Neighborhood-level fatal police violence and severe maternal morbidity in California

Abstract

Police violence is a pervasive issue that may have adverse implications for severe maternal morbidity (SMM). We assessed how the occurrence of fatal police violence (FPV) in one's neighborhood before or during pregnancy may influence SMM risk. Hospital discharge records from California between 2002 and 2018 were linked with the Fatal Encounters database (n = 2 608 682). We identified 2184 neighborhoods (census tracts) with at least 1 FPV incident during the study period and used neighborhood fixed-effects models adjusting for individual sociodemographic characteristics to estimate odds of SMM associated with experiencing FPV in one's neighborhood anytime within the 24 months before childbirth. We did not find conclusive evidence on the link between FPV occurrence before delivery and SMM. However, estimates show that birthing people residing in neighborhoods where 1 or more FPV events had occurred within the preceding 24 months of giving birth may have mildly elevated odds of SMM than those residing in the same neighborhoods with no FPV occurrence during the 24 months preceding childbirth (odds ratio [OR] = 1.02; 95% confidence interval [CI], 0.99-1.05), particularly among those living in neighborhoods with fewer FPV incidents (1-2) throughout the study period (OR = 1.03; 95% CI, 1.00-1.06). Our findings provide evidence for the need to continue to examine the population health consequences of police violence.

Keywords: maternal health; police violence; severe maternal morbidity.

Figure 1

Association between the occurrence of neighborhood fatal police violence (FPV) within the 24 months preceding childbirth and severe maternal morbidity, California, 2002-2018. Estimates are from neighborhood fixed-effects regression models adjusting for maternal race (overall sample only), maternal age, maternal education, and insurance. Error bars indicate 95% confidence intervals. Estimates for American Indian/Alaska Native individuals were not included in figure due to high imprecision.