Examining Racial/Ethnic Disparities in Mortality Associated with the Criminal Justice System

项目总结 刑事司法人口的快速增长对司法具有重要的健康影响-- 涉及个人、他们的家庭和社区，最脆弱的人群面临更大的风险。一个 最近的一项审查发现，与普通人群相比，出狱人员的死亡率更高， 这表明，即使在个人重返社区后，监禁也可能产生持久的后果。 鉴于一些群体(例如非洲裔美国人、土著居民)对健康差距的影响至关重要 与白人相比，美国人的监禁率更高，死亡率更高。然而，我们有 几乎不了解刑事司法暴露会在多大程度上增加死亡风险，以及这是否 少数群体之间的关系更紧密。这项研究将提供严格的准实验 关于刑事司法风险暴露如何影响死亡率和差异的证据 对分配到监狱、监狱、社区监督或释放的被捕者进行的全州范围的人口普查。 我们的研究利用了一项自然政策实验，在有倾向性得分的差异设计中 权重和工具变量与关于犯罪历史和犯罪的罕见全面数据相结合 死亡率。南达科他州2013年公共安全改善法案(以下简称SB70)减少了监禁刑期， 增加对缓刑的分配，将重罪重新归类到较低的严重性级别，并允许那些 社区监督以赚取监督时间的减少。基本上，在SB70事件后被捕的人是 与SB70之前因相同罪行被捕的人相比，受到不同的惩罚和监管，基于 只是在时机上。我们的研究利用这一政策实验来评估所需的外生变异 刑事司法暴露与死亡率之间的关系。一个内在的方面是通过以下方式来评估差异 种族/民族和性别，有一个独特的机会来提供关于美洲原住民的证据。对于这个项目，我们 获得了所有202,594名被捕者(2000-2019年)的犯罪历史数据以及匹配的死亡记录。 总之，这项研究将为被捕者死亡率过高提供亟需的证据 被判入狱、监禁、社区监管或整体和按人口统计群体释放；评估是否 SB70影响了总体和人口群体的死亡风险、时间和原因；最后， 估计刑事司法暴露如何影响总体和以下方面的死亡风险、时间和原因 人口统计组。了解暴露在刑事司法系统中如何影响死亡率 特别是考虑到美国的大规模监禁和各州努力减少其对 预算和社会。刑事司法暴露的差异反映了死亡率的差异，这表明 两种现象可能交织在一起。因此，这项研究不是对SB70的简单评估，而是一种准 对刑事司法暴露对公共卫生和健康差距的影响进行实验性评估。

PROJECT SUMMARY The rapid increase in the criminal justice population has important health implications for justice- involved individuals, their families and communities with the most vulnerable populations at greater risk. A recent review found elevated mortality among those released from prison relative to the general population, suggesting that incarceration may have lasting consequences even after individuals return to the community. The implications for health disparities are crucial given that some groups (e.g. African Americans, Native Americans) have higher rates of incarceration and experience excess mortality relative to Whites. Yet, we have little understanding of the degree to which criminal justice exposure elevates mortality risk and whether this relationship is stronger among minority groups. This study will provide rigorous quasi-experimental evidence on how criminal justice exposure influences mortality and disparities using longitudinal data from a statewide census of arrestees assigned to prison, jail, community supervision, or released. Our study leverages a natural policy experiment in a difference-in-difference design with propensity score weighting and instrumental variables combined with rare comprehensive data on criminal history and mortality. South Dakota's Public Safety Improvement Act of 2013 (hereafter, SB70) reduced prison sentences, increased assignment to probation, re-classified felony offenses to lower severity classes, and allowed those on community supervision to earn reductions in time on supervision. Essentially, those arrested post-SB70 were subject to different penalties and supervision relative to those arrested pre-SB70 for the same offenses, based only on timing. Our study utilizes this policy experiment for the exogenous variation needed to assess the relationship between criminal justice exposure and mortality. An intrinsic aspect is to assess disparities by race/ethnicity and sex with a unique opportunity to provide evidence on Native Americans. For this project, we have obtained criminal history data on all 202,594 arrestees (2000-2019) as well as matched mortality records. In summary, this study will provide much-needed evidence on excess mortality among arrestees sentenced to prison, jail, community supervision or released overall and by demographic group; assess whether SB70 influenced the risk, timing and causes of mortality overall and by demographic group; and finally, estimate how criminal justice exposure influenced the risk, timing and causes of mortality overall and by demographic group. Understanding how exposure to the criminal justice system influences mortality is particularly policy-relevant given the mass incarceration in the US and states' efforts to reduce its impact on budgets and society. Disparities in criminal justice exposure mirror disparities in mortality, suggesting that the two phenomena may be intertwined. Thus, this study is not simply an evaluation of SB70, but rather a quasi- experimental assessment of the impact of criminal justice exposure on public health and health disparities.