Abstract
SummaryBackgroundThe burden of fatal police violence is an urgent public health crisis in the USA. Mounting evidence shows that deaths at the hands of the police disproportionately impact people of certain races and ethnicities, pointing to systemic racism in policing. Recent high-profile killings by police in the USA have prompted calls for more extensive and public data reporting on police violence. This study examines the presence and extent of under-reporting of police violence in US Government-run vital registration data, offers a method for correcting under-reporting in these datasets, and presents revised estimates of deaths due to police violence in the USA.MethodsWe compared data from the USA National Vital Statistics System (NVSS) to three non-governmental, open-source databases on police violence: Fatal Encounters, Mapping Police Violence, and The Counted. We extracted and standardised the age, sex, US state of death registration, year of death, and race and ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic of other races, and Hispanic of any race) of each decedent for all data sources and used a network meta-regression to quantify the rate of under-reporting within the NVSS. Using these rates to inform correction factors, we provide adjusted estimates of deaths due to police violence for all states, ages, sexes, and racial and ethnic groups from 1980 to 2019 across the USA.FindingsAcross all races and states in the USA, we estimate 30 800 deaths (95% uncertainty interval [UI] 30 300–31 300) from police violence between 1980 and 2018; this represents 17 100 more deaths (16 600–17 600) than reported by the NVSS. Over this time period, the age-standardised mortality rate due to police violence was highest in non-Hispanic Black people (0·69 [95% UI 0·67–0·71] per 100 000), followed by Hispanic people of any race (0·35 [0·34–0·36]), non-Hispanic White people (0·20 [0·19–0·20]), and non-Hispanic people of other races (0·15 [0·14– 0·16]). This variation is further affected by the decedent's sex and shows large discrepancies between states. Between 1980 and 2018, the NVSS did not report 55·5% (54·8–56·2) of all deaths attributable to police violence. When aggregating all races, the age-standardised mortality rate due to police violence was 0·25 (0·24–0·26) per 100 000 in the 1980s and 0·34 (0·34–0·35) per 100 000 in the 2010s, an increase of 38·4% (32·4–45·1) over the period of study.InterpretationWe found that more than half of all deaths due to police violence that we estimated in the USA from 1980 to 2018 were unreported in the NVSS. Compounding this, we found substantial differences in the age-standardised mortality rate due to police violence over time and by racial and ethnic groups within the USA. Proven public health intervention strategies are needed to address these systematic biases. State-level estimates allow for appropriate targeting of these strategies to address police violence and improve its reporting.FundingBill & Melinda Gates Foundation, National Institute on Minority Health and Health Disparities, and National Heart, Lung, and Blood Institute.
Highlights
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) in 2019 found that police conflict and executions accounted for 293 000 global deaths (95% uncertainty interval [UI] 215 000–344 000) from 1980 to 2019.1 In 2019, the USA accounted for 13·2% (95% UI 11·6–15·1) of the 8770 global deaths (7710–9930) due to police conflict while only accounting for 4% of the global population;[1] police conflict and executions was the estimated cause of death for 1150 deaths (998–1310) in the USA.[1]
To correct for under-reporting in US vital registration data, we developed a statistical framework using both open-source and government data sources to provide appropriately revised estimates of deaths due to police violence stratified by age, sex, year of death, and race and ethnicity for each state within the USA from 1980 to 2019
In 2018, the most recent year of National Vital Statistics System (NVSS) data available to us, there were 642 deaths (596–690) missing out of 1240 total estimated deaths (1190–1290) in our analysis, which is a misclassification of 51·8% (50·0–53·7)
Summary
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) in 2019 found that police conflict and executions accounted for 293 000 global deaths (95% uncertainty interval [UI] 215 000–344 000) from 1980 to 2019.1 In 2019, the USA accounted for 13·2% (95% UI 11·6–15·1) of the 8770 global deaths (7710–9930) due to police conflict while only accounting for 4% of the global population;[1] police conflict and executions was the estimated cause of death for 1150 deaths (998–1310) in the USA.[1]. 1000 Black men are killed by the police in the USA, making them 2·5 times more likely to be killed by police than White men.[2] Black women are about 1·4 times more likely to be killed by police than are White women.[2] Systemic and direct racism, manifested in laws and policies as well as personal implicit biases, result in Black, Indigenous, and Hispanic Americans being the targets of police violence.[6,7,8,9]. Within GBD, deaths due to police conflict and executions include civilians killed by police, police killed by civilians, and government-led executions.[1] Police violence is defined in GBD as police-related altercations leading to death or bodily harm. For the purpose of this study, we estimate numbers of civilians killed by police www.thelancet.com Vol 398 October 2, 2021
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