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INCARCERATION AND POPULATION HEALTH IN WEALTHY DEMOCRACIES*: INCARCERATION AND POPULATION HEALTH
Abstract
Everywhere you look, incarceration seems to be doing harm. Research has implicated incarceration not only in worse outcomes for individuals, their families, and their communities but also in growing inequality. Yet incarceration may not always harm society-even if it does harm those who experience it. To consider this possibility, I build an argument demonstrating how the macro-level consequences of incarceration may be distinctively harmful in the United States, focusing on the incarceration-health relationship as one indicator of a broader phenomenon. I then test my hypothesis by using an unbalanced panel data set including 21 developed democracies (N = 414) and a series of ordinary least-squares models predicting three measures of population health as a function of incarceration. Models including only a main effect of incarceration demonstrate an inverse association between changes in incarceration and changes in population health. Models including an incarceration by U.S. interaction, however, indicate that the population health consequences of changes in incarceration are far worse in the United States than elsewhere. Taken together, the results indicate that the United States is exceptional for both its rate of incarceration and its effects of incarceration, although it is unclear what drives this exceptionalism in effects.
... 4,5 Widespread correctional control disproportionately affects racial and ethnic minority groups, particularly Black communities, both nationwide and at the state level. [4][5][6][7] Black people make up only 6% of Rhode Island's population but 30% of those in prisons and jails. 2 Research has shown that experiences of incarceration and community supervision are associated with worse health outcomes for incarcerated individuals, their families, and their communities both during and after incarceration. [6][7][8][9][10][11] Compared with the general population, formerly incarcerated individuals are more likely to experience chronic health conditions and substance use disorders owing to challenges with social integration, reintegration, and stress. ...
... [4][5][6][7] Black people make up only 6% of Rhode Island's population but 30% of those in prisons and jails. 2 Research has shown that experiences of incarceration and community supervision are associated with worse health outcomes for incarcerated individuals, their families, and their communities both during and after incarceration. [6][7][8][9][10][11] Compared with the general population, formerly incarcerated individuals are more likely to experience chronic health conditions and substance use disorders owing to challenges with social integration, reintegration, and stress. 12,13 Each year served in prison is associated with a 2-year decrease in life expectancy. ...
... 20,21 Discrimination in housing and employment, difficulty accessing transportation and social services, and fragmented transitional health care are all aspects of structural violence that shape health inequalities for formerly incarcerated individuals. 5,6,22 Establishing primary care and managing chronic illness are often lower priorities for formerly incarcerated people than finding housing, employment, and food. 23 However, engaging individuals in primary care soon after release from prison has been associated with benefits, including increasing use of primary care and decreasing use of emergency department (ED) care. ...
Importance
Research has shown that experiences of incarceration, probation, and parole are associated with worse health outcomes for incarcerated individuals and their families.
Objectives
To quantify the proportion of patients in an urban primary care clinic with an individual or family history of incarceration, probation, and/or parole and to evaluate how correctional control is associated with subjective and objective health outcomes.
Design, Setting, and Participants
This cross-sectional, mixed-methods study used patient surveys and retrospective medical record review to assess the experience of correctional control among 200 English-speaking adult patients presenting for care at the Rhode Island Hospital Center for Primary Care between July 9, 2019, and January 10, 2020.
Main Outcomes and Measures
Patient surveys included closed and open-ended questions pertaining to personal or familial experiences of incarceration, probation, and parole, as well as health outcomes associated with these experiences. Medical record review abstracted key health indicators and health care use data.
Results
In this cross-sectional study of 200 adult patients (1 participant was removed from the full analytic sample owing to missing ethnicity data; 113 of 199 men [56.8%]; mean [SD] age, 51.2 [14.0] years) presenting for primary care, 78 of 199 (39.2%) had a history of incarceration, 32 of 199 (16.1%) were on probation or parole at the time of the study, and 92 of 199 (46.2%) reported having a family member with a history of incarceration. Of the 199 patients, 62 (31.2%) identified as non-Hispanic Black, 93 (46.7%) identified as non-Hispanic White, and 44 (22.1%) identified as belonging to another race (American Indian and Alaska Native, Asian, Native Hawaiian and Other Pacific Islander, or other nonspecified). Compared with participants without a history of correctional control, those with a personal history of incarceration were at greater odds of having an emergency department visit that did not result in hospitalization in models adjusted for age, sex, and race and ethnicity (odds ratio, 2.87; 95% CI, 1.47-5.75).
Conclusions and Relevance
This cross-sectional study suggests that primary care clinicians should screen for correctional control as a prevalent social determinant of health.
... We use empirical estimates of excess mortality among formerly incarcerated adult populations to compute low bounds for the magnitude of the contribution of U.S. incarceration to the U.S. adult mortality disadvantage relative to peer countries (the United Kingdom). Although tentative, these estimates highlight the significance of U.S. incarceration policies and practices for adult U.S. mortality levels, trends, and patterns, thus expanding previous research based on aggregate data (Wildeman 2016). The analysis demonstrates that the investigation of excess mortality among those incarcerated has much larger implications than those associated with the population affected. ...
... That some of these implications are quite significant is demonstrated by results of previous research that attempted to assess the impact of individuals' incarceration on their own well-being, health, and mortality and that of related individuals (close kin, spouses and children, and neighbors). A small body of that research evaluated the impact of aggregate levels of incarceration on U.S. national levels of health and mortality (Wildeman 2016). In this section, we contribute to this literature by examining the implications of U.S. incarceration experiences for recent adult U.S. mortality. ...
... To what extent is the U.S. health and mortality disadvantage among young and older adults accounted for by disparities in the composition of populations by incarceration experiences? In light of both differences in rates of incarceration in the United States vis-à-vis other countries (Wildeman 2016) and of qualitative and quantitative evidence showing that imprisonment experiences increase health risks and mortality, these are not far-fetched questions. Furthermore, over the last 40 years, the U.S. penal system has experienced a large expansion (National Research Council 2014), and this, jointly with excess health and mortality risks of the population that experiences imprisonment, is consistent with a gradual trend of increased U.S. deterioration relative to peer countries. ...
Previous research has suggested that incarceration has negative implications for individuals’ well-being, health, and mortality. Most of these studies, however, have not followed former prisoners over an extended period and into older adult ages, when the risk of health deterioration and mortality is the greatest. Contributing to this literature, this study is the first to employ the Panel Study of Income Dynamics (PSID) to estimate the long-run association between individual incarceration and mortality over nearly 40 years. We also supplement those analyses with data from the National Longitudinal Survey of Youth 1979 (NLSY79). We then use these estimates to investigate the implications of the U.S. incarceration regime and the post-1980 incarceration boom for the U.S. health and mortality disadvantage relative to industrialized peer countries (the United Kingdom).
... A small but growing body of research has examined the relationship between level of incarceration and aggregate population health outcomes. Studies have examined this issue comparing nations (Stuckler, Basu, McKee, & King, 2008;Wildeman, 2016) and states (Johnson & Raphael, 2009;Wildeman, 2012aWildeman, , 2012bWildeman et al., 2014) as well as intercounty differences within a single state (Thomas & Sampson, 2005;Thomas & Torrone, 2009). Even smaller jurisdictions have been the focus of analysis. ...
... Regarding research on the relationship between incarceration rates and health across nations, in an analysis of European and central Asian countries for the years 1991-2002, Stuckler et al. (2008) found that mass incarceration explained increases in tuberculosis and multidrug-resistant tuberculosis. Wildeman (2016) examined the relationship between incarceration rates and health across 21 wealthy democratic nations. He found that population health consequences -i.e., increased infant mortality and decreased life expectancy at birth -of increases in incarceration rates are much worse in the United States than other countries, largely because its absolute levels of incarceration are so much higher. ...
... Mass incarceration is a distinctly American phenomenon. The high rates of incarceration in the U.S. also makes it an outlier in terms of how incarceration rates affect population health (Wildeman, 2016). Moreover, because of the uneven distribution of incarceration rates, the negative health effects associated with incarceration rates could be a major factor in racial health disparities (Wildeman & Wang, 2017). ...
A collateral consequence of mass incarceration in the United States is its negative effects on population health. Using data from 2015, this study examines the relationship between incarceration rates and population health for a national sample of U.S. counties. To obtain unbiased estimates of the effect of incarceration on health, we use multivariate models which account for the endogeneity of incarceration rates when determining their effect on population health by employing an instrumental variable approach where the robust instrumental (exogenous) variable per capita corrections expenditures is used to predict incarceration rate. We then estimate population health outcomes as a function of predicted incarceration rate alongside factors such as public health spending, indicators of health behavior and control variables in models explaining county-level population health. Consistent with findings from prior research on individuals, families and at the state level, results of our analyses indicate that higher levels of incarceration are associated with higher levels of both morbidity (percentage reporting fair or poor health) and mortality (life expectancy). Implications of these findings for health and criminal justice policy, as well as research, are considered.
... First, given the historical and comparative novelty of American incarceration, the children of incarcerated parents represent a uniquely vulnerable group, and focused attention on them will best inform public health interventions. Second, the consequences of parental incarceration may differ, especially at the macro level, between the United States and other developed democracies (14,15). Third, the number of studies on the health implications of parental incarceration for American children has substantially expanded since 2000. ...
... For cross-national inequality, little existing research indicates that mass incarceration has caused the United States to lag increasingly behind other developed democracies on core indicators of population health like infant mortality. For example, a recent analysis indicated that the US infant mortality rate would have decreased nearly 40% more since 1983 without increases in the incarceration rate, with clear implications for cross-national child health disparities (15). ...
... Fourth, because of the concentration of parental incarceration among US children from historically marginalized groups and the substantial consequences of paternal incarceration on child health and well-being, mass incarceration has almost certainly exacerbated disparities in child health. Although the literature on the implications of mass incarceration for intracountry (33,36,90,95) and intercountry (15,96) disparities in child health is sparse, the existing research in this domain provides strong, consistent, if preliminary, evidence. ...
Mass incarceration has profoundly restructured the life courses of not only marginalized adult men for whom this event is now so prevalent but also their families. We examined research published from 2000 to 2017 on the consequences of parental incarceration for child health in the United States. In addition to focusing on specific health outcomes, we also considered broader indicators of child well-being because there has been little research on the association between parental incarceration and objectively measured child health outcomes. Our findings support 4 conclusions. First, paternal incarceration is negatively associated-possibly causally so-with a range of child health and well-being indicators. Second, although some research has suggested a negative association between maternal incarceration and child health, the evidence on this front is mixed. Third, although the evidence for average effects of paternal incarceration on child health and well-being is strong, research has also suggested that some key factors moderate the association between paternal incarceration and child health and well-being. Finally, because of the unequal concentration of parental incarceration and the negative consequences this event has for children, mass incarceration has increased both intracountry inequality in child health in the United States and intercountry inequality in child health between the United States and other developed democracies. In light of these important findings, investment in data infrastructure-with emphasis on data sets that include reliable measures of parental incarceration and child health and data sets that facilitate causal inferences-is needed to understand the child health effects of parental incarceration.
... However, much less is known about whether incarceration rates have an impact on inequality outcomes in the aggregate, particularly in a cross-national context (Western & Muller, 2013;Wildeman, 2016). In the one study that has explored the cross-national implications of incarceration, Wildeman (2016) found that countries with high rates of incarceration tended to have worse health outcomes in the aggregate, but that finding was driven solely by the United States. ...
... However, much less is known about whether incarceration rates have an impact on inequality outcomes in the aggregate, particularly in a cross-national context (Western & Muller, 2013;Wildeman, 2016). In the one study that has explored the cross-national implications of incarceration, Wildeman (2016) found that countries with high rates of incarceration tended to have worse health outcomes in the aggregate, but that finding was driven solely by the United States. ...
... I log the incarceration rate because incarceration rates are severely positively skewed (Sutton, 2004;Sutton, 2013). Following Wildeman (2016), I lag the incarceration rate one year to ensure temporal priority, while still allowing for the short-term consequences of incarceration, such as incapacitation, to have an impact. ...
A growing body of scholarship explores how incarceration contributes to inequality. The majority of this scholarship focuses on individual-level outcomes or aggregate outcomes within the United States. Despite substantial cross-national variation in incarceration rates, we know little about whether these differences contribute to cross-national variation in inequality outcomes. Using data from the period 1971–2010 from 15 advanced democracies, this study begins to fill this gap by exploring whether cross-national differences in incarceration rates help to explain cross-national differences in relative poverty rates. Although this research finds no average association, this null association obscures the important moderating role of country context. The association between incarceration and relative poverty is contingent upon a country's female employment rate and welfare state generosity.
... Thus, incarceration is a pressing public health concern affecting not only incarcerated persons, but also their families and communities (Brinkley-Rubenstein, 2013;Dumont, Brockmann, Dickman, Alexander, & Rich, 2012;Massoglia & Pridemore, 2015;Schnittker, Uggen, Shannon, & McElrath, 2015;Turney, 2017). There are also potential macro-level consequences for U.S. society (Wildeman, 2016). ...
... One of the goals for Health People 2020 is to reduce health disparities for people of color. Yet, it is unclear how the criminal justice system can contribute to this goal (Freudenberg & Heller, 2016 To better understand why Americans fare so poorly relative to individuals in other high-income countries in terms of health, we argue that incarceration rates should be considered when comparing health within and among countries (see Wildeman, 2016). ...
... Thus, the poor international ranking of the United States on health characteristics would worsen if the incarcerated populations were included in the estimates. Furthermore, the exceptionally high rates of incarceration may also worsen health for the noninstitutionalized population due to spillover effects (Brinkley-Rubenstein, 2013;Schnittker et al., 2015;Wildeman, 2016). The high rates of hypertension, diabetes, and STIs experienced in prison may contribute to high rates in the community, especially as prisoners with poor health conditions are released back into the community. ...
This paper compares black-white health disparities among state prisoners to disparities in the noninstitutionalized community to provide a more complete portrait of the nation’s heath. We use data from the 2004 Survey of Inmates in State and Federal Correctional Facilities and the 2002 and 2004 National Health and Nutrition Examination Survey for incarcerated and noninstitutionalized adult (aged 18 to 65) men and women, respectively. Health disparities between black and white male prisoners based on self-reported prevalence are similar to disparities in the general population for hypertension and diabetes but significantly reduced for kidney problems and stroke. Health disparities between black and white female prisoners are similar to disparities in the general population for obesity but significantly reduced for hypertension, diabetes, heart problems, kidney problems, and stroke. Our study reveals that prisoners report far worse health profiles than non-prisoners but there is differential health selection into prison for whites and blacks, and population health estimates for adult black men in particular are underreporting the true health burden for U.S. adults. Our findings highlight the importance of incorporating prison populations in demographic and public health analyses.
... The trend toward mass incarceration over the past several decades has resulted in significant collateral damage to the U.S. citizenry. Recent research has revealed that the post-1980 incarceration boom significantly undermined the health and wellness of the U.S. populace relative to industrialized peer nations (e.g., the United Kingdom), given its long-term effects on mortality and life expectancy (Daza et al., 2020;Wildeman, 2016). Indeed, as Wildeman andWang (2017, p. 1470) suggest, "the uniquely high incarceration prevalence in the USA might partly underlie the country's poor showing relative to other developed democracies on population health measures over the past 40 years." ...
... Recent research has revealed that the post-1980 incarceration boom significantly undermined the health and wellness of the U.S. populace relative to industrialized peer nations (e.g., the United Kingdom), given its long-term effects on mortality and life expectancy (Daza et al., 2020;Wildeman, 2016). Indeed, as Wildeman andWang (2017, p. 1470) suggest, "the uniquely high incarceration prevalence in the USA might partly underlie the country's poor showing relative to other developed democracies on population health measures over the past 40 years." Perhaps those most impacted by this devastating trend are the families whose loved one has been incarcerated. ...
The purpose of the current study is to examine associations between parental incarceration and children’s living arrangements in the United States. Data from the 2016–2018 National Survey of Children’s Health are utilized in the present study (N = 102,341). Difference-of-means t-tests and multinomial logistic regression were employed to analyze the data. Nearly 3 in 4 children with no history of parental incarceration lived with married parents, yet only 1 in 7 children with lifetime exposure to parental incarceration did. Furthermore, while exclusively non-parent caregiver arrangements were exceedingly rare for children with no lifetime exposure to parental incarceration (~ 2.5%), more than one-quarter of children exposed to parental incarceration were in exclusively non-parent caregiver arrangements. In homes with non-parent caregivers, parental incarceration is associated with a reduced prevalence of stepparent caregivers, yet an increased prevalence of grandparent, foster parent, and aunt/uncle caregivers. Additionally, over 70% of grandparent-caregiver households where children have experienced parental incarceration are skipped-generation households. The findings point to a substantial need to support diverse family structures in the wake of parental incarceration.
... Taken together, these fi ndings echo the call to increase the focus on physical health in lifecourse research in addition to examining (where relevant) both health constructs simultane ously. For various reasons, health costs are conferred on those in contact with the criminal justice system (Wildeman 2016). In turn, how these health states hinder or facilitate the achievement of adult roles and statuses, including those other than employment and positive relationships, is an area with great potential for further elaboration. ...
... Finally, it is an open question of how any of these health-related dynamics play out in contexts other than in the U.S. In Canada, the health status of the incarcerated compared to the general population is poor (Kouyoumdjian et al. 2016). Yet perhaps for various reasons, including the provision of healthcare (or lack of it), pronounced mental illness stigma, the enduring effects of deinstitutionalization, and the notable adverse health effects of incarceration (Wildeman 2016), it is possible that health problems are excep tionally pronounced and influential on the life course in the U.S. How these macro-level forces shape individual health and its life-course consequences is an important and un explored question. ...
Scholarship from the life-course paradigm has produced much evidence on the crime-reducing benefits of turning points such as securing a good job or developing a stable, positive relationship. Building on these insights, recent work has demonstrated the utility of incorporating health into the study of desis-tance; for various reasons, both mental and physical health statuses have been shown to influence the like-lihood of achieving these key life-course milestones. What is less well understood, however, is how mental and physical health may interact with each other and how this model applies to certain salient subgroups in criminal justice, such as those with serious mental illnesses. Importing the mental health–crime literature, we examine both the main and synergistic effects of mental and physical health on employment focus and relationship worry among a sample of persons with serious mental illness (N = 184). Findings from logistic and ordinary least squares regression models reveal that better physical health is associated with improved employment focus and that this effect is moderated by mental health status. In addition, better physical health is associated with a decrease in worry over one’s relationships. These findings point to the value of including physical and mental health states in life-course and desistance research, studies of persons with serious mental illnesses, and intervention and policy efforts to improve lives and promote desistance. © 2020 Canadian Journal of Criminology and Criminal Justice / Revue canadienne de criminologie et de justice pénale,.
... DeMarco, 2019;Turney, Wildeman, & Schnittker, 2012;Wakefield & Uggen, 2010;Wildeman, 2016). Several study findings have demonstrated the deleterious impact of incarceration on morbidities related to infectious diseases and stress (Massoglia, 2008;Massoglia & Pridemore, 2015;Schnittker & John, 2007). ...
... . Several study findings have demonstrated the deleterious impact of incarceration on morbidities related to infectious diseases and stress (Massoglia, 2008;Massoglia & Pridemore, 2015;Schnittker & John, 2007). Clearly, incarceration has serious implications for the life course (Wakefield & Apel, 2016), including that it serves an additional punishment of decreased life expectancy (Patterson, 2013)-an effect that seems exceptionally strong in the United States (Wildeman, 2016). 1 Health issues associated with incarceration do not take a lifetime to develop. Confinement can trigger or worsen general health and depressive symptoms over short periods during the life course (Esposito, Lee, Hicken, Porter, & Herting, 2017). ...
During the last few decades, criminologists have identified several adult roles and statuses, including employment, positive family relations, and economic stability, as critical for promoting successful reintegration and desistance. Very few researchers, however, have investigated the conditions that serve to bring about these transitions and successes crucial for behavior change. As a complement to a burgeoning amount of literature on the impact of incarceration on health, we emphasize the reverse: Health has important implications for reentry outcomes and reincarceration. Informed by multiple disciplines, we advance a health‐based model of desistance in which both mental and physical dimensions of health affect life chances in the employment and family realms and ultimately recidivism. Investigating this issue with longitudinal data from the Serious and Violent Offender Reentry Initiative (SVORI) and structural equation models, we find overall support for the health‐based model of desistance. Our results indicate several significant pathways through which both manifestations of health influence employment, family conflict, financial problems, and crime and reincarceration. The findings highlight the need for implementation of correctional and transitional policies to improve health among the incarcerated and avert health‐related reentry failures.
... Over the past 40 years, the prison population in the United States has increased more than sevenfold, with a current prevalence of 743 incarcerated individuals per 100,000; second on the list of developed nations is New Zealand at 173 per 100,000. 8 The reasons for this mass incarceration are complex, as are the public health implications. 9 The literature on correctional health care is limited, 10 with no standards for data reporting or oversight currently required. ...
Purpose Incarcerated patients represent a uniquely vulnerable population in the outpatient ophthalmology setting, and the reliability of follow-up in this group is undetermined.
Methods This was a retrospective, observational chart review of consecutive incarcerated patients evaluated at the ophthalmology clinic of a single academic medical center between July 2012 and September 2016. For each encounter the following were recorded: patient age, gender, incarcerated status at the time of encounter (a subset of patients had encounters before/after incarceration), interventions performed, follow-up interval requested, urgency of follow-up, and actual time to subsequent follow-up. Primary outcome measures were no-show rate and timeliness, which was defined as follow-up within 1.5× the requested period.
Results There were 489 patients included during the study period, representing a total of 2,014 clinical encounters. Of the 489 patients, 189 (38.7%) were seen once. Of the remaining 300 patients with more than one encounter, 184 (61.3%) ultimately did not return and only 24 (8%) were always on time for every encounter. Of 1,747 encounters with specific follow-up requested, 1,072 were considered timely (61.3%). Factors significantly associated with subsequent loss to follow-up include whether a procedure was performed ( p < 0.0001), urgency of follow-up ( p < 0.0001), incarcerated status ( p = 0.0408), and whether follow-up was requested ( p < 0.0001).
Conclusion Almost two-thirds of incarcerated patients in our population requiring repeat examination were lost to follow-up, particularly those who underwent an intervention or required more urgent follow-up. Patients entering and exiting the penal system were less likely to follow-up while incarcerated. Further work is needed to understand how these gaps compare to those in the general population and to identify means of improving these outcomes.
... Mass incarceration is increasingly being understood as a driver of health and social inequities (Massoglia & Pridemore, 2015;Massoglia & Remster, 2019;Wildeman, 2016;Wildeman & Wang, 2017). Prison populations have risen sharply in recent decades, with over 30 million adults released from prisons and other places of incarceration globally on an annual basis (Borschmann et al., 2020). ...
Background
People who enter and leave places of incarceration experience considerable health inequities and are at increased risk of premature death compared to the general population. Causes of premature death in this population vary markedly between countries and so country-specific information is needed. Additionally, there is a lack of large population-based studies which can disaggregate mortality risk based on person and incarceration factors. This study is the first examination of mortality in the period following release from incarceration in New Zealand.
Methods
We linked deidentified administrative data on incarceration and release between 1 January 1998 and 31 December 2016 with national mortality data for the same period to examine mortality after release in those who had been incarcerated for at least 1 day. Age standardised mortality rates and mortality ratios compared to the general New Zealand population were calculated separately for men and women, for releases from remand compared with prison, and by cause of death and time since release.
Results
90,195 individuals (13% women, 49% Māori) were followed up for 9.4 years after release from incarceration, with 4,764 deaths over the follow-up period. The overall standardised mortality ratio was 3.3 (95% CI 3.2, 3.4) compared to the general population, and higher for women (3.8) than men (2.7). The most common causes of death were cardiovascular disease, cancer and suicide. Rates of death were similar following release from remand versus prison, however suicide rates were highest following release from remand. Regardless of the type of incarceration, mortality was highest in the first month after release.
Conclusion
Experience of incarceration in New Zealand is associated with high rates of mortality from both chronic conditions and external causes. There are urgent policy imperatives to recognise and actively address the increased health and mortality risks faced by people released from New Zealand prisons.
... Although incarcerated people have a legal right to healthcare, access to healthcare is often limited by facilities that focus on security over patient wellbeing (Berk, et al., 2021). Average life expectancy is lower among the formerly incarcerated in the population in the United States (Wildeman, 2016). There are few physical and mental health services in prison, for example, less than 30% of incarcerated people access mental health services (Haney, 2002;Sipma-Dyscio, 2013). ...
Alongside the rise of mass incarceration in the United States, reentry programs have been developed with the intention of assisting formerly incarcerated people in their reentry process. Reentry programs can take many different forms, and researchers have encounter (Berghuis, 2018). Further literature around reentry programs has also critiqued the individual-level focus of many interventions, pointing out that mass incarceration has to be understood at a systemic level (Nixon, et al., 2008). Using the framework of abolitionism and critical race theory, I conducted three focus groups with formerly incarcerated men in a reentry program. The purpose of this study was to center how formerly incarcerated men understood the role of a reentry program in their lives in order to reframe reentry from an abolitionist able to stay out of prison, the role of peers in informing a positive post-incarcerated identity, and freedom.
... Incarceration adds to these stark inequalities [7]. In the past five decades, the U.S. increased its incarceration rate faster than any other developed democracy in the world [8], resulting in significant consequences for population health [9,10] and an ever-growing population of affected pregnant women and mothers [11]. Indeed, whether the woman is exposed to incarceration herself or vicariously through a partner, deleterious health effects abound, yielding a high risk of poorer maternal and infant health outcomes [12][13][14][15][16][17]. ...
Background
Extant research reveals that currently and formerly incarcerated individuals exhibit higher rates of disability. Moreover, recent research highlights that women exposed to incarceration during pregnancy —either personally or vicariously through a partner— face poorer health. However, prior research has not detailed the connection between incarceration exposure and risk for maternal disability.
Methods
The aim of this study is to evaluate the association between a women’s exposure to incarceration during pregnancy and disability including difficulty with: communication, hearing, remembering, seeing, self-care, or walking. Data are from Pregnancy Risk Assessment Monitoring System (PRAMS), 2019 (N = 12,712). Logistic and negative binomial regression were used to assess the relationship between incarceration exposure and maternal disability.
Results
Among the sample of women who delivered a recent live birth, approximately 3.3% of the sample indicated they were personally or vicariously exposed to incarceration in the 12 months before birth. Compared to those who did not have incarceration exposure, women with incarceration exposure have elevated odds of several disabilities, including difficulty remembering (Adjusted Odds Ratio [AOR] = 1.971; 95% Confidence Interval [CI] = 1.429, 2.718), difficulty seeing (AOR = 1.642, 95% CI = 1.179, 2.288), difficulty walking (AOR = 1.896, 95% CI = 1.413, 2.544), and a greater number of cumulative disabilities (Incidence Risk Ratio [IRR] = 1.483; 95% CI = 1.271, 1.731).
Conclusions
Women personally or vicariously exposed to incarceration during pregnancy endure greater odds of having a disability. Considering both incarceration and disability are important public health issues with implications for maternal and child well-being, these findings highlight the need for further research that can better understand the connection between incarceration and disability.
... Second, our exposure variable is binary; due to the survey design, we are unable to capture a cumulative or qualitative effect of CLI. Prior work has suggested that cumulative time spent incarcerated has an increasingly deleterious effect on risk of death 33,34 ; future research could consider the relationship between cumulative CLI and SAI. Third, the survey excludes individuals who are currently incarcerated, meaning that a substantial proportion of U.S. adults with CLI are not included in our exposed population. ...
Background:
Exposure to the criminal legal system is associated with negative health outcomes and profound socioeconomic health disparities. The social adaptability index (SAI) is a validated composite scale based on five indicators of socioeconomic status; a higher score predicts better health outcomes. However, little is known about the relationship between cumulative social risk factors as measured by the SAI and lifetime criminal legal involvement (CLI).
Methods:
Using a cross-sectional, nationally representative sample of U.S. adults, we calculated SAI score by lifetime CLI status, and used logistic regression with predictive margins to calculate risk of lifetime CLI by SAI quartile adjusting for demographic and clinical covariates.
Results:
A total of 213,678 participants were included, among whom 16.8% reported lifetime CLI. Mean SAI score was lower among those with lifetime CLI compared with those without (7.77, 95% confidence interval [CI]: 7.72-7.83 vs. 8.52, 95% CI: 8.50-8.55). There was a linear association between SAI quartile and predicted probability of lifetime CLI: first quartile: 23.9% (95% CI: 23.0-24.7); second quartile: 19.2% (95% CI: 18.6-19.8); third quartile: 17.5% (95% CI: 16.9-18.1); and fourth quartile: 12.5% (95% CI: 12.1-13.0).
Conclusion:
The SAI score is associated in a reverse linear manner with lifetime risk of CLI, suggesting that to successfully improve health outcomes among those with CLI, interventions may need to target multiple SAI components simultaneously. Interventions that successfully position individuals to achieve higher social adaptability by targeting multiple factors may reduce the health-harming effects of exposure to the criminal legal system.
... In the same year, nearly three-quarters of a million adults were confined in U.S. jails on any given day (Zeng, 2019). The sheer volume of people who experience incarceration each year in the United States, coupled with the links between population health outcomes and incarceration (Wildeman, 2016), means that improved correctional health care is critical to improving the nation's overall public health. ...
Distinct challenges exist in the delivery of medical services in correctional facilities, yet little is known about the sources of health information incarcerated patients rely upon to understand and manage their health. Using a nationally representative sample of U.S. incarcerated adults (N = 1,319) from the Programme for the International Assessment of Adult Competencies, we examine patterns in health information seeking behavior. We find incarcerated persons report television (72.9%) and social contacts (61.8%) as their most common sources of health information and use of magazines and books/brochures is significantly related to better health. We argue that asking incarcerated patients how they get health information and using this knowledge to provide them with health information in formats they will use are important steps toward reducing incarcerated individuals' health disparities.
... 8,9 The experience of incarceration, which is linked to numerous ill health effects, may contribute to racial health disparities and to the relatively poor health of the population as a whole. [10][11][12] A variety of mechanisms may explain this connection to health, from the stressful disruption of detention and release, to the enduring effects of stigma, decreased earning potential, frayed social bonds, and other challenges that persist long after a person returns home. [13][14][15] However, the true effect of incarceration on life expectancy in the US has been difficult to measure. ...
Importance
The association between incarceration and long-term mortality risk is unknown and may contribute to racial disparities in overall life expectancy.
Objective
To determine whether incarceration in the US is associated with an increase in mortality risk and whether this association is different for Black compared with non-Black populations.
Design, Setting, and Participants
This generational retrospective cohort study used data from the National Longitudinal Survey of Youth 1979, a nationally representative cohort of noninstitutionalized youths aged 15 to 22 years, from January 1 to December 31, 1979, with follow-up through December 31, 2018. A total of 7974 non-Hispanic Black and non-Hispanic non-Black participants were included. Statistical analysis was performed from October 26, 2019, to August 31, 2021.
Exposures
Time-varying exposure of having experienced incarceration during follow-up.
Main Outcomes and Measures
The main outcome was time to death. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs, adjusted for baseline sociodemographic, economic, and behavioral risk factors. Models were evaluated for the full cohort and stratified by race.
Results
Of the 7974 individuals included in our sample, 4023 (50.5%) were male, and 2992 (37.5%) identified as Black (median age, 18 [IQR, 17-20] years). During a median follow-up of 35 years (IQR, 33-37 years), 478 participants were incarcerated and 818 died. Unadjusted exposure to at least 1 incarceration between 22 and 50 years of age was 11.5% (95% CI, 10.4%-12.7%) for Black participants compared with 2.5% (95% CI, 2.1%-2.9%) for non-Black participants. In the multivariable Cox proportional hazards model with the full cohort, time-varying exposure to incarceration was associated with an increased mortality rate (adjusted HR [aHR], 1.35; 95% CI, 0.97-1.88), a result that was not statistically significant. In the models stratified by race, incarceration was significantly associated with increased mortality among Black participants (aHR, 1.65; 95% CI, 1.18-2.31) but not among non-Black participants (aHR, 1.17; 95% CI, 0.68-2.03).
Conclusions and Relevance
In this cohort study with 4 decades of follow-up, incarceration was associated with a higher mortality rate among Black participants but not among non-Black participants. These findings suggest that incarceration, which was prevalent and unevenly distributed, may have contributed to the lower life expectancy of the non-Hispanic Black population in the US.
... In addition, research has found that incarceration adversely affects employment trajectories of the formerly incarcerated populations in Finland, Norway, Sweden as well as Denmark (Aaltonen et al. 2017). Furthermore, some evidence indicates that incarceration is inversely related to life expectancy and infant mortality in an even wider variety of Western democracies, even if the effect is the strongest in the United States (Wildeman 2016). In general, it is important to examine the incarceration-health relationship in other parts of the world, including countries where the incarceration rate is comparatively low, as a way to evaluate whether the United States is exceptional (Massoglia and Pridemore 2015). ...
There is growing evidence that incarceration is associated with adverse health outcomes, but little is known about how circumstances surrounding incarceration relate to health. In the present study, we estimate the effect of timing of incarceration on mental health using panel data constructed from the Danish population registry. We exploit a 1994 criminal justice reform as a natural experiment that created exogenous variation in the age at which offenders were first incarcerated: because of policy change, incarceration occurred earlier than it would have otherwise. For the three out of the four mental health outcomes assessed in the study—having undergone psychiatric treatment, being in therapy or consultation, and being charged with the possession of drugs—we found consistent support for the notion that earlier incarceration is more harmful. The study refines our understanding of the collateral consequences of incarceration and it is the first to provide quasi-experimental evidence for the mental health effects of timing of incarceration.
... Finally, this paper aims to begin filling the literature gap between the U.S. and Latin American advancing empirical sociological research in the latter. Diverse scholars in the field have recognized the importance of comparative analysis to understand better the complex causal relationships that exist in national contexts (Munroe, Munroe, and Whiting 1981;Ruback and Weiner 1993;Sampson and Lauritsen 1997;Wildeman 2016); however, few empirical investigations outside the U.S. and Europe have been done in this area. By focusing on how changes in the prosecutor's discretion and the procedure length affected incarceration patterns, I intend to contribute to this empirical comparative conversation using different national settings in a causal inference framework. ...
During the two decades after the end of the Cold War, the U.S. promoted and sponsored Latin America's deepest criminal reform transformation. By the end of 2010, approximately 70 percent of Latin American countries had abandoned their inquisitorial system and adopted the U.S. adversarial model. In the era of mass incarceration, the U.S. decided to expand its criminal justice model without considering the potential negative consequences this could have in foreign penitentiary systems. Despite a large body of literature documenting the scale of felony conviction and imprisonment in the U.S., and its effects on inequality outcomes, we know relatively little about the impact of the U.S. model in Latin American prisons. After the reform took place, almost every country that introduced it experienced an acceleration in the incarceration rate. Almost three decades after the first legal transplant, Latin America lives one of its majors' prison crisis, while the effect of the adversarial model in the carceral outcomes remains empirically unexplored. In this project, I seek to advance the literature regarding the consequences of the U.S. transnational agenda by analyzing how the implementation of the U.S. model in one key jurisdiction-Colombia-resulted in changes to the convicted prison population. Mainly, I will explore the effects of introducing highly controversial institutions like the plea bargaining into the Latin American context. To carry out this analysis, I exploit the variation resulting from the Colombian quasi-experimental implementation of the reform to evaluate how the U.S. criminal justice approach changed the incarceration dynamics and whether the new system caused a convicted prison population growth.
... A growing body of research documents that incarceration carries negative ramifications for population health (Blankenship et al., 2018;Jahn et al., 2020;Stuckler et al., 2008;Testa et al., 2020;Weidner and Schultz, 2019;Wildeman, 2016;Wildeman and Wang, 2017) and shows increased incarceration has spillover effects that negatively impact other institutions including labor markets (Western and Beckett, 2001) and political institutions (Uggen and Manza, 2002). While the influence of incarceration on population health and other social institutions has received considerable attention, less research has focused on how incarceration effects the wider functioning of health care systems (Schnittker et al., 2015). ...
Rationale. Incarceration carries several negative ramifications for population health, while
diverting scarce resources from other public goods. At a time when health care systems around the world are strained, the current study investigates the long-term relationship between incarceration and health care infrastructure.
Objective. We investigated the longitudinal association between incarceration rates and hospital beds per capita for 36 countries between 1971-2015. Method. Fixed effects regression analyses were employed to examine the effect of within-country changes in incarceration rates on hospital beds per capita.
Results. Findings demonstrated that increases in national incarceration rates over time were associated with declines in hospital beds per capita, net of controls for socio-demographic and economic factors.
Conclusions. Increased incarceration negatively impacts hospital bed availability at the cross-national level.
... For example, Wildeman's analysis of Pregnancy Risk Assessment and Monitoring System linked data from 1990 to 2003 suggested that mass incarceration has a "substantial and significant" effect on black infant mortality [26]. In a separate analysis of health consequences of mass incarceration in an unbalanced panel dataset of developed democracies, including the U.S. 1981-2007 (N = 414), Wildeman concluded that with each 1 per 1000 increase in incarceration, there was a .25 per 1000 increase in the U.S. infant mortality rate [27]. Wildeman also found that for each 1 per 1000 increase in U.S. incarceration, there is an associated .29 (for U.S. males) and .37 (for U.S. females) decline in life expectancy years at birth for the sample, with these associations being highly significant at the .001 ...
Background:
A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist.
Methods:
We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area.
Results:
There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models.
Conclusion:
Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.
... Thus, there are documented scenarios in which incarceration paradoxically buffers against poorer health, especially amongst African American men. Furthermore, Wildeman (2016) demonstrates that the relationship between incarceration and health is not found across all countries, indicating that the U.S. may be exceptional in confronting this issue. Finally, the stigma of incarceration has been shown to vary across racial groups (Schnittker and John, 2007), suggesting a differential impact on certain health outcomes. ...
Rationale:
Research demonstrates a significant link between incarceration history and poorer physical and mental health. Yet, few studies have examined how a formerly incarcerated person's barriers to reintegration in the months upon release influence health outcomes.
Method:
We use data on recently incarcerated men from the Serious and Violent Offender Reentry Initiative (SVORI) to examine how multiple barriers to reintegration related to employment, housing, childcare, and service needs accumulate to influence physical and mental health three, nine, and 15 months after release.
Results:
A series of cross-lagged panel models indicate that a greater number of barriers to reintegration after release from prison (1) decreases self-rated health at all three waves and (2) increases symptoms of depression three and nine months after release. Moreover, both lower self-rated physical health and increased symptoms of depression are found to increase reintegration barriers.
Conclusions:
Enhanced policy to ease the burden of reintegration and provide comprehensive services upon release may not only bolster chances for successful community reintegration but also improve the health of those formerly incarcerated at a critical juncture in their lives.
... Offenders may also have been less likely to appear in voter registration records and telephone directories, both of which were used to find respondents. The small number of convicted offenders precluded an analysis of the effect the number of convictions or incarceration; both factors may play a role in health outcomes among offenders and population-wide health disparities (Lee, Wildeman, Wang, Matusko, & Jackson, 2014;Massoglia, 2008;Porter & DeMarco, 2018;Rosen et al., 2008;Schnittker et al., 2011;Wang et al., 2009;Wildeman, 2016;Wildeman & Wang, 2017). The small sample size also prevented further reliable exploration of genetic and environmental influence (Verhulst, 2017). ...
Importance
Health disparities between African Americans and Whites have persisted in the United States. Researchers have recently hypothesized that the relatively poor health of African Americans may be caused, in part, by African American overrepresentation in the criminal justice system.
Objectives
To test the hypothesis that criminal justice system involvement is associated with poor health and greater health risk when controlling for unobserved family factors through a discordant sibling design.
Methods
Subjects were drawn from the Carolina African American Twin Study of Aging (CAATSA). Criminal conviction records were extracted from North Carolina’s Department of Public Safety. Six measures of health and one measure of health risk were analyzed. The health of convicted respondents was compared to that of unrelated non-convicted respondents matched on childhood and demographic factors (“matched sample”). Convicted respondents were also compared to non-convicted siblings (“discordant sibling sample”).
Results
The matched sample included 134 CAATSA respondents. On average, convicted CAATSA respondents, compared to matched non-convicted respondents, were in worse health. Convicted respondents had worse mean self-reported health, worse lung function, more depressive symptoms, and smoked more. The discordant sibling sample included 74 respondents. Convicted siblings and non-convicted siblings had similar self-reported health, depressive symptoms, and smoking. In general, non-convicted siblings were in worse health than non-convicted respondents from the matched sample, implying that poor health runs in families.
Conclusions
This study provided preliminary evidence that some of the association between a criminal record and poor health is confounded by family factors. Though more research is needed to support these results, the study suggests that criminal involvement may not be associated with the surfeit of health problems observed among African Americans. The criminal justice system, nonetheless, could be used to decrease the health disparity.
... The unsustainable financial, political, social, and cultural effects of mass incarceration, particularly in the United States (US), have disproportionately affected and disenfranchised poor and racialized men and women, their families, and their communities (De Giorgi, 2017;Fox, 2014;Miller, 2014;Nixon et al., 2008;Wacquant, 2010), leading to a resurgence of interest in reentry. The scale of imprisonment in the US is unparalleled to that in other countries (Wildeman, 2016) and has consequently produced a sizeable population of released prisoners reentering their communities. Building on the notion of the "prison industrial complex," some scholars have pointed to the emergence of the "prisoner reentry industry" À a set of related penal systems tasked with managing the release of prisoners into their communities and the policing of ex-prisoners therein to ensure "successful" reintegration, thus "now parallel[ing] the prison system itself in terms of its political-economic spread" (Thompkins, Curtis, & Wendel, 2010, p. 428). ...
Drawing on qualitative interviews with formerly imprisoned people in Canada, we show that most prisoners experience reentry into communities with little to no prerelease planning, and must rely upon their own resourcefulness to navigate fragmented social services and often informal supports. In this respect, our research findings contrast with much US punishment and society scholarship that highlights a complex shadow carceral state that extends the reach of incarceration into communities. Our participants expressed a critical analysis of the failure of the prison to address the needs of prisoners for release planning and supports in the community. Our findings concur with other empirical studies that demonstrate the enduring effects of the continuum of carceral violence witnessed and experienced by prisoners after release. Thus, reentry must be understood in relation to the conditions of confinement and the experience of incarceration itself. We conclude that punishment and society scholarship needs to attend to a nuanced understanding of prisoner reentry and connect reentry studies to a wider critique of the prison industrial complex, offering more empirical evidence of the failure of prisons. © 2019 by Emerald Publishing Limited All rights of reproduction in any form reserved.
... Research findings also link incarceration to many deleterious outcomes involving health and well-being (see Massoglia and Pridemore, 2015, for a review). Imprisonment worsens indicators of population health (Schnittker et al., 2015;Wildeman, 2016) and heightens risks for both infectious (Massoglia, 2008) and foodborne illnesses (Marlow et al., 2017). Furthermore, incarceration is tied to chronic disease (Binswanger, Krueger, and Steiner, 2009;Schnittker and John, 2007), obesity (Houle, 2014), diminished mental health (Porter and Novisky, 2017;Schnittker, 2014;Schnittker, Massoglia, and Uggen, 2012), trauma exposure (Anderson, Geier, and Cahill, 2016), and hastened mortality (Binswanger et al., 2007;Patterson, 2013;Pridemore, 2014;Spaulding et al., 2011). ...
The link between incarceration and health is of emerging empirical interest to criminological scholars. Yet, we still know little about the needs of the rising population of older prisoners and the health issues they face. By drawing on qualitative data gathered from 193 interviews with older men incarcerated across three U.S. prisons, I examine the specific health promotion strategies available to, and used by, these men through a cultural health capital framework. Findings show that older prisoners make deliberate choices to protect their health from the constraints and deprivations inherent in their carceral lives. In the hopes of better managing chronic and acute disease, the strategies prisoners reference include acquiring medical information, making food and diet modifications, and health advocacy. Notably, the mobilization of cultural health capital is situated within a context of privilege, leaving important implications for both incarcerated individuals and correctional administrators.
... The unsustainable financial, political, social, and cultural effects of mass incarceration, particularly in the United States (US), have disproportionately affected and disenfranchised poor and racialized men and women, their families, and their communities (De Giorgi, 2017;Fox, 2014;Miller, 2014;Nixon et al., 2008;Wacquant, 2010), leading to a resurgence of interest in reentry. The scale of imprisonment in the US is unparalleled to that in other countries (Wildeman, 2016) and has consequently produced a sizeable population of released prisoners reentering their communities. Building on the notion of the "prison industrial complex," some scholars have pointed to the emergence of the "prisoner reentry industry" À a set of related penal systems tasked with managing the release of prisoners into their communities and the policing of ex-prisoners therein to ensure "successful" reintegration, thus "now parallel[ing] the prison system itself in terms of its political-economic spread" (Thompkins, Curtis, & Wendel, 2010, p. 428). ...
Drawing on qualitative interviews with formerly imprisoned people in Canada, we show that most prisoners experience reentry into communities with little to no pre-release planning, and must rely upon their own resourcefulness to navigate fragmented social services and often informal supports. In this respect, our research findings contrast with U.S. punishment and society scholarship that highlights a complex shadow carceral state that extends the reach of incarceration into communities. Our participants expressed a critical analysis of the failure of the prison to address the needs of prisoners for release planning and supports in the community. Our findings concur with other empirical studies that demonstrate the enduring effects of the continuum of carceral violence witnessed and experienced by prisoners after release. Thus, reentry must be understood in relation to the conditions of confinement and the experience of incarceration itself. We conclude that punishment and society scholarship needs to attend to a nuanced understanding of prisoner reentry and connect reentry studies to a wider critique of the prison industrial complex, offering more empirical evidence of the failure of prisons.
... Prior research, however, indicates that personally being stopped in an aggressive way by police is linked to mental illness symptoms (Geller et al. 2014) and that living in areas where incarceration rates are high is linked to higher rates of both physical and mental health problems among nonincarcerated residents of an area (Frank et al. 2013;Hatzenbuehler et al. 2014). Furthermore, research shows that incarceration matters for those with affective ties to the incarcerated, as mortality rises among middle-aged females living in countries with more extreme increases in incarceration (Wildeman 2016) and women and children with familial ties to the criminal justice system demonstrate poorer physical and mental health (Lee et al. 2014;Wildeman et al. 2012). More recently, Wildeman (2016) demonstrated that the United States' extreme move toward mass incarceration recently is associated with poorer life expectancy and infant mortality rates at the population level, especially for those adults who are near the typical age of prison release. ...
Previous research suggests police surveillance practices confer health risks to community members. This study examines whether the public health burden of excessive or ethnoracially inequitable police use of force are amplified or buffered by ethnoracial composition. Multilevel models are used to assess data from the 2009–2012 New York City Community Health Survey merged at the United Hospital Fund level with data from the 2009–2012 New York City Stop, Question, and Frisk Database. The illness associations of ethnoracial composition are amplified by the areal density of police use of force but buffered by the disproportionate police use of force against minorities. Specifically, living in minority communities with a high concentration of use of force by police against pedestrians is associated with an increased risk of diabetes and obesity. However, living in areas with a heavy presence of whites where there are large racial differences in police use of force is associated with an increased risk of poor/fair self-rated health, high blood pressure, diabetes, and obesity. The article concludes by considering the implications of the findings for better understanding the racialized nature of police violence and the consequences of place in distributing surveillance stress and structuring legal cynicism.
This research examines how news constructed vulnerability in the coverage of COVID-19 and populations in prisons and jails. Focused on key moments during the moral panic around the pandemic, the analysis of publications from across the U.S. found substantial reporting earlier in 2020, and a striking absence and ignorance of key developments later into 2021. Six news discourses - journalistic objectivity, blaming and abandonment, vulnerability, compassion, vilification, and absence - were complicated by the climate of demonstrations for racial justice.
Exceptionally high rates of partner violence perpetration are evident among men returning from prison. Two bodies of scholarship, one on family stress and another on exposure to state violence, each suggest that criminal legal system exposure could promote partner violence perpetration via changes in men’s behavioral health and interpersonal approach and in couples’ conflict dynamics. Such relationships have not been tested in quantitative research. Structural equation models were fitted to longitudinal, couples-based survey data from the Multi-site Family Study on Incarceration, Parenting, and Partnering. Participants included men returning from a state prison term in five U.S. states ( N = 1112) and their committed intimate or co-parenting partners ( N = 1112). Models tested hypothesized pathways from three dimensions of criminal legal system exposure to later partner violence perpetration. In fitted models, men’s childhood criminal legal system exposure predicts their post-prison partner violence perpetration via adult post-traumatic stress symptoms, reactivity, avoidance, and dysfunctional couple conflict dynamics. Men’s cumulative criminal legal system exposure in adulthood predicts their post-prison partner violence perpetration via addiction and dysfunctional couple conflict. These initial results suggest that mass-scale incarceration could worsen partner violence via men’s psychological and interpersonal adaptations to criminal legal system contact, particularly when such contact is sustained or occurs at a developmentally significant period in the life course.
Incarceration rates have grown in concentrated ways, especially effecting poor minority males who come from impoverished neighborhoods.
The COVID-19 pandemic has disproportionately impacted LGBTQ+ communities. Many disparities mirror those of the HIV/AIDS epidemic. These health inequities have repeated throughout history due to the structural oppression of LGBTQ+ people. We aim to demonstrate that the familiar patterns of LGBTQ+ health disparities reflect a perpetuating, deeply rooted cycle of injustice imposed on LGBTQ+ people. Here, we contextualize COVID-19 inequities through the history of the HIV/AIDS crisis, describe manifestations of LGBTQ+ structural oppression exacerbated by the pandemic, and provide recommendations for medical professionals and institutions seeking to reduce health inequities.
Dramatic increases in criminal justice contact in the United States have rendered prison and jail incarceration common for US men and their loved ones, with possible implications for women's health. This review provides the most expansive critical discussion of research on family member incarceration and women's health in five stages. First, we provide new estimates showing how common family member incarceration is for US women by race/ethnicity and level of education. Second, we discuss the precursors to family member incarceration. Third, we discuss mechanisms through which family member incarceration may have no effect on women's health, a positive effect on women's health, and a negative effect on women's health. Fourth, we review existing research on how family member incarceration is associated with women's health. Fifth, we continue our discussion of the limitations of existing research and provide some recommendations for future research.
Expected final online publication date for the Annual Review of Sociology, Volume 47 is July 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Involvement in the criminal justice system is one of the most fundamental upstream determinants of health. Fortunately, a model for helping patients navigate legal issues that negatively affect their health does exist in medicine: the medical–legal partnership.
This study investigates the longitudinal relationship between international migration and homicide using a sample of 88 developed and developing countries from 1993 to 2015. Drawing on research demonstrating that (1) economic development reduces violent crime within countries, and (2) migrants often move to countries with improving economic conditions in search of better economic opportunities, we test the hypothesis that the relationship between international migration and homicide is spurious at the cross-national level, as both factors may be attributed to economic development. Using fixed-effects regression, we find that a negative direct association between international migration and homicide is explained by economic development. We conclude that an increase in international migration and a decrease in homicide may both be consequences of a broader process of development.
Recently, there have been many attempts to develop a mathematical model that captures the nature of crime. One of the successful models has been based on diffusion‐type differential equations that describe how criminals spread in a specific area. Here, we propose a dynamic model that focuses on the effect of interactions between distinct types of criminals. The accumulated criminal records show that serious and minor crimes differ in many measures and are related in a complex way. While some of those who have committed minor crime spontaneously evolve into serious criminals, the transition from minor crime to major crime involves many social factors and has not been fully understood yet. In this work, we present a mathematical model to describe how minor criminals turn into major criminals inside and outside of prisons. The model assumes that a population can be divided into a set of compartments, according to the level of crime and whether arrested or not, and individuals have equal probability to change compartment. The model is design to implement two social effects which respectively have been conceptualized in popular terms “broken windows effect” and “prison as a crime school.” Analysis of the system shows how the crime‐related parameters such as the arrest rate, the period of imprisonment, and the in‐prison contact rate affect the criminal distribution at equilibrium. Without proper control of contact between prisoners, the longer imprisonment rather increases occurrence of serious crimes in society. An optimal allocation of the police resources to suppress crimes is also discussed.
Among the myriad collateral consequences of the high level of incarceration in the United States is its detrimental effects on public health. Just as there are geographic variations in level of incarceration within the United States, so too are there variations in health outcomes. This study examines the relationship between incarceration rates and population health for a national sample of counties from 2015, with a focus on how this relationship is influenced by both region (South vs. non-South) and whether a jurisdiction is rural. To obtain unbiased estimates of the effect of incarceration rates on two alternate health outcomes, it employs two-stage least-squares modeling, which accounts for the endogeneity of incarceration rates when determining their effect on population health. Results indicate that level of incarceration has a detrimental effect on both mortality (i.e., premature death) and morbidity (i.e., self-reported health), and that these effects are more pronounced in rural and Southern counties. Implications of these findings for both policy and research are considered.
This article provides a critical overview in five stages of roughly 50 years of research on the intergenerational transmission of criminal justice contact. In the first stage, I document that research on the intergenerational transmission of crime and criminal justice contact focused primarily on crime until the mid-1990s, at which point research rapidly shifted in the direction of criminal justice contact (specifically, incarceration). In the second stage, I document that research on the intergenerational transmission of crime and the intergenerational transmission of criminal justice contact tended to use the same measures—i.e., self-reported and administrative indicators of criminal justice contact with minimal information on criminal activity—but discussed them in different ways. In the third stage, research on the broader effects of incarceration is reviewed to highlight mechanisms through which parental criminal justice contact may independently influence children's criminal activity. In the fourth stage, research on the intergenerational transmission of criminal justice contact is reviewed. In the final stage, I conclude by calling for new data collection efforts that provide high-quality measures of both crime and criminal justice contact of both parents and children.
Expected final online publication date for the Annual Review of Criminology, Volume 3 is January 13, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Increasing evidence suggests that even minor forms of contact with the criminal justice system-such as being stopped by police-may be implicated in poor health. Police use of force can increase the risk of physical injury, whereas interactions accompanied by abusive rhetoric or threats can lead to psychological and emotional harm. Police contact may also have no health consequences for individuals or even be linked to good health because of an increased sense of public safety and confidence in law enforcement. This is the first study that explores whether contact with law enforcement is related to health and wellbeing in Europe. We estimated multilevel models with data from 26 countries that participated in the 2010 round of the European Social Survey. Across all outcomes-self-rated health, functional limitations, happiness, loneliness, and emotional wellbeing-having been approached, stopped or contacted by police was associated with worse health and wellbeing, especially when police treatment was perceived as unsatisfactory.
There is robust evidence of associations between parental imprisonment (PI) and a variety of harms to children, but the consequences of other forms of family imprisonment are largely unknown. Using Household, Income, and Labour Dynamics in Australia (HILDA), a nationally representative Australian data set, this article looked at the direct effects of PI, household member imprisonment (HI), or close family member imprisonment (CFI) on the social support and mental health of nonincarcerated adults and young people. Recent PI, HI, or CFI had no association with social support. Recent CFI did increase men’s risk of poor mental health, but not women’s or young people’s. We consider the implications of these findings in the context of strong negative effects of paternal imprisonment on mothers in the United States.
The justifications for the dramatic expansion of the prison population in recent decades have focused on public safety. Prior research on the efficacy of incarceration offers support for such claims, suggesting that increased incarceration saves lives by reducing the prevalence of homicide. We challenge this view by arguing that the effects of mass incarceration include collateral infant mortality consequences that call into question the number of lives saved through increased imprisonment. Using an instrumental variable estimation on state-level data from 1978 to 2010, this article simultaneously considers the effects of imprisonment on homicide and infant mortality to examine two of the countervailing mortality consequences of mass incarceration. Results suggest that while incarceration saves lives by lowering homicide rates, these gains are largely offset by the increases in infant mortality. Adjusted figures that count the number of increased infant deaths attributable to incarceration suggest that the mortality benefits of imprisonment over the past three decades are 82% lower than previously thought.
In this Series paper, we examine how mass incarceration shapes inequality in health. The USA is the world leader in incarceration, which disproportionately affects black populations. Nearly one in three black men will ever be imprisoned, and nearly half of black women currently have a family member or extended family member who is in prison. However, until recently the public health implications of mass incarceration were unclear. Most research in this area has focused on the health of current and former inmates, with findings suggesting that incarceration could produce some short-term improvements in physical health during imprisonment but has profoundly harmful effects on physical and mental health after release. The emerging literature on the family and community effects of mass incarceration points to negative health impacts on the female partners and children of incarcerated men, and raises concerns that excessive incarceration could harm entire communities and thus might partly underlie health disparities both in the USA and between the USA and other developed countries. Research into interventions, policies, and practices that could mitigate the harms of incarceration and the post-incarceration period is urgently needed, particularly studies using rigorous experimental or quasi-experimental designs.
Though sociologists have examined how mass incarceration affects stratification, remarkably little is known about how it shapes educational disparities. Analyzing the Fragile Families Study and its rich paternal incarceration data, I ask whether black and white children with fathers who have been incarcerated are less prepared for school both cognitively and non-cognitively as a result, and whether racial and gendered disparities in incarceration help explain the persistence of similar gaps in educational outcomes and trajectories. Using a variety of estimation strategies, I show that experiencing paternal incarceration by age five is associated with lower non-cognitive school readiness. While the main effect of incarceration does not vary by race, boys with incarcerated fathers have substantially worse non-cognitive skills at school entry, impacting the likelihood of special education placement at age nine. Mass incarceration facilitates the intergenerational transmission of male behavioral disadvantage, and because of the higher exposure of black children to incarceration, it also plays a role in explaining the persistently low achievement of black boys.
After decades of stability from the 1920s to the early 1970s, the rate
of incarceration in the United States more than quadrupled in the
past four decades. The Committee on the Causes and Consequences
of High Rates of Incarceration in the United States was established under
the auspices of the National Research Council, supported by the National
Institute of Justice and the John D. and Catherine T. MacArthur Foundation,
to review evidence on the causes and consequences of these high
incarceration rates and the implications of this evidence for public policy.
Our work encompassed research on, and analyses of, the proximate
causes of the dramatic rise in the prison population and the societal dynamics
that supported those proximate causes. Our analysis reviewed evidence
of the effects of high rates of incarceration on public safety as well as those
in prison, their families, and the communities from which these men and
women originate and to which they return. We also examined the effects
on U.S. society.
After assessing the evidence, the committee found that the normative
principles that both limit and justify the use of incarceration as a response
to crime were a necessary element of the analytical process. Public policy
on the appropriate use of prison is not determined solely by weighing
evidence of costs and benefits. Rather, a combination of empirical findings
and explicit normative commitments is required. Issues regarding criminal
punishment necessarily involve ideas about justice, fairness, and just deserts.
Accordingly, this report includes a review of established principles of
jurisprudence and governance that have historically guided society’s use of
incarceration.
Finally, we considered the practical implications of our conclusions for
public policy and for research.
Nearly 13 percent of young adult men report that their biological father has served time in jail or prison; yet surprisingly little research has examined how a father's incarceration is associated with delinquency and arrest in the contemporary United States. Using a national panel of Black, White, and Hispanic males, this study examines whether experiencing paternal incarceration is associated with increased delinquency in adolescence and young adulthood. We find a positive association with paternal incarceration that is robust to controls for several structural, familial, and adolescent characteristics. Relative to males not experiencing a father's incarceration, our results show that those experiencing a father's incarceration have an increased propensity for delinquency that persists into young adulthood. Using a national probability sample, we also find that a father's incarceration is highly and significantly associated with an increased risk of incurring an adult arrest before 25 years of age. These observed associations are similar across groups of Black, White, and Hispanic males. Taken as a whole, our findings suggest benefits from public policies that focus on male youth “at risk” as a result of having an incarcerated father.
High rates of imprisonment among American fathers have motivated an ongoing examination of incarceration's role in family life. A growing literature suggests that incarceration creates material and socioemotional challenges not only for prisoners and former prisoners but also for their families and communities. The authors examined the relationship between fathers' incarceration and one such challenge: the housing insecurity of the mothers of their children. Using data from the Fragile Families and Child Wellbeing Study (N = 4,125) and a series of longitudinal regression models, they found that mothers' housing security was compromised following their partners' incarceration, an association likely driven in part, but not entirely, by financial challenges following his time in prison or jail. Given the importance of stable housing for the continuity of adult employment, children's schooling, and other inputs to healthy child development, the findings suggest a grave threat to the well-being of children with incarcerated fathers.
Objectives:
We used Danish registry data to examine the association between parental incarceration and child mortality risk.
Methods:
We used a sample of all Danish children born in 1991 linked with parental information. We conducted discrete-time survival analysis separately for boys (n = 30 146) and girls (n = 28 702) to estimate the association of paternal and maternal incarceration with child mortality, controlling for parental sociodemographic characteristics. We followed the children until age 20 years or death, whichever came first.
Results:
Results indicated a positive association between paternal and maternal imprisonment and male child mortality. Paternal imprisonment was associated with lower child mortality risks for girls. The relationship between maternal imprisonment and female child mortality changed directions depending on the model, suggesting no clear association.
Conclusions:
These results indicate that the incarceration of a parent may influence child mortality but that it is important to consider the gender of both the child and the incarcerated parent.
High rates of incarceration among American men, coupled with a high prevalence of fatherhood among the incarcerated, have led to millions of children and families whose fathers are, or have been, in the nation’s jails and prisons. This study uses data from the Fragile Families and Child Wellbeing Survey to estimate the extent to which paternal incarceration increases family material hardship. Analyses from a series of longitudinal regression models suggest that material hardship is statistically significantly and positively associated with paternal incarceration. These hardships are found to reflect not only a reduction in fathers’ income and financial contributions but also an increase in financial and other family strains. The findings underscore the challenges facing families with incarcerated fathers. They also emphasize the need for efforts by criminal justice agencies and social service providers to help mitigate the risks associated with paternal incarceration.
Using street ethnography and interviews with homeless men in San Francisco and St Louis, this article examines the dynamic connection between incarceration and homelessness. Among the homeless men in the study, crimes of desperation, aggressive policing of status offenses, and the close proximity of many ex-cons created a strong likelihood of incarceration and reincarceration. Conversely, for jail and prison inmates, time inside consistently eroded employability, family ties, and other defences against homelessness: several of the men had become homeless for the first time directly following release from a carceral establishment. Each of these dynamics was present in both San Francisco and St Louis but the process of becoming homeless and the experience of homelessness itself varied significantly with the differing economic and cultural configurations presented by the two cities. In both cases, each trajectory reinforced the other, creating a homelessness/incarceration cycle more powerful than the sum of its parts, a racialized exclusion/punishment nexus which germinates, isolates, and perpetuates lower-class male marginality.
This article explores how incarceration affects crime rates at the neighborhood level. Incarceration is analyzed as a form of residential mobility that may damage local network structures and undermine informal control. Geocoded data are combined with census data, data on incarceration convictions and releases, and crime data for Tallahassee, Florida. The results show a positive relationship between the rate of releases one year and the community's crime rates the following year. They also show that low rates of admissions to prison have an uncertain impact on crime rates, moderate rates reduce crime, and higher rates increase crime. Implications for criminal justice policies are discussed.
A selection of panel studies appearing in the American Sociological Review and the American Journal of Sociology between 1990 and 2003 shows that sociologists have been slow to capitalize on the advantages of panel data for controlling unobservables that threaten causal inference in observational studies. This review emphasizes regression methods that capitalize on the strengths of panel data for consistently estimating causal parameters in models for metric outcomes when measured explanatory variables are correlated with unit-specific unobservables. Both static and dynamic models are treated. Among the major subjects are fixed versus random effects methods, Hausman tests, Hausman-Taylor models, and instrumental variables methods, including Arrelano-Bond and Anderson-Hsaio estimation for models with lagged endogenous variables.
Psychiatric disorders are unusually prevalent among current and former inmates, but it is not known what this relationship reflects. A putative causal relationship is contaminated by assorted influences, including childhood disadvantage, the early onset of most disorders, and the criminalization of substance use. Using the National Comorbidity Survey Replication (N = 5692), we examine the relationship between incarceration and psychiatric disorders after statistically adjusting for multidimensional influences. The results indicate that (1) some of the most common disorders found among former inmates emerge in childhood and adolescence and therefore predate incarceration; (2) the relationships between incarceration and disorders are smaller for current disorders than lifetime disorders, suggesting that the relationship between incarceration and disorders dissipates over time; and (3) early substance disorders anticipate later incarceration and other psychiatric disorders simultaneously, indicating selection. Yet the results also reveal robust and long-lasting relationships between incarceration and certain disorders, which are not inconsequential for being particular. Specifically, incarceration is related to subsequent mood disorders, related to feeling "down," including major depressive disorder, bipolar disorder, and dysthymia. These disorders, in turn, are strongly related to disability, more strongly than substance abuse disorders and impulse control disorders. Although often neglected as a health consequence of incarceration, mood disorders might explain some of the additional disability former inmates experience following release, elevating their relevance for those interested in prisoner reintegration.
Objectives:
We examined whether the burden of violence in a child's community environment alters the child's behavior and functioning in the classroom setting.
Methods:
To identify the effects of local violence, we exploited variation in the timing of local homicides, based on data from the Chicago Police Department, relative to the timing of interview assessments conducted as part of a randomized controlled trial conducted with preschoolers in Head Start programs from 2004-2006, the Chicago School Readiness Project. We compared children's scores when exposed to recent local violence with scores when no recent violence had occurred to identify causal effects.
Results:
When children were assessed within a week of a homicide that occurred near their home, they exhibited lower levels of attention and impulse control and lower preacademic skills. The analysis showed strong positive effects of local violence on parental distress, providing suggestive evidence that parental responses may be a likely pathway by which local violence affects young children.
Conclusions:
Exposure to homicide generates acute psychological distress among caregivers and impairs children's self-regulatory behavior and cognitive functioning.
We present new evidence on the effect of aggregate changes in incarceration on changes in crime that accounts for the potential simultaneous relationship between incarceration and crime. Our principal innovation is that we develop an instrument for future changes in incarceration rates based on the theoretically predicted dynamic adjustment path of the aggregate incarceration rate in response to a shock (from whatever source) to prison entrance or exit transition probabilities. Given that incarceration rates adjust to permanent changes in behavior with a dynamic lag (given that only a fraction of offenders are apprehended in any one period), one can identify variation in incarceration that is not contaminated by contemporary changes in criminal behavior. We isolate this variation and use it to tease out the causal effect of incarceration on crime. Using state level data for the United States covering the period from 1978 to 2004, we find crime-prison elasticities that are considerably larger than those implied by OLS estimates. For the entire time period, we find average crime-prison effects with implied elasticities of between -0.06 and -0.11 for violent crime and between -0.15 and -0.21 for property crime. We also present results for two sub-periods of our panel: 1978 to 1990 and 1991 to 2004. Our IV estimates for the earlier time period suggest much larger crime-prison effects, with elasticity estimates consistent with those presented in Levitt (1996) who analyzes a similar time period yet with an entirely different identification strategy. For the latter time period, however, the effects of changes in prison on crime are much smaller. Our results indicate that recent increases in incarceration have generated much less bang-per-buck in terms of crime reduction.
Rates of imprisonment have risen in many Western democracies over the past few decades, most dramatically in the United States. The development of a systematic and general explanation of im-prisonment trends has been impeded because of the theoretical and methodological limitations of prior quantitative studies. Most use data from a single country or jurisdiction and focus narrowly on the Rusche-Kirchheimer "labor surplus" hypothesis, with little at-tention to alternative explanations. This study takes a cross-national perspective, using longitudinal data from Australia, Canada, New Zealand, the United Kingdom, and the United States to offer an institutional account of imprisonment rates. The labor surplus effect is treated as a special case of a more general process by which individuals are allocated among alternative life-course paths. This allocation process is likely to be influenced by macrolevel institu-tional arrangements and contests for political power. Hypotheses are tested using pooled time-series cross-section regression techniques. Results support this broadened perspective: prison growth is driven not only by crime rates and unemployment rates, but also by welfare spending and the power of right parties.
In the past three decades, incarceration has become an increasingly powerful force for reproducing and reinforcing social inequalities. A new wave of sociological research details the contemporary experiment with mass incarceration in the United States and its attendant effects on social stratification. This review first describes the scope of imprisonment and the process of selection into prison. It then considers the implications of the prison boom for understanding inequalities in the labor market, educational attainment, health, families, and the intergenerational transmission of inequality. Social researchers have long understood selection into prison as a reflection of existing stratification processes. Today, research attention has shifted to the role of punishment in generating these inequalities.
The impact of state prison populations on crime is typically estimated by applying the lambda, the individual crime rate, of prisoners or arrestees. We outline the problems with this approach, attempt to reanalyze the widely divergent lambdas derived in past research, and make adjustments necessary to use lambdas for estimating the incapacitation impact. The result is an uncertain estimate of 16 to 25 index crimes averted per year per each additional prisoner. We argue that regression analysis can provide a better estimate of the impact of prison population growth. Applying the Granger test to pooled state data over 19 years, we found that prison population growth leads to lower crime rates but that crime rate changes have little or no short-term impact on prison population growth. Next we regressed crime rates on prison population and conclude that, on average, at least 17 index crimes are averted per additional prisoner. The impact is limited mainly to property crime.
High rates of incarceration among American men, coupled with high rates of fatherhood among men in prison, have motivated recent research on the effects of parental imprisonment on children's development. We use data from the Fragile Families and Child Wellbeing Study to examine the relationship between paternal incarceration and developmental outcomes for approximately 3,000 urban children. We estimate cross-sectional and longitudinal regression models that control not only for fathers' basic demographic characteristics and a rich set of potential confounders, but also for several measures of pre-incarceration child development and family fixed effects. We find significant increases in aggressive behaviors and some evidence of increased attention problems among children whose fathers are incarcerated. The estimated effects of paternal incarceration are stronger than those of other forms of father absence, suggesting that children with incarcerated fathers may require specialized support from caretakers, teachers, and social service providers. The estimated effects are stronger for children who lived with their fathers prior to incarceration but are also significant for children of nonresident fathers, suggesting that incarceration places children at risk through family hardships including and beyond parent-child separation.
The number of people incarcerated in U.S. prisons and jails more than quadrupled between 1975 and 2005, reaching the unprecedented level of over two million inmates today. Annual corrections spending now exceeds 64 billion dollars, and many of the social and economic burdens resulting from mass incarceration fall disproportionately on minority communities. Yet crime rates across the country have also dropped considerably during this time period. In Do Prisons Make Us Safer? leading experts systematically examine the complex repercussions of the massive surge in our nation?s prison system. Do Prisons Make Us Safer? asks whether it makes sense to maintain such a large and costly prison system. The contributors expand the scope of previous analyses to include a number of underexplored dimensions, such as the fiscal impact on states, effects on children, and employment prospects for former inmates. Steven Raphael and Michael Stoll assess the reasons behind the explosion in incarceration rates and find that criminal behavior itself accounts for only a small fraction of the prison boom. Eighty-five percent of the trend can be attributed to "get tough on crime" policies that have increased both the likelihood of a prison sentence and the length of time served. Shawn Bushway shows that while prison time effectively deters and incapacitates criminals in the short term, long-term benefits such as overall crime reduction or individual rehabilitation are less clear cut. Amy Lerman conducts a novel investigation into the effects of imprisonment on criminal psychology and uncovers striking evidence that placement in a high security penitentiary leads to increased rates of violence and anger-particularly in the case of first time or minor offenders. Rucker Johnson documents the spill-over effects of parental incarceration-children who have had a parent serve prison time exhibit more behavioral problems than their peers. Policies to enhance the well-being of these children are essential to breaking a devastating cycle of poverty, unemployment, and crime. John Donohue?s economic calculations suggest that alternative social welfare policies such as education and employment programs for at-risk youth may lower crime just as effectively as prisons, but at a much lower human cost. The cost of hiring a new teacher is roughly equal to the cost of incarcerating an additional inmate. The United States currently imprisons a greater proportion of its citizens than any other nation in the world. Until now, however, we?ve lacked systematic and comprehensive data on how this prison boom has affected families, communities, and our nation as a whole. Do Prisons Make Us Safer? provides a highly nuanced and deeply engaging account of one of the most dramatic policy developments in recent U.S. history.
The expansion of the penal system has been one of the most dramatic trends in contemporary American society. A wealth of research has examined the impact of incarceration on a range of later life outcomes and has considered how the penal system has emerged as a mechanism of stratification and inequality in the United States. In this article, we review the literature from a comparatively new vein of this research: the impact of incarceration on health outcomes. We first consider the impact of incarceration on a range of individual outcomes, from chronic health conditions to mortality. We then consider outcomes beyond the individual, including the health of family members and community health outcomes. Next, we discuss mechanisms linking incarceration and health outcomes before closing with a consideration of limitations in the field and directions for future research.
We consider statistical inference for regression when data are grouped into clusters, with regression model errors independent across clusters but correlated within clusters. Examples include data on individuals with clustering on village or region or other category such as industry, and state- year differences- in- differences studies with clustering on state. In such settings, default standard errors can greatly overstate estimator precision. Instead, if the number of clusters is large, statistical inference after OLS should be based on cluster- robust standard errors. We outline the basic method as well as many complications that can arise in practice. These include cluster- specifi c fi xed effects, few clusters, multiway clustering, and estimators other than OLS. © 2015 by the Board of Regents of the University of Wisconsin System.
An unrelenting prison boom, marked by racial disparities, characterized the latter third of the twentieth century. Drawing upon broadly representative survey data and qualitative interviews, Children of the Prison Boom describes the devastating effects of America's experiment in mass incarceration for a generation of vulnerable children. Parental imprisonment has transformed from an event affecting only the unluckiest of children-children of parents whose involvement in crime would have been quite serious-to one that is remarkably common, especially for black children. Even for high-risk youth, Children of the Prison Boom shows that paternal incarceration makes a bad situation worse, increasing mental health and behavioral problems, infant mortality, and child homelessness. These findings have broad implications for social inequality. Contrary to a great deal of research on the consequences of mass incarceration for inequality among adult men, these harms to children translate into large-scale increases in racial inequalities at the aggregate level. Parental imprisonment has become a distinctively American force for promoting intergenerational social inequality that should be placed alongside a decaying urban public school system and highly concentrated disadvantaged populations in urban centers as factors that distinctively touch-and disadvantage-poor black children. More troubling, even if incarceration rates were reduced dramatically in the near future, the long-term harms of incarcerating marginalized men have yet to be fully revealed. Optimism about current reductions in the imprisonment rate and the resilience of children must therefore be set against the backdrop of the children of the prison boom-a lost generation now coming of age.
At no time in history, and certainly in no other democratic society, have prisons been filled so quickly and to such capacity than in the United States. And nowhere has this growth been more concentrated than in the disadvantaged-and primarily minority-neighborhoods of America's largest urban cities. In the most impoverished places, as much as 20% of the adult men are locked up on any given day, and there is hardly a family without a father, son, brother, or uncle who has not been behind bars. While the effects of going to and returning home from prison are well-documented, little attention has been paid to the impact of removal on neighborhoods where large numbers of individuals have been imprisoned. In the first detailed, empirical exploration of the effects of mass incarceration on poor places, this book demonstrates that in high doses incarceration contributes to the very social problems it is intended to solve-it breaks up family and social networks; deprives siblings, spouses, and parents of emotional and financial support; threatens the economic and political infrastructure of already struggling neighborhoods; and destabilizes the community, thus further reducing public safety. Especially at risk are children who, research shows, are more likely to commit a crime if a father or brother has been to prison. Demonstrating that the current incarceration policy in urban America does more harm than good, from increasing crime to widening racial disparities and diminished life chances for youths, the book argues that we cannot overcome the problem of mass incarceration concentrated in poor places without incorporating an idea of community justice into our failing correctional and criminal justice systems.
In just the last forty years, imprisonment has been transformed from an event experienced by only the most marginalized to a common stage in the life course of American men—especially Black men with low levels of educational attainment. Although much research considers the causes of the prison boom and how the massive uptick in imprisonment has shaped crime rates and the life course of the men who experience imprisonment, in recent years, researchers have gained a keen interest in the spillover effects of mass imprisonment on families, children, and neighborhoods. Unfortunately, although this new wave of research documents the generally harmful effects of having a family member or loved one incarcerated, it remains unclear how much the prison boom shapes social inequality through these spillover effects because we lack precise estimates of the racial inequality in connectedness—through friends, family, and neighbors—to prisoners. Using the 2006 General Social Survey, we fill this pressing research gap by providing national estimates of connectedness to prisoners—defined in this article as knowing someone who is currently imprisoned, having a family member who is currently imprisoned, having someone you trust who is currently imprisoned, or having someone you know from your neighborhood who is currently imprisoned—for Black and White men and women. Most provocatively, we show that 44% of Black women (and 32% of Black men) but only 12% of White women (and 6% of White men) have a family member imprisoned. This means that about one in four women in the United States currently has a family member in prison. Given these high rates of connectedness to prisoners and the vast racial inequality in them, it is likely that mass imprisonment has fundamentally reshaped inequality not only for the adult men for whom imprisonment has become common, but also for their friends and families.
Research on the relationship between parental incarceration and foster care placement is limited in three ways: it (1) it
focuses solely on maternal imprisonment and provides neither (2) strong causal tests nor (3) tests of mediation. In this article,
we address these gaps by providing a rationale for how paternal imprisonment may increase children's risk of foster care placement
and by using Danish registry data to conduct a strong causal test of this relationship (using a recent policy change) and
to test relevant mechanisms. The results provide compelling evidence of a causal effect of paternal imprisonment on children's
risk of foster care placement in Denmark and imply that changes in family finances and family structure do little to explain
these effects.
A life course perspective on crime indicates that incarceration can disrupt key life transitions. Life course analysis of occupations finds that earnings mobility depends on stable employment in career jobs. These two lines of research thus suggest that incarceration reduces ex-inmates' access to the steady jobs that usually produce earnings growth among young men. Consistent with this argument, evidence for slow wage growth among ex-inmates is provided by analysis of the National Longitudinal Survey of Youth. Because incarceration is so prevalent-one-quarter of black non-college males in the survey were interviewed between 1979 and 1998 while in prison or jail-the effect of imprisonment on individual wages also increases aggregate race and ethnic wage inequality.
Objectives. We examined whether residence in neighborhoods with high levels of incarceration is associated with psychiatric morbidity among nonincarcerated community members.
Methods. We linked zip code–linked information on neighborhood prison admissions rates to individual-level data on mental health from the Detroit Neighborhood Health Study (2008–2012), a prospective probability sample of predominantly Black individuals.
Results. Controlling for individual- and neighborhood-level risk factors, individuals living in neighborhoods with high prison admission rates were more likely to meet criteria for a current (odds ratio [OR] = 2.9; 95% confidence interval [CI] = 1.7, 5.5) and lifetime (OR = 2.5; 95% CI = 1.4, 4.6) major depressive disorder across the 3 waves of follow-up as well as current (OR = 2.1; 95% CI = 1.0, 4.2) and lifetime (OR = 2.3; 95% CI = 1.2, 4.5) generalized anxiety disorder than were individuals living in neighborhoods with low prison admission rates. These relationships between neighborhood-level incarceration and mental health were comparable for individuals with and without a personal history of incarceration.
Conclusions. Incarceration may exert collateral damage on the mental health of individuals living in high-incarceration neighborhoods, suggesting that the public mental health impact of mass incarceration extends beyond those who are incarcerated.
Mass incarceration is disproportionately concentrated among men, African Americans, and those with low education. Yet our national data systems and the social facts they produce are based on information that excludes inmates and former inmates. This presentation show that because these populations differ in systematic ways from those living in households, data gathered through household-based surveys offer a biased glimpse into the American experience and obscures accounts of racial inequality.
Rising imprisonment rates and declining marriage rates among low-education African Americans motivate an analysis of the effects of incarceration on marriage. An event history analysis of 2,041 unmarried men from the National Longitudinal Survey of Youth suggests that men are unlikely to marry in the years they serve in prison. A separate analysis of 2,762 married men shows that incarceration during marriage significantly increases the risk of divorce or separation. We simulate aggregate marriage rates using estimates from the National Longitudinal Survey of Youth and find that the prevalence of marriage would change little if incarceration rates were reduced.
Ex‐prisoners consistently manifest high rates of criminal recidivism and unemployment. Existing explanations for these poor outcomes emphasize the stigmatizing effects of imprisonment on prisoners seeking postrelease employment as well as the deleterious effects of imprisonment on prisoners’ attitudes and capabilities. However, these explanations must be distinguished from selection effects in the criminal sentencing process, which also could explain some or all of these poor outcomes. To distinguish between criminogenic and selection explanations for ex‐prisoners’ postrelease experience, I analyze data from a natural experiment in which criminal cases were assigned randomly to judges with sizable sentencing disparities. Using these exogenous sentencing disparities, I produce unbiased estimates of the causal effects of imprisonment on the life course. The results of this analysis suggest that selection effects could be sufficiently large to account for prisoners’ poor postrelease outcomes because judges with large sentencing disparities in their use of imprisonment had similarly high caseload unemployment and criminal recidivism rates.
There is a growing body of research on the effects of incarceration on health, though there are few studies in the sociological literature of the association between incarceration and premature mortality. This study examined the risk of male premature mortality associated with incarceration. Data came from the Izhevsk (Russia) Family Study, a large-scale population-based case-control design. Cases (n = 1,750) were male deaths aged 25 to 54 in Izhevsk between October 2003 and October 2005. Controls (n = 1,750) were selected at random from a city population register. The key independent variable was lifetime prevalence of incarceration. I used logistic regression to estimate mortality odds ratios, controlling for age, hazardous drinking, smoking status, marital status, and education. Seventeen percent of cases and 5 percent of controls had been incarcerated. Men who had been incarcerated were more than twice as likely as those who had not to experience premature mortality (odds ratio = 2.2, 95 percent confidence interval: 1.6-3.0). Relative to cases with no prior incarceration, cases who had been incarcerated were more likely to die from infectious diseases, respiratory diseases, non-alcohol-related accidental poisonings, and homicide. Taken together with other recent research, these results from a rigorous case-control design reveal not only that incarceration has durable effects on illness, but that its consequences extend to a greater risk of early death. I draw on the sociology of health literature on exposure, stress, and social integration to speculate about the reasons for this mortality penalty of incarceration.
We examine the relationship between incarceration and premature mortality for men and women. Analyses using the National Longitudinal Survey of Youth (NLSY79) reveal strong gender differences. Using two different analytic procedures the results show that women with a history of incarceration are more likely to die than women without such a history, even after controlling for health status and criminal behavior prior to incarceration, the availability of health insurance, and other socio-demographic factors. In contrast, there is no relationship between incarceration and mortality for men after accounting for these factors. The results point to the importance of examining gender differences in the collateral consequences of incarceration. The results also contribute to a rapidly emerging literature linking incarceration to various health hazards. Although men constitute the bulk of inmates, future research should not neglect the special circumstances of female former inmates and their rapidly growing numbers.
Objectives:
We examined the association of family member incarceration with cardiovascular risk factors and disease by gender.
Methods:
We used a sample of 5470 adults aged 18 years and older in the National Survey of American Life, a 2001-2003 nationally representative cross-sectional survey of Blacks and Whites living in the United States, to examine 5 self-reported health conditions (diabetes, hypertension, heart attack or stroke, obesity, and fair or poor health).
Results:
Family member incarceration was associated with increased likelihood of poor health across all 5 conditions for women but not for men. In adjusted models, women with family members who were currently incarcerated had 1.44 (95% confidence interval [CI] = 1.03, 2.00), 2.53 (95% CI = 1.80, 3.55), and 1.93 (95% CI = 1.45, 2.58) times the odds of being obese, having had a heart attack or stroke, and being in fair or poor health, respectively.
Conclusions:
Family member incarceration has profound implications for women's cardiovascular health and should be considered a unique risk factor that contributes to racial disparities in health.
The U.S. prison and jail population has grown fivefold in the 40 years since the early 1970s. The aggregate consequences of the growth in the penal system are widely claimed but have not been closely studied. We survey evidence for the aggregate relationship among the incarceration rate, employment rates, single-parenthood, public opinion, and crime. Employment among very low-skilled men has declined with rising incarceration. Punitive sentiment in public opinion has also softened as imprisonment increased. Single-parenthood and crime rates, however, are not systematically related to incarceration. We conclude with a discussion of the conceptual and empirical challenges that come with assessing the aggregate effects of mass incarceration on American poverty.
A burgeoning literature considers the consequences of mass imprisonment for the well-being of adult men and—albeit to a lesser degree—their children. Yet virtually no quantitative research considers the consequences of mass imprisonment for the well-being of the women who are the link between (former) prisoners and their children. This article extends research on the collateral consequences of mass imprisonment by considering the association between paternal incarceration and maternal mental health using data from the Fragile Families and Child Wellbeing Study. Results show that recent paternal incarceration increases a mother’s risk of a major depressive episode and her level of life dissatisfaction, net of a variety of influences including prior mental health. The empirical design lends confidence to a causal interpretation: effects of recent incarceration persist even when the sample is limited to mothers attached to previously incarcerated men, which provides a rigorous counterfactual. In addition, the empirical design is comprehensive; after isolating key mechanisms anticipated in the literature, we reduce the relationship between recent paternal incarceration and maternal mental health to statistical insignificance. These results imply that the penal system may have important effects on poor women’s well-being beyond increasing their economic insecurity, compromising their marriage markets, or magnifying their risk of divorce.
Globalization has attained a prominent place on the sociological agenda, and stratification scholars have implicated globalization in the increased income inequality observed in many advanced capitalist countries. But sociologists have given much less attention to a different yet increasingly prevalent form of internationalization: regional integration. Regional integration, or the construction of international economy and polity within negotiated regions, should matter for income inequality. Regional economic integration should raise income inequality, as workers are exposed to international competition and labor unions are weakened. Regional political integration should also raise income inequality, but through a different mechanism: political integration should drive welfare state retrenchment in market-oriented regional polities as states adopt liberal policies in a context of fiscal austerity. Evidence from random-effects and fixedeffects models of income inequality in Western Europe supports these arguments. The results show that regional integration explains nearly half of the increase in income inequality in the Western European countries analyzed in this article. The effects of regional integration on income inequality are net of several controls, including two established measures of globalization, suggesting that a sociological approach to regional integration adds to our understanding of rising income inequality in Western Europe.
With over 2 million individuals currently incarcerated, and over half a million prisoners released each year, the large and growing number of men being processed through the criminal justice system raises important questions about the consequences of this massive institutional intervention. This article focuses on the consequences of incarceration for the employment outcomes of black and white job seekers. The present study adopts an experimental audit approach-in which matched pairs of individuals applied for real entry-level jobs-to formally test the degree to which a criminal record affects subsequent employment opportunities. The findings of this study reveal an important, and much underrecognized, mechanism of stratification. A criminal record presents a major barrier to employment, with important implications for racial disparities.
Comparative research contrasts the corporatist welfare states of Europe with the unregulated U.S. labor market to explain low rates of U.S. unemployment in the 1980s and 1990s. In contrast, this article argues that the U.S. state made a large and coercive intervention into the labor market through the expansion of the penal system. The impact of incarceration on unemployment has two conflicting dynamics. In the short run, U.S. incarceration lowers conventional unemployment measures by removing able-bodied, working-age men from labor force counts. In the long run, social survey data show that incarceration raises unemployment by reducing the job prospects of ex-convicts. Strong U.S. employment performance in the 1980s and 1990s has thus depended in part on a high and increasing incarceration rate.
Using data from the U.S. Bureau of Justice Statistics and Census Bureau, I estimate death rates of working-age prisoners and
nonprisoners by sex and race. Incarceration was more detrimental to females in comparison to their male counterparts in the
period covered by this study. White male prisoners had higher death rates than white males who were not in prison. Black male
prisoners, however, consistently exhibited lower death rates than black male nonprisoners did. Additionally, the findings
indicate that while the relative difference in mortality levels of white and black males was quite high outside of prison,
it essentially disappeared in prison. Notably, removing deaths caused by firearms and motor vehicles in the nonprison population
accounted for some of the mortality differential between black prisoners and nonprisoners. The death rates of the other groups
analyzed suggest that prison is an unhealthy environment; yet, prison appears to be a healthier place than the typical environment
of the nonincarcerated black male population. These findings suggest that firearms and motor vehicle accidents do not sufficiently
explain the higher death rates of black males, and they indicate that a lack of basic healthcare may be implicated in the
death rates of black males not incarcerated.
This article extends research on the consequences of parental incarceration for child well-being, the effects of mass imprisonment on black-white inequalities in child well-being, and the factors shaping black-white inequalities in infant mortality by considering the relationship between imprisonment and infant mortality, using individual- and state-level data from the United States, 1990 through 2003. Results using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) show that parental incarceration is associated with elevated early infant mortality risk and that partner violence moderates this relationship. Infants of recently incarcerated fathers who are not abusive have twice the mortality risk of other infants, but there is no association if the father was abusive. Results from state-level analyses show a positive association between the imprisonment rate and the total infant mortality rate, black infant mortality rate, and black-white inequality in the infant mortality rate. Assuming a causal effect, results show that had the imprisonment rate remained at its 1990 level, the 2003 infant mortality rate would have been 3.9 percent lower, black-white inequality in the infant mortality rate 8.8 percent lower. Thus, results imply that imprisonment may have health consequences that extend beyond ever-imprisoned men to their social correlates and that these health spillover effects are not limited to infectious disease.
In response to drastic increases and enduring disparities in American imprisonment, researchers have produced an expansive literature on the effects of mass imprisonment on inequality in America. We discuss this literature in three parts. First, we consider the obstacles to estimating the effects of imprisonment on individuals and to using those estimates to calculate the macrolevel impact of incarceration. Second, we review existing literature on the effect of mass imprisonment on inequalities in health and family life. Finally, we close by suggesting directions for future research.
This article extends research on the consequences of mass imprisonment and the factors shaping population health and health inequalities by considering the associations between imprisonment and population health-measured as life expectancy at birth and the infant mortality rate-and black-white differences in population health using state-level panel data from the United States (N=669), 1980-2004. Results show that imprisonment is significantly associated with poorer population health, though associations between imprisonment and infant mortality and female life expectancy are somewhat more consistently statistically significant than are associations with male life expectancy, and associations are more pronounced and statistically significant for blacks than they are for whites. Results also show, however, that increases in imprisonment are associated with decreases in the mortality rates of young black men. Thus, though imprisonment tends to be associated with higher mortality risk and greater black-white differences in mortality, it may, in the short-run, have some paradoxical mortality benefits for young black men.
This essay provides estimates of the influence of mass imprisonment on racial disparities in childhood well-being. To do so, we integrate results from three existing studies in a novel way. The first two studies use two contemporary, broadly representative data sets to estimate the effects of paternal incarceration on a range of child behavioral and mental health problems. The third study estimates changes in Black–White disparities in the risk of paternal imprisonment across the 1978 and 1990 American birth cohorts. Our research demonstrates the following:
Our results add to a growing research literature indicating that the costs associated with mass imprisonment extend far beyond well-documented impacts on current inmates. The legacy of mass incarceration will be continued and worsening racial disparities in childhood mental health and well-being, educational attainment, and occupational attainment. Moreover, the negative effects of mass imprisonment for childhood well-being are likely to remain, even if incarceration rates returned to pre-1970s levels. Our results show that paternal incarceration exacerbates child behavioral and mental health problems and that large, growing racial disparities in the risk of imprisonment have contributed to significant racial differences in child well-being. The policy implications of our work are as follows:
In the United States, lawbreakers are treated as social isolates, and the sentences imposed upon them are conceived of as affecting a discrete individual. However, people who commit or are suspected of committing crimes are generally embedded in kinship webs and social networks that draw others into the ambit of the state's punishment apparatus. Through their association with someone convicted of a crime, legally innocent people have firsthand and often intense contact with criminal justice authorities and correctional facilities, they experience variants of the direct and indirect consequences of incarceration, and they are confronted by the paradox of a penal state that has become the primary distributor of social services for the poor in the United States. Collectively, studies investigating punishment beyond the offender contribute to the understanding of the wide and multi-faceted impact of punitive sanctions and spotlight the importance of considering this full range of repercussions when evaluating the scope of the nation's policing, judicial, and correctional policies.
Population health tends to be better in societies where income is more equally distributed. Recent evidence suggests that many other social problems, including mental illness, violence, imprisonment, lack of trust, teenage births, obesity, drug abuse, and poor educational performance of schoolchildren, are also more common in more unequal societies. Differences in the prevalence of ill health and social problems between more and less equal societies seem to be large and to extend to the vast majority of the population. Rather than referencing all the literature, this paper attempts to show which interpretations of these relationships are consistent with the research evidence. After discussing their more important and illuminating characteristics, we conclude that these relationships are likely to reflect a sensitivity of health and social problems to the scale of social stratification and status competition, underpinned by societal differences in material inequality.
Several prominent empirical studies estimate models of a constant proportional effect of prison on crime, finding that effect is substantial and negative. A separate literature argues against the crime-reducing effect of prison but mainly on theoretical grounds. This second literature suggests that the elasticity of the prison/crime relationship is not constant. We provide a model that nests these two literatures. Using data from the United States over 30 years, we find strong evidence that the negative relationship between prison and crime becomes less strongly negative as the scale of imprisonment increases. This revisionist model indicates that (1) at low levels of incarceration, a constant elasticity model underestimates the negative relationship between incarceration and crime, and (2) at higher levels of incarceration, the constant elasticity model overstates the negative effect.
These results go beyond the claim of declining marginal returns, instead finding accelerating declining marginal returns. As the prison population continues to increase, albeit at a slower rate, after three decades of phenomenal growth, these findings provide an important caution that for many jurisdictions, the point of accelerating declining marginal returns may have set in. Any policy discussion of the appropriate scale of punishment should be concerned with the empirical impact of this expensive and intrusive government intervention.
There is no scholarly consensus as to the proper functional form of the crime equation, particularly with regard to one critical,
explanatory variable—prison population. The critical questions are whether crime and prison rates must be differenced, whether
they are cointegrated, and whether they are simultaneously determined—whether crime and prison cause one another. To determine
the proper specification, different researchers have applied unit-root, cointegration, and Granger tests to very similar data
sets and obtained very different results. This has led to very different specifications and predictably different implications
for public policy. These differences are more likely to be due to the methods used, rather than to real differences among
the data sets. When the best available methods are used to identify the proper specification for a panel of U.S. states, results
are fairly clear. Crime rates and prison populations are close to unit-root; crime and prison are not cointegrated; crime
clearly affects subsequent prison populations. Thus the best specification of the crime equation must rely on differenced
data and instrumental variables. Alternative specifications run a substantial risk of spurious results.
Most papers that employ Differences-in-Differences estimation (DD) use many years of data and focus on serially correlated outcomes but ignore that the resulting standard errors are inconsistent. To illustrate the severity of this issue, we randomly generate placebo laws in state-level data on female wages from the Current Population Survey. For each law, we use OLS to compute the DD estimate of its "effect" as well as the standard error of this estimate. These conventional DD standard errors severely understate the standard deviation of the estimators: we find an "effect" significant at the 5 percent level for up to 45 percent of the placebo interventions. We use Monte Carlo simulations to investigate how well existing methods help solve this problem. Econometric corrections that place a specific parametric form on the time-series process do not perform well. Bootstrap (taking into account the autocorrelation of the data) works well when the number of states is large enough. Two corrections based on asymptotic approximation of the variance-covariance matrix work well for moderate numbers of states and one correction that collapses the time series information into a "pre"-and "post"-period and explicitly takes into account the effective sample size works well even for small numbers of states.
We compared mortality rates among state prisoners and other state residents to identify prisoners' health care needs.
We linked North Carolina prison records with state death records for 1995-2005 to estimate all-cause and cause-specific death rates among black and white male prisoners ages 20-79 years and used standardized mortality ratios (SMRs) to compare these observed deaths with the expected number on the basis of death rates among state residents.
The all-cause SMR of black prisoners was 0.52 (95% confidence interval, 0.48-0.57), with fewer deaths than expected from accidents, homicides, cardiovascular disease, and cancer. The all-cause SMR of white prisoners was 1.12 (95% confidence interval, 1.01-1.25) with fewer deaths than expected for accidents but more deaths than expected from viral hepatitis, liver disease, cancer, chronic lower respiratory disease, and HIV.
The mortality of black prisoners was lower than that of black state residents for both traumatic and chronic causes of death. The mortality of white prisoners was lower than that of white state residents for accidents but greater for several chronic causes of death. Future studies should investigate the effect of prisoners' preincarceration and in-prison morbidity, the prison environment, and prison health care on prisoners' patterns of mortality.