The Health Consequences of Governing Through Criminal Legal Institutions

• In Event: Sociology of Population Section Roundtables
  In Refereed Roundtable (60 minute): Table 1. Health Disparities

Abstract

Research links conservative policy regimes, structural racism, and limited welfare provision to the poor health performance of the United States compared to other high-income democracies. By contrast, a defining feature of the American state, the dramatic expansion of the criminal legal system, has not been examined as a population health determinant. I address this gap by assessing whether the share of state budgets devoted to policing, jails, prisons, probation, and parole is associated with mortality across U.S. states from 1985 to 2016, using two-way fixed-effects models. I also assess whether fiscal trade-offs between criminal legal spending and three core social domains —education, welfare, and health— predict mortality, examining whether shifts in state priorities away from social investment constitute a pathway linking penal expansion to health. My analysis yields four findings. (1) Within states, increases in the share of spending devoted to criminal legal institutions are associated with higher age-adjusted mortality among White and Black groups. (2) The associations emerge over time, consistent with the idea that penal expansion impacts population health through gradual institutional processes. (3) Among fiscal trade-offs, only reallocation from education to criminal legal spending is consistently associated with higher mortality. (4) Socioeconomic conditions play a role in explaining the harmful effects of criminal legal spending. These findings suggest that criminal legal expansion operates as a macro-level determinant of population health. Fiscal trade-offs that favor criminal legal spending over educational investment may constitute a key pathway linking penal expansion to mortality.

Author

• Paola Langer, Princeton University