Incarceration and mortality in the United States.
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ABSTRACT:
SUBMITTER: Nosrati E
PROVIDER: S-EPMC8193150 | biostudies-literature | 2021 Sep
REPOSITORIES: biostudies-literature
Publications
Incarceration and mortality in the United States.
Nosrati Elias E Kang-Brown Jacob J Ash Michael M McKee Martin M Marmot Michael M King Lawrence P LP
SSM - population health 20210601
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. ...[more]
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Project description:Background and objectivesIncarceration is linked to poor health outcomes across the life course. However, little is known whether and to what extent incarceration histories shape pain in later life. This study examines the relationships between incarceration histories and pain outcomes among middle-aged and older adults in the United States.Research design and methodsData from a nationally representative sample of community-dwelling adults aged 51 and over in the 2012-2018 biennial waves of the U.S. Health and Retirement Study was analyzed to examine how incarceration histories influence older adults' risks of reporting moderate-to-severe pain and pain with physical limitations. We relied on a propensity score matching approach to account for the potential confounding bias. We fit weighted generalized estimating equation models to assess the relationships between incarceration history and pain outcomes. Models were further stratified by gender.ResultsAfter propensity score matching, our sample included 2,516 respondents aged 65 years on average (SD = 8.72), 21% female, and 838 with incarceration histories. Persons with incarceration histories have a greater risk of reporting moderate-to-severe pain (prevalence ratio [PR] = 1.30, 95% confidence Interval [CI]: 1.20, 1.52) and pain with physical limitations (PR = 1.48, 95% CI: 1.30, 1.68) even after adjusting for sociodemographic covariates and early life experiences. In the models stratified by gender, the associations between incarceration histories and incarceration were similar among women and men.Discussion and implicationsIn a nationally representative sample of older adults (with or without incarceration history), our study demonstrates an independent association between a history of incarceration and pain in later life. Our findings highlight the far-reaching impact of incarceration and the need for developing optimal management strategies to reduce the burden of disabling pain. Interventions should prioritize socioeconomically vulnerable groups who may have the least access to pain treatment in later life.
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