From the American Journal of Public Health study County Jail Incarceration Rates and County Mortality Rates in the United States, 1987–2016:
Mass incarceration is hypothesized to have collateral health consequences not only for incarcerated individuals1–3 but also for their families and communities.4–10 This phenomenon is often described as a “spillover” effect of mass incarceration.10 For example, incarceration of a family member has adverse intergenerational health consequences, including a high risk of learning disabilities, mental health conditions, behavioral problems, and developmental delays in children.4,5 Women with incarcerated partners have elevated rates of cardiovascular risk factors, anxiety, depression, and overall poor health.6–8 Furthermore, given the extensively documented structural racism inherent in and reproduced by mass incarceration,11 its collateral consequences contribute to and exacerbate racialized health inequities. Most research concerning the spillover effects of mass incarceration defines incarceration as an individual-level exposure.4–9
Few studies consider incarceration as a community-level contextual exposure, but there are strong theoretical reasons to do so. Multiple pathways link incarceration to negative health effects that operate at the community level through the destruction of community social and economic resources.2 The cycle of imprisonment and reentry disrupts local economies and housing markets and increases the strain on social service systems.12–14 Furthermore, incarceration impedes social integration, an important community-level protective factor against morbidity and mortality.2 As mass incarceration erodes these crucial social and economic resources, it threatens the ability of communities to collectively build safe and healthy environments.15 Jail incarceration, in particular, threatens social ties and local economies through what has been described as“coercive mobility,” or the disruptive effects of individuals cycling in and out of the criminal justice system.15,16
Emerging empirical literature supports the hypothesis that community-level exposure to high incarceration rates affects community health. Living in a community with high incarceration rates is associated with a higher risk of cardiometabolic disease, major depressive disorder, and generalized anxiety disorder, after adjusting for community level risk factors such as poverty and crime rates.10,17 However, studies have been conducted primarily among local samples using cross-sectional data, with the exception of a recent study examining the association between incarceration and drug-related mortality nationally.18 We build on the literature and address previous study design limitations; our study is among the first, to our knowledge, to analyze the association between jail incarceration as a contextual exposure and an essential indicator of county health— mortality—drawing on a longitudinal national data set. Continue reading >>>
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