• Michael Siegel, Rebecca Sherman, Cindy Li, and Anita Knopov.
• Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA. Electronic address: mbsiegel@bu.edu.
• J Natl Med Assoc. 2019 Dec 1; 111 (6): 580-587.

BackgroundAlthough there is a disparity in the rates of fatal police shootings of Black victims compared to White victims throughout the nation, the magnitude of this racial disparity varies widely between cities. Examining the reasons behind this vast variation in the racial disparity in fatal police shootings across different localities could be helpful in identifying the underlying causes of this problem. Therefore, the objective of this study was to assess potential causes of the Black-White racial disparities in police shootings at the city level.MethodsUsing a cross-sectional design, we examined the relationship between the level of racial residential segregation in a city and the ratio of the rates of fatal police shootings of Black people compared to White people within that city during the period 2013-2017, using data from 69 of the largest cities in the United States. Using linear regression analysis, we modeled the ratio of Black to White fatal police shooting rates as a function of the level of racial segregation in each city as measured by the index of dissimilarity calculated at the Census block level. We controlled for several factors at the city level that might be expected to influence the rate of police shootings by race/ethnicity, including the level of deprivation of the Black population in economic status, the degree of Black representation in the city's police force, the relative size of the police force, crime rates, racial composition of the city, and city population.ResultsThe level of racial residential segregation was significantly associated with the racial disparity in fatal police shooting rates. For each one standard deviation increase in the index of dissimilarity, the ratio of Black to White fatal police shooting rates increased by 44.4% (95% confidence interval, 17.1%-71.7%).ConclusionsRacial residential segregation is a significant predictor of the magnitude of the Black-White disparity in fatal police shootings at the city level. Efforts to ameliorate the problem of fatal police violence must move beyond the individual level and consider the interaction between law enforcement officers and the neighborhoods that they police.Copyright © 2019 National Medical Association. Published by Elsevier Inc. All rights reserved.

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