Policing as a Structural Determinant of Health

Abstract

Policing in the United States functions as a structural determinant of health, with direct and collateral impacts that extend well beyond maintaining order and public safety. This review synthesizes recent evidence (from 2015 to 2025) on the relationship between policing and health. Using a rapid evidence assessment, we examine peer-reviewed and gray literature to capture physical, mental, and community-level outcomes, as well as pathways and mechanisms that link policing to health. Findings indicate that police use of force results in significant injury and deaths annually, disproportionately affecting communities of color. Beyond direct effects, policing contributes to chronic stress, trauma, and economic strain across community and occupational ecosystems. These collateral impacts compound existing structural inequities. Despite promising alternatives to police responses, evidence gaps and reliance on cross-sectional studies limit causal inference. Future research should strengthen data systems, focus on causal research, and integrate public health priorities into public safety strategies.