• Aldina Mesic, Lydia Franklin, Alev Cansever, Fiona Potter, Anika Sharma, Anita Knopov, and Michael Siegel.
• Department of Community Health Sciences, Boston University School of Public Health 801 Massachusetts Avenue, Boston MA 02118, USA.
• J Natl Med Assoc. 2018 Apr 1; 110 (2): 106-116.

ObjectiveThe objective of this study was to discern the relationship between state-level structural racism and Black-White disparities in police shootings of victims not known to be armed.MethodsUsing a Poisson regression, we evaluated the effect of structural racism on differences between states in Black-White disparities in fatal police shootings involving victims not known to be armed during the period from January 1, 2013 through June 30, 2017. We created a state racism index, which was comprised of five dimensions: (1) residential segregation; and gaps in (2) incarceration rates; (3) educational attainment; (4) economic indicators; and (5) employment status.ResultsAfter controlling for numerous state-level factors and for the underlying rate of fatal shootings of black victims in each state, the state racism index was a significant predictor of the Black-White disparity in police shooting rates of victims not known to be armed (incidence rate ratio: 1.24; 95% confidence interval, 1.02-1.50). For every 10-point increase in the state racism index, the Black-White disparity ratio of police shooting rates of people not known to be armed increased by 24%.ConclusionThese findings suggest that structural racism is an important predictor of the Black-White disparity in rates of police shootings of unarmed victims across states.Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.

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