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• “Usually, health disparities are defined by socioeconomic and ethnic factors, but here you have a health disparity caused by an occupation.”

  John Violanti

  Professor, Department of Social and Preventive Medicine

By ELLEN GOLDBAUM

Published: July 12, 2012

The daily psychological stresses that police officers experience in their work put them at significantly higher risk than the general population for a host of long-term physical and mental health effects. That’s the overall finding of a major scientific study of the Buffalo Police Department called Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) conducted over five years by a UB researcher.

“This is one of the first police population-based studies to test the association between the stress of being a police officer and psychological and health outcomes,” says John Violanti, professor of social and preventive medicine in the UB School of Public Health and Health Professions, and principal investigator on the study, funded by the National Institute for Occupational Safety and Health.

The research, which is in press this month in a special issue of the International Journal of Emergency Mental Health, reveals connections between the daily stressors of police work and obesity, suicide, sleeplessness and cancer, as well as general health disparities between police officers and the general population.

The study was prompted by the assumption that the danger, high demands and exposure to human misery and death that police officers experience on the job contribute to an increased risk of cardiovascular disease and other chronic health outcomes.

“We wanted to know, in addition to stress, what are other contributing factors that lead to cardiovascular disease in police?” asks Violanti, a former New York State trooper.

“In an earlier pilot study of 100 police officers, we found, for example, that shift work is a contributing factor to an increase in metabolic syndrome, which is a cluster of symptoms that includes abdominal obesity, hypertension, high triglycerides, low HDL cholesterol and glucose intolerance. Having metabolic syndrome increases the risk for developing cardiovascular disease and type 2 diabetes.”

The current findings, from a larger, cross-sectional study of 464 police officers, include:

• More than 25 percent of the officers had metabolic syndrome versus 18.7 percent of the general employed population.
• Female and male officers experiencing the highest level of self-reported stress were four- and six-times more likely to have poor sleep quality, respectively.
• Organizational stress and lack of support was associated with the metabolic syndrome in female but not male police officers.
• Overall, an elevated risk of Hodgkin’s lymphoma was observed relative to the general population. The risk of brain cancer, although only slightly elevated relative to the general population, was significantly increased with 30 years or more of police service.
• Suicide rates were more than eight times higher in working officers than they were in officers who had retired or left the police force.

“This finding challenges the common assumption that separated or retired officers are at increased risk for suicide,” says Violanti, noting, however, that the need for suicide-prevention efforts remains important for both active and retired officers.

The findings of the BCOPS study demonstrate that police work by itself can put officers at risk for adverse health outcomes.

“Usually, health disparities are defined by socioeconomic and ethnic factors, but here you have a health disparity caused by an occupation,” says Violanti, “highlighting the need to expand the definition of health disparity to include occupation as well.”

He adds that while police officers do have health insurance, the culture of police work often goes against the goal of improving health.

“The police culture doesn’t look favorably on people who have problems,” he notes. “Not only are you supposed to be superhuman if you’re an officer, but you fear asking for help.” Police officers who reveal that they suffer from a chronic disease or health problem may lose financial status, professional reputation or both, he explains.

The answer, Violanti says, is to change the training of officers in the police academy so that they understand signs of stress and how to get them treated.

“Police recruits need to receive inoculation training against stress,” says Violanti. “If I tell you that the first time you see a dead body or an abused child that it is normal to have feelings of stress, you will be better able to deal with them; exposure to this type of training inoculates you so that when it does happen, you will be better prepared. At the same time, middle and upper management in police departments need to be trained in how to accept officers who ask for help and how to make sure that officers are not afraid to ask for that help,” he says.

The BCOPS study is based on extensive and rigorous medical testing and integrates a broad range of psychological, physiological and subclinical measures of stress, allowing for correlations between on-the-job stress and stress biomarkers that reveal the potential for adverse mental and physical health outcomes.

Violanti and his co-authors note: “This study would not have been possible without the cooperation of the Buffalo Police Department administration, the Police Benevolent Association and the exceptional men and women of the Buffalo Police Department. Our sincere thanks to them, as we look forward to our follow-up study.”

Co-authors with Violanti are Michael E. Andrew, Cecil M. Burchfiel, Luenda E. Charles, Desta Fekedulegn, Ja Kook Gu, Tara Hartley, Clauda Ma and Anna Mnatsakanova, all from the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention, as well as Lindsay M. Smith of West Virginia University, James E. Slaven of Indiana University and Bryan J. Vila of Washington State University.

In addition to Violanti, co-investigators on BCOPS are Jean Wactawski-Wende, professor of social and preventive medicine and vice provost for strategic initiatives, and Joan Dorn, professor emerita of exercise and nutrition sciences, both in the UB School of Public Health and Health Professions; John Vena of the University of Georgia-Athens; and Bryan Vila. Diane B. Miller was a NIOSH co-investigator.