"Surveilling Health: The Community Consequences of “Stop and Frisk” Policing,"by Abigail A. Sewell October-December 2016 issue of Poverty & Race
Increasingly, public attention has turned to the “collateral damage” of America’s carceral state (Hatzenbuehler et al. 2015). The most highlighted forms of collateral damage include false arrests and police killings of innocents, along with failures to indict police officers for murder in high profile cases like those of Tamir E. Rice, Sandra Bland, and Michael Brown. Yet, the everyday toll the carceral state takes on ordinary citizens is often overlooked.
Examining data from New York City residents and the New York City Stop, Question, and Frisk Data Base, research I have conducted with colleagues identifies whether reports of well-being and illness are shaped by neighborhood policing practices. My interpretation of these results suggests that “Stop and Frisk” policies may pose a health risk for residents of highly and inequitably surveilled neighborhoods, even when a resident is not personally involved in criminal activity and even when a resident lives in a neighborhood that does not have a high crime rate. Policing matters for the health of those who are not incarcerated. Policing matters in ways that suggest that over-policing may be conceived of as a public health problem. Moreover, social status groups that are most vulnerable to policing—ethnoracial minorities and men—also accumulate some of its most negative health effects, both physically and psychologically.
Study BackgroundIn a study published in the Journal of Urban Health (Sewell and Jefferson 2016), I focus on data from 32,452 non-institutionalized adults living in 34 neighborhoods between 2009 and 2012. The study provides a comprehensive look at whether general and physical health problems are more prevalent in highly and inequitably surveilled neighborhoods. Highly surveilled neighborhoods refer to areas with above-average rates of pedestrian stops and likelihoods of frisking and use of force by police, while inequitably surveilled neighborhoods refer to areas where Black and Latinos are more likely than white pedestrians to be stopped, frisked, or have force used against them. The average neighborhood experienced 29 stops per 100 non-institutionalized residents. About 54% of pedestrian stops involved frisking, and nearly 21% of pedestrian stops incurred use of force by police. Racial disparities in police actions were substantial. Black and Latino pedestrians were stopped six times for every time a white pedestrian was stopped. Moreover, Black and Latino pedestrians were 25% more likely than whites to be frisked and 28% more likely than whites to have force used against them by police. These statistics indicate that police surveillance is a common fact of life in many neighborhoods and that racial minorities are more likely to bear the brunt of police activity.
My analysis merges two datasets — an annual community health survey administered by the New York City Department of Health and Mental Hygiene and the annual administrative database of police reports of pedestrian stops collected by the New York City Police Department. These datasets have been analyzed separately to study community health patterns or the correlates of stop-and-frisk practices but had not previously been jointly assessed.
The study presents a complex picture of police surveillance and health and deepens our understanding of how stop and frisk impacts communities at the local level. The basic question at the heart of this line of inquiry is: Are people who live in neighborhoods where police stops are more likely to incur frisking and use of force less healthy than people who live in less (inequitably) surveilled neighborhoods? To answer this question, we started by identifying five health outcomes that are known to vary in prevalence across place—1) self-ratings of general health, 2) diagnoses of diabetes, 3) diagnoses of high blood pressure, 4) diagnoses of asthma, and 5) overweight/obese body weight status. We then identified six indicators of pedestrian stops: 1) the neighborhood stop rate, 2) the proportion of pedestrian stops in a neighborhood that involve frisking, 3) the proportion of pedestrian stops in a neighborhood that involve use of force by police, and 4) racial inequalities in: the neighborhood stop, 5) the neighborhood frisking proportion, and the 6) neighborhood use of force proportion. Racial inequalities in neighborhood indicators captured differences within neighborhoods in how police treated Black and Latino pedestrians versus how police treated white pedestrians. We next examined associations between these health indicators and police surveillance, comparing people with similar demographic characteristics who live in neighborhoods with similar racial, economic, and crime characteristics.
Is the Health of New Yorkers Affected by Stop, Question, and Frisk?The results indicate that the risk of illness increases for the average New Yorker who lives in an area where police are more likely to frisk pedestrians. For example, a 9% increase in the risk of frisking is associated with an 8.8% increase in the risk of reporting poor or fair health, a 11.7% increase in the risk of reporting diabetes, and a 17.2% increase in the risk of reporting high blood pressure. The neighborhood frisk risk was the single most consistent measure associated with ill health in this study.
A second study revealed that such associations could also be identified with regards to mental health problems (Sewell, Jefferson, and Lee 2016). Published in Social Science and Medicine, this analysis focused on 8,066 residents of New York City who were 18-59 years old in 2012 and characterized the areas they lived in according to policing conditions in 2009-2011. Similar patterns were shown as with physical health. Higher levels of non-specific psychological distress are noted for individuals living in communities where pedestrians face a higher risk of being frisked by police.
What Does Police Surveillance Mean for the Health of Racial Minorities?Given prior claims of racial bias in New York City’s Stop, Question, and Frisk program by the New York Civil Liberties Union, we assess whether the health of racial minorities—specifically, Blacks, Latinos, and Asians— was more likely to be affected by the neighborhood surveillance practices of police. For many associations, we found racial parity in the effects of police surveillance indicators: Blacks, Latinos, and Asians were similarly affected as whites by Stop and Frisk.
High blood pressure revealed a different pattern. For this indicator of poor health, there was evidence that Blacks, Latinos, and Asians were more detrimentally affected by stop-and-frisk policies than whites. Specifically, Blacks who lived in neighborhoods where minorities were more likely than whites to be frisked by police were more likely to report having high blood pressure than Blacks who lived in more equitably surveilled neighborhoods. Latinos who lived in neighborhoods where frisking and use of force by police were more common among pedestrian stops were more likely to report high blood pressure than Latinos who lived in less surveilled neighborhoods. Asians, although less likely to be the targets of pedestrian stops than are Blacks and Latinos, demonstrated adverse associations. Asians who lived in neighborhoods with a higher burden of pedestrian stops or who lived in neighborhoods where use of force by police were more common among pedestrian stops were more likely to report high blood pressure than Asians who lived in less surveilled neighborhoods.
What Does Police Surveillance Mean for the Health of Men?Given that the vast majority of pedestrians stopped by police are identified as male, my colleagues and I assess whether the mental health of men are more likely to be affected by the neighborhood surveillance practices of police (Sewell, Jefferson, and Lee 2016). A striking pattern was discovered. Men who lived in neighborhoods with higher risks of frisking by police for pedestrians and higher risks of use of force by police for pedestrians reported higher levels of psychological distress. Police surveillance patterns, meanwhile, often did not differentiate the mental health of women. Specifically, men who lived in high-frisk communities faced a 16% increase in the likelihood of reporting feelings of both nervousness and worthlessness. Similarly, compared to women who lived in areas with higher levels of use of force by police against pedestrians, men who lived in such areas faced a 21% increase in the likelihood of reporting clinical levels of non-specific psychological distress, a 14% increase in reporting feelings of nervousness, a 12% increase in reporting feelings of effort, and a 18% increase in reporting feelings of worthlessness.
What Are the Implications of These Findings?These findings present a quandary for public health concerns with violence victimization prevention, since a key intervention mechanism thought to reduce criminal activity is stop-and-frisk policies. However, the evidence is inconclusive regarding whether, in fact, New York City’s Stop and Frisk program was responsible for the decline in violent crime against New York City residents. As such, the line of research presented here prompts us to consider ways of bringing about a safe society without police brutality. These findings suggest that more attention should be paid to identifying intervention mechanisms that prevent crime and increase community engagement. Without such mechanisms, it is likely that America’s carceral state will continue to feed itself and, ultimately, to contribute to increasing levels of areal, racial, and gender inequality in the quality and quantity of life. In sum, the research presented here suggests that the impact of stop-and-frisk policing may not only be to potentially curb crime: it may also curb the health of New York City residents. Fortunately, there is convincing evidence that the public health community has begun to take seriously the health consequences of America’s carceral state. For example, a recent study in the American Journal of Public Health shows that young urban men who say they have been surveilled unfairly by police report worse mental health outcomes (Geller et al. 2014). In fact, leading public health researchers (Krieger et al. 2015) have called for police killings to be considered a public health event, which is a particularly pressing matter as research suggests that legal intervention deaths— that is, killings by law enforcement— are on the rise (Feldman, Chen, Waterman, and Krieger 2016). Such research also suggests that considering such types of killings will also help us better understand racial disparities in health between Blacks and whites, as Blacks are three times more likely to be die at the hands of police than their representation in the population (Feldman, Chen, Waterman, and Krieger 2016). Our findings indicate that criminal justice policies have health consequences that extend to shaping morbidity and well-being as well. In short, criminal justice policies are also health policies.
ReferencesGeller, Amanda, Jeffrey Fagan, Tom Tyler and Bruce G. Link. 2014. “Aggressive Policing and the Mental Health of Young Urban Men.” American Journal of Public Health 104(12):2321-27.
Feldman, Justin M., Jarvis T. Chen, Pamela D. Waterman and Nancy Krieger. 2016. “Temporal Trends and Racial/Ethnic Inequalities for Legal Intervention Injuries Treated in Emergency Departments: Us Men and Women Age 15–34, 2001–2014.” Journal of Urban Health 93(5):797-807.
Hatzenbuehler, Mark L., Katherine Keyes, Ava Hamilton, Monica Uddin, and Sandro Galea. 2015. “The Collateral Damage of Mass Incarceration: Risk of Psychiatric Morbidity Among Nonincarcerated Residents of High-Incarceration Neighborhoods.” American Journal of Public Health 105(1): 138-143.
Krieger, Nancy, Jarvis T. Chen, Pamela D. Waterman, Mathew V. Kiang, and Justin Feldman. 2015. “Police Killings and Police Deaths Are Public Health Data and Can Be Counted.” PLoS Medicine 12(12):e1001915.
Sewell, Abigail A. and Kevin A. Jefferson. 2016. “Collateral Damage: The Health Effects of Invasive Police Encounters in New York City.” Journal of Urban Health 93(1):42-67.
Sewell, Abigail A., Kevin A. Jefferson and Hedwig Lee. 2016. “Living under Surveillance: Gender, Psychological Distress, and Stop-Question-and-Frisk Policing in New York City.” Social Science & Medicine 159:1-13.
Abigail A. Sewell is an Assistant Professor at Emory University in the Department of Sociology. firstname.lastname@example.org
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