We use data on police-involved deaths to estimate how the risk of being killed by police use of force in the United States varies across social groups. We estimate the lifetime and age-specific risks of being killed by police by race and sex. We also provide estimates of the proportion of all deaths accounted for by police use of force. We find that African American men and women, American Indian/Alaska Native men and women, and Latino men face higher lifetime risk of being killed by police than do their white peers. We find that Latina women and Asian/Pacific Islander men and women face lower risk of being killed by police than do their white peers. Risk is highest for black men, who (at current levels of risk) face about a 1 in 1,000 chance of being killed by police over the life course. The average lifetime odds of being killed by police are about 1 in 2,000 for men and about 1 in 33,000 for women. Risk peaks between the ages of 20 y and 35 y for all groups. For young men of color, police use of force is among the leading causes of death.

Importance Child maltreatment is a risk factor for poor health throughout the life course. Existing estimates of the proportion of the U.S. population maltreated during childhood are based on retrospective self-reports. Records of officially confirmed maltreatment have been used to produce annual rather than cumulative counts of maltreated individuals. Objective To estimate the proportion of U.S. children who are substantiated or indicated for maltreatment by Child Protective Services (referred to as confirmed maltreatment) by age 18. Design, Setting, and Participants The National Child Abuse and Neglect Data System (NCANDS) Child File includes information on all U.S. children with a confirmed report of maltreatment, totaling 5,689,900 children (2004-2011). We developed synthetic cohort life tables to estimate the cumulative prevalence of confirmed childhood maltreatment by age 18. Main Outcome Measure The cumulative prevalence of confirmed child maltreatment between birth and age 18 by race/ethnicity, sex, and year. Results At 2011 rates, 12.5% [95% CI: 12.5%, 12.6%] of U.S. children will experience a confirmed case of maltreatment by age 18. Girls have a higher cumulative prevalence than boys (13.0% [95% CI: 12.9%, 13.0%] vs. 12.0% [95% CI: 12.0%, 12.1%]). Black (20.9% [95% CI: 20.8%, 21.1%]), Native American (14.5% [95% CI: 14.2%, 14.9%]), and Hispanic (13.0% [95% CI: 12.9%, 13.1%]) children have higher prevalences than White (10.7% [95% CI: 10.6%, 10.8%]) or Asian/Pacific Islander (3.8% [95% CI: 3.7%, 3.8%]) children. The risk of maltreatment is highest in the first few years of life; 2.1% [95% CI: 2,1%, 2.1%] of children have confirmed maltreatment by age 1, and 5.8% [95% CI: 5.8%, 5.9%] have confirmed maltreatment by age 5. Estimates from 2011 were consistent with those from 2004-2010. Conclusions and Relevance Annual rates of confirmed child maltreatment dramatically understate the cumulative number of children confirmed as maltreated during childhood. Our findings indicate that 1 in 8 U.S. children will be confirmed as victims of maltreatment by age 18, far greater than the 1 in 100 children whose maltreatment is confirmed annually. For Black children, the cumulative prevalence is 1 in 5; for Native American children, it is 1 in 7.

Although racial/ethnic disparities in health have been well-characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well-understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-White compared to White Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially-salient chronic stress – “racism-related vigilance” – and sleep difficulty. We found that, compared to the White adults in our sample, Black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (White, Black, Hispanic). Black adults reported greater levels of sleep difficulty compared to White adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to White adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.

Provider recommendations were strongly associated with HPV vaccination. Racial/ethnic minorities and non-Hispanic Whites were equally likely to obtain an HPV vaccine after receiving a recommendation. Vaccine education efforts should target health care providers to increase recommendations, particularly among racial/ethnic minority populations.