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18 Neighborhood police complaints associated with increased preterm delivery among black individuals

      Objective

      Stress is associated with adverse perinatal outcomes. Police misconduct is a reported stressor for some Americans, particularly those living in lower-income communities of color. We examined whether reports of excessive use of force by police in a person’s neighborhood are associated with preterm birth (PTB).

      Study Design

      The study sample includes singleton live births at a single Chicago hospital between March 2008 and March 2018. Parental age, race/ethnicity, parity, gestational age at delivery, and billing address were obtained from medical records. Individuals were considered exposed to excessive use of force by police if at least one complaint was filed in their block group in the year leading up to delivery. Marginal models were used to estimate PTB (<37 weeks) as a function of exposure to a complaint about police use of force. Models included interaction between exposure and race/ethnicity and adjustment for parental age, parity, a composite measure of the block group’s socioeconomic status (SES) and the block group’s population size. Exposure to a homicide in the block group during the same period was also included to control for crime.

      Results

      Of the 71,007 individuals in the sample, 56.2% were white and 11.1% were Black (Table 1). A complaint about police use of force was filed in the block group of 15.9% of the sample and 8.1% delivered preterm. In an adjusted model, the association between exposure to a complaint about police use of force and PTB varied by race/ethnicity (p=0.02). Exposed Black individuals were 1.3 times as likely to deliver preterm as unexposed Black individuals (95% CI: 1.1, 1.5, Table 2), even after adjustment for homicide exposure and block group SES. Associations were not observed among white, Hispanic, or Asian individuals. Findings were consistent in a sensitivity analysis evaluating PTB defined as <34 weeks.

      Conclusion

      Our results suggest that among Black individuals, complaints about excessive use of force by police in the neighborhood are associated with increased odds of PTB, even after controlling for individual and community characteristics.
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