upstream contributor to racial disparities in health.