Assessing the impact of incarceration and its socio-structural correlates on post-release risk of death

• In Event: Health Criminology Panel: Social-Ecological Consequences of Criminal Legal System Involvement for Health

Abstract

There is a deep body of knowledge relevant to the connection between incarceration and health of individuals. Less is known on the combined impacts of incarceration and socio-structural, community factors and how they may mitigate or exacerbate various health outcomes, including mortality. We utilized data from the Rhode Island Data Ecosystem, a dataset that has linked data across governmental agencies, to assess the degree to which, among people who have been incarcerated, socio-structural factors (e.g., housing services, social benefits) impact risk of death. We used a retrospective cohort study design. The cumulative incidence of death was estimated as a function of structural and healthcare use factors using the cumulative incidence function and hazard ratios (HRs) from Fine-Gray models. Most deaths that occurred during the study period involved substance use. People who had more previous incarcerations had a higher risk of substance use-related death. We found that receiving social benefits and reporting taxable wages or unemployment benefits resulted in a lower risk of substance use-related death. Many structural factors were associated with reduced risk of substance use-related death post-release from incarceration. Attending to the socio-structural factors beyond the carceral experience itself is an important intervention to improve health outcomes after release.

Author

• Lauren Brinkley-Rubinstein, Duke University