Association between county jail incarceration and cause-specific county mortality in the USA, 1987-2017: a retrospective, longitudinal study.
Association between county jail incarceration and cause-specific county mortality in the USA, 1987-2017: a retrospective, longitudinal study.
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DOI：
10.1016/s2468-2667(20)30283-8
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发表时间：
2021-04
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影响因子：
--
通讯作者：
Prins SJ
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文献类型：
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作者：
Kajeepeta S;Mauro PM;Keyes KM;El-Sayed AM;Rutherford CG;Prins SJ
大规模监禁对社区卫生产生附带影响，这反映在县级卫生指标中，包括县死亡率。在美国，县监狱监禁率与全因死亡率相关。我们评估了导致县级监狱监禁与死亡率之间关系的死亡原因。在这项回顾性纵向研究中，我们使用Vera司法研究所获得的美国1094个县的县监狱监禁数据（1987-2017年）和美国国家生命统计系统获得的县总人口中年龄小于75岁的个体（1988-2018年）的原因特异性死亡率数据，评估了县级监狱监禁率与县级原因特异性死亡率之间的关系。我们拟合了具有县固定效应的9种常见死因（脑血管疾病、慢性下呼吸道疾病、糖尿病、心脏病、传染病、恶性肿瘤、药物使用、自杀和意外伤害）的准泊松模型，控制了所有未测量的稳定县特征和测量的时变混杂因素(县中位年龄、县贫困率、县黑人居民百分比、县犯罪率、县失业率、和州监禁率)。我们将县监狱的监禁率滞后1年来评估短期，滞后5年来评估中期，滞后10年来评估监狱监禁率与过早死亡率的长期关系。县内监禁率每增加1‰，与以下因素相关：传染病死亡率增加6.5%（风险比1.065,95%可信区间1.061 - 1.070）、慢性下呼吸道疾病死亡率增加4.9%（1.049,1.045 - 1.052）、药物使用死亡率增加2.6%（1.026,1.020 - 1.032）、自杀死亡率增加2.5%（1.025,1.020 - 1.029）、心脏病死亡率增加较小（1.021,1.019 - 1.023）。1年后意外伤害（1.015、1.011 - 1.018）、恶性肿瘤（1.014、1.013 - 1.016）、糖尿病（1.013、1.09 - 1.018）、脑血管疾病（1.010、1.007 - 1.013）。监禁与特定原因死亡率之间的联系随着时间滞后的增加而减弱，但与潜伏期一般较短的死亡原因（传染病和自杀）相比，潜伏期一般较长的死亡原因（心脏病、恶性肿瘤和脑血管疾病）之间的联系更大。监禁率是美国许多死亡原因的潜在驱动因素。监禁不仅对被监禁者的健康有害，而且对更广泛的公共卫生有害。我们的研究结果提出了重要的干预措施，包括从医疗系统中撤资，并投资于社会和公共卫生服务，如以社区为基础的药物使用障碍治疗。
Mass incarceration has collateral consequences for community health, which are reflected in county-level health indicators, including county mortality rates. County jail incarceration rates are associated with all-cause mortality rates in the USA. We assessed the causes of death that drive the relationship between county-level jail incarceration and mortality. In this retrospective, longitudinal study, we assessed the association between county-level jail incarceration rates and county-level cause-specific mortality using county jail incarceration data (1987–2017) for 1094 counties in the USA obtained from the Vera Institute of Justice and cause-specific mortality data for individuals younger than 75 years in the total county population (1988–2018) obtained from the US National Vital Statistics System. We fitted quasi-Poisson models for nine common causes of death (cerebrovascular disease, chronic lower respiratory disease, diabetes, heart disease, infectious disease, malignant neoplasm, substance use, suicide, and unintentional injury) with county fixed effects, controlling for all unmeasured stable county characteristics and measured time-varying confounders (county median age, county poverty rate, county percentage of Black residents, county crime rate, county unemployment rate, and state incarceration rate). We lagged county jail incarceration rates by 1 year to assess the short-term, by 5 years to assess the medium-term, and by 10 years to assess the long-term associations of jail incarceration with premature mortality. A 1 per 1000 within-county increase in jail incarceration rate was associated with a 6·5% increase in mortality from infectious diseases (risk ratio 1·065, 95% CI 1·061–1·070), a 4·9% increase in mortality from chronic lower respiratory disease (1·049, 1·045–1·052), a 2·6% increase in mortality induced from substance use (1·026, 1·020–1·032), a 2·5% increase in suicide mortality (1·025, 1·020–1·029), and smaller increases in mortality from heart disease (1·021, 1·019–1·023), unintentional injury (1·015, 1·011–1·018), malignant neoplasm (1·014, 1·013–1·016), diabetes (1·013, 1·009–1·018), and cerebrovascular disease (1·010, 1·007–1·013) after 1 year. Associations between jail incarceration and cause-specific mortality rates weakened as time lags increased, but to a greater extent for causes of death with generally shorter latency periods (infectious disease and suicide) than for those with generally longer latency periods (heart disease, malignant neoplasm, and cerebrovascular disease). Jail incarceration rates are potential drivers of many causes of death in US counties. Jail incarceration can be harmful not only to the health of individuals who are incarcerated, but also to public health more broadly. Our findings suggest important points of intervention, including disinvestment from carceral systems and investment in social and public health services, such as community-based treatment of substance-use disorders.