Police-related violence may be a source of chronic stress underlying entrenched racial inequities in reproductive health in the USA. Using publicly available data on police-related fatalities, we estimated total and victim race-specific rates of police-related fatalities (deaths per 100,000 population) in 2018–2019 for Metropolitan Statistical Areas (MSA) and counties within MSAs in the USA. Rates were linked to data on live births by maternal MSA and county of residence. We fit adjusted log-Poisson models with generalized estimating equations and cluster-robust standard errors to estimate the relative risk of preterm birth associated with the middle and highest tertiles of police-related fatalities compared to the lowest tertile. We included a test for heterogeneity by maternal race/ethnicity and additionally fit race/ethnicity-stratified models for associations with victim race/ethnicity-specific police-related fatality rates. Fully adjusted models indicated significant adverse associations between police-related fatality rates and relative risk of preterm birth for the total population, non-Hispanic Black, and non-Hispanic White groups separately. Results confirm the role of fatal police violence as a social determinant of population health outcomes and inequities, including preterm birth.

Police-related violence may be a source of chronic stress underlying entrenched racial inequities in reproductive health in the USA. Using publicly available data on police-related fatalities, we estimated total and victim race-specific rates of police-related fatalities (deaths per 100,000 population) in 2018–2019 for Metropolitan Statistical Areas (MSA) and counties within MSAs in the USA. Rates were linked to data on live births by maternal MSA and county of residence. We fit adjusted log-Poisson models with generalized estimating equations and cluster-robust standard errors to estimate the relative risk of preterm birth associated with the middle and highest tertiles of police-related fatalities compared to the lowest tertile. We included a test for heterogeneity by maternal race/ethnicity and additionally fit race/ethnicity-stratified models for associations with victim race/ethnicity-specific police-related fatality rates. Fully adjusted models indicated significant adverse associations between police-related fatality rates and relative risk of preterm birth for the total population, non-Hispanic Black, and non-Hispanic White groups separately. Results confirm the role of fatal police violence as a social determinant of population health outcomes and inequities, including preterm birth.

Police brutality harms women. Structural racism and structural sexism expose women of color to police brutality through 4 interrelated mechanisms: (1) desecration of Black womanhood, (2) criminalization of communities of color, (3) hypersexualization of Black and Brown women, and (4) vicarious marginalization. We analyze intersectionality as a framework for understanding racial and gender determinants of police brutality, arguing that public health research and policy must consider how complex intersections of these determinants and their contextual specificities shape the impact of police brutality on the health of racially minoritized women. We recommend that public health scholars (1) measure and analyze multiple sources of vulnerability to police brutality, (2) consider policies and interventions within the contexts of intersecting statuses, (3) center life course experiences of marginalized women, and (4) assess and make Whiteness visible. People who hold racial and gender power-who benefit from racist and sexist systems-must relinquish power and reject these benefits. Power and the benefits of power are what keep oppressive systems such as racism, sexism, and police brutality in place. (Am J Public Health. 2023;113(S1):S29-S36. https:// P olice brutality is a social determinant of health, causing mortality, morbidity, and disability. 1,2 Police brutality also extends to police neglect and words, policies, and actions that dehu-manize, intimidate, and cause physical, psychological, and sexual harm. 1,3 Police brutality can be experienced directly through personal contact with the police, vicariously through witnessing or hearing about police actions in the media or within one's kin and social networks, and ecologically through living , working, or attending schools in heavily policed neighborhoods. 2,4 Exposure to and health consequences of police brutality are not equally distributed. Racially minoritized communities are disproportionately exposed to police brutality, significantly increasing mortality rates and elevating odds of physical and psychological problems. 2 Even though most of the research focuses on male victims of police brutality, 5 Black and other women and gender-nonconforming people of color are significantly harmed, and their experiences rendered invisible. 6 Intersection-ality behooves us to analyze beyond the racism of police brutality. We examine how intersecting systems of racism and sexism expose racially minoritized women to police brutality. We also discuss the relevance of applying an intersectionality framework in research that examines the health impacts of police brutality and in the development of policies to eliminate this form of structural violence that harms women of color. We use "women of color" to refer to Black women and other racially minori-tized women who are not racialized as White. We understand that anti-Blackness is at the center of structural racism and police brutality 7 and that, even within the heterogeneous category of "women of color," Black women experience anti-Black racism perpetrated and sustained by other women of color. 8 However, our analysis focuses on the experiences of women of color to acknowledge the complex reality that we are all victims of the White Analytic Essay Peer Reviewed Alang et al. S29

Police brutality harms women. Structural racism and structural sexism expose women of color to police brutality through 4 interrelated mechanisms: (1) desecration of Black womanhood, (2) criminalization of communities of color, (3) hypersexualization of Black and Brown women, and (4) vicarious marginalization. We analyze intersectionality as a framework for understanding racial and gender determinants of police brutality, arguing that public health research and policy must consider how complex intersections of these determinants and their contextual specificities shape the impact of police brutality on the health of racially minoritized women. We recommend that public health scholars (1) measure and analyze multiple sources of vulnerability to police brutality, (2) consider policies and interventions within the contexts of intersecting statuses, (3) center life course experiences of marginalized women, and (4) assess and make Whiteness visible. People who hold racial and gender power—who benefit from racist and sexist systems—must relinquish power and reject these benefits. Power and the benefits of power are what keep oppressive systems such as racism, sexism, and police brutality in place.