VA Connecticut Healthcare System, Department of Internal Medicine, West Haven, Connecticut, USA
National Clinician Scholars Program, Yale University, New Haven, Connecticut, USA.
J Epidemiol Community Health. 2021 Oct;75(10):1019-1022. doi: 10.1136/jech-2020-216077. Epub 2021 Apr 27.
Jail incarceration rates are positively associated with mortality at the county level. However, incarceration rates vary within counties, limiting the generalisability of this finding to neighbourhoods, where incarceration may have the greatest effects.
We performed a cross-sectional analysis of census tract-level state imprisonment rates in New York State (2010) and life expectancy data from the US Small-area Life Expectancy Estimates Project (2010-2015). We modelled fixed-effects for counties and controlled for tract-level poverty, racial makeup, education, and population density from the American Community Survey (2010-2014), and violent crime data from the New York City Police Department (2010). We also examined interactions between incarceration rate and poverty, racial makeup, and population density on life expectancy.
Life expectancy at the highest quintile of incarceration was 5.5 years lower than in the lowest quintile, and over 2 years lower in a fully-adjusted model. Census tract-level poverty and racial makeup both moderated the association between incarceration and life expectancy.
Census tract-level incarceration is associated with lower life expectancy. Decarceration, including alternatives to incarceration, and release of those currently incarcerated, may help to improve life expectancy at the neighbourhood level.
监狱监禁率与县级死亡率呈正相关。然而,监禁率在县内存在差异,这限制了这一发现对监禁可能产生最大影响的社区的通用性。
我们对纽约州(2010 年)的普查区层面州监禁率和美国小地区预期寿命估计项目(2010-2015 年)的预期寿命数据进行了横断面分析。我们为县建立了固定效应模型,并控制了来自美国社区调查(2010-2014 年)的普查区层面贫困、种族构成、教育和人口密度,以及来自纽约市警察局(2010 年)的暴力犯罪数据。我们还检查了监禁率与贫困、种族构成和人口密度对预期寿命的相互作用。
监禁率最高五分位数的预期寿命比最低五分位数低 5.5 年,在完全调整后的模型中低 2 年以上。普查区层面的贫困和种族构成都调节了监禁与预期寿命之间的关联。
普查区层面的监禁与较低的预期寿命有关。减少监禁,包括替代监禁和释放目前被监禁的人,可能有助于提高社区层面的预期寿命。