Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana
Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana
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DOI：
10.1186/s12884-019-2690-z
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发表时间：
2019-12-27
影响因子：
3.1
通讯作者：
Wallace, Maeve
中科院分区：
文献类型：
--
作者：
Dyer, Lauren;Hardeman, Rachel;Wallace, Maeve
背景越来越多的证据开始强调大规模监禁如何影响人口健康的不平等。非西班牙裔黑人受到监禁和刑事执法的影响不成比例，这是带有种族偏见的刑事司法系统的持久遗产，对黑人家庭和社区产生了广泛的健康影响。路易斯安那州一直是全国黑人监禁率最高的州之一。与此同时，人口健康方面的巨大种族差距依然存在。方法我们对2014年路易斯安那州非西班牙裔黑人妇女的所有生育情况进行了横断面分析，以确定黑人人口中教区级别(相当于县)的监禁发生率与不良生育结果之间的关系(N=23,954)。我们将LogPoisson模型与广义估计方程进行拟合，以近似估计早产和低出生体重与监禁四分位数范围增加相关的相对风险，并控制混杂因素。在敏感性分析中，我们还对教区一级的犯罪率指数进行了调整，并分析了回归模型，在回归模型中，白人监禁被用来预测不良生育结果的风险，以便量化大规模监禁对健康的损害程度，而不仅仅是生活在犯罪率较高的地区。结果在不考虑其他因素的情况下，黑人女性早产的风险显著增加3%，且黑人个体的教区水平监禁患病率在四分位数范围内增加。对指数犯罪的流行率进行调整并没有对模型的结果产生实质性的影响。结论由于被关押在路易斯安那州监狱的黑人的流行与估计的早产风险之间存在显著的正相关，大规模监禁可能是路易斯安那州黑人妇女在生殖健康结果方面持续不平等的潜在原因。大规模监禁不仅会产生经济和社会影响，而且还可能对人口健康和健康不平等产生影响，包括在早产和低出生体重方面持续存在种族差距。
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.