Incarceration and mortality in the United States

Elias Nosrati; Jacob Kang-Brown; Michael Ash; Martin McKee; Michael Marmot; Lawrence P King

doi:10.1016/j.ssmph.2021.100827

Incarceration and mortality in the United States

SSM Popul Health. 2021 Jun 1:15:100827. doi: 10.1016/j.ssmph.2021.100827. eCollection 2021 Sep.

Authors

Elias Nosrati¹, Jacob Kang-Brown², Michael Ash³, Martin McKee⁴, Michael Marmot⁵, Lawrence P King³

Affiliations

¹ University of Oxford, Merton College, Merton Street, OX1 4JD, Oxford, UK.
² Vera Institute of Justice, 233 Broadway, 12th Floor, New York, NY, 10279, USA.
³ University of Massachusetts Amherst, Department of Economics, Crotty Hall, 412 North Pleasant Street, University of Massachusetts, Amherst, MA, 01002, USA.
⁴ London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
⁵ Institute of Health Equity, Department for Epidemiology & Public Health, University College London, 1-19, Torrington Place, WC1E 7HB, London, UK.

Abstract

The ongoing COVID-19 pandemic has spotlighted the role of America's overcrowded prisons as vectors of ill health, but robust analyses of the degree to which high rates of incarceration impact population-level health outcomes remain scarce. In this paper, we use county-level panel data from 2927 counties across 43 states between 1983 and 2014 and a novel instrumental variable technique to study the causal effect of penal expansion on age-standardised cause-specific and all-cause mortality rates. We find that higher rates of incarceration have substantively large effects on deaths from communicable, maternal, neonatal, and nutritional diseases in the short and medium term, whilst deaths from non-communicable disease and from all causes combined are impacted in the short, medium, and long run. These findings are further corroborated by a between-unit analysis using coarsened exact matching and a simulation-based regression approach to predicting geographically anchored mortality differences.

Keywords: Incarceration; Instrumental variables; Matching; Mortality.