A stint behind bars can significantly shorten the life expectancy of Black Americans, but not their white counterparts, new research has found.
Black Americans who have spent time in jail or prison are 65% more likely to die prematurely, even if it's been years since their incarceration, according to an analysis of data from a decades-long federal study.
However, jail time did not appear to have any meaningful impact on the long-term health of white former inmates, researchers recently reported in the journal JAMA Network Open.
"That is on top of the fact that Black individuals are much more likely to become incarcerated in the first place than white individuals," said lead researcher Dr. Benjamin Bovell-Ammon, a visiting fellow in general internal medicine at Boston Medical Center.
"Those two factors combined suggest to us that mass incarceration could be contributing to the overall disparities in life expectancy that we see between Black and white individuals," he added.
The United States puts more people behind bars than any country in the world, with its incarcerated population quadrupling over the last four decades, researchers said in background notes.
Black people and those in other minority groups have been disproportionately affected by mass incarceration, with a stint in prison during young adulthood as common among Black men as college graduation is for white men, the researchers said.
Previous studies have suggested that jail time itself might be harmful to people's long-term health. To examine that possibility, Bovell-Ammon's team analyzed data from the National Longitudinal Survey of Youth, a study run by the U.S. Bureau of Labor Statistics (BLS) since 1979.
The BLS study recruited more than 7,900 people between 15 and 22 years of age in 1979 and followed them through 2018. About half were male, and 38% were Black.
"This is the first generation of Americans coming of age in what many call the era of mass incarceration, which started to take off in the '80s," Bovell-Ammon said. "These individuals would be approaching 60 years of age, so any deaths that have occurred are by definition premature."
During an average follow-up of 35 years, 478 people had been jailed at least once and 818 had died. The BLS data did not track how long each person spent behind bars or their cause of death, Bovell-Ammon said.
Black people had a higher death rate after they'd spent time imprisoned, the researchers found. On the other hand, white former inmates lived as long as they would have otherwise.
The way prisons are run could have something to do with this increased rate of death, said Bryan Sykes, an assistant professor of criminology, law and society at the University of California-Irvine.
Solitary confinement has been shown to harm a person's long-term health, and simply being housed with so many others in close quarters increases the spread of infectious diseases, said Sykes, who co-wrote an editorial accompanying the study. Prison food is lousy and meager, often prompting inmates to load up on unhealthy junk food from the commissary.
Inmates in poor health also can expect to receive poor medical care, Sykes added.
Prisons "tend to be highly inequipped -- the medical personnel and medical expertise, even just medical supplies -- to deal with immediate health concerns while incarcerated," Sykes said. "For some inmates, they have to wait considerable lengths of time before they can even see a medical professional because sometimes the medical professional comes once a week."
Bovell-Ammon suspects that the stress Black convicts face upon their release from confinement probably has even more to do with their long-term health than their treatment behind bars.
"When applicants are applying for jobs, a white individual with a criminal record is more likely to get a call back than a Black individual without a criminal record," he said. "Blacks already face limited opportunities that get even worse after spending time in prison and carrying a criminal record."
Black people re-entering society after serving their time also must deal with disruptions in their social networks, educational opportunities and ability to access programs like low-income housing and food stamps, Bovell-Ammon said.
Further, Black people are less likely to have enough money on hand or enough connections to successfully pick themselves up and become a productive member of society, compared with white people, he said.
"If you or your family have some sort of cushion of wealth to fall back on or a family or social network where there is access to opportunity, there's just much more opportunity to bounce back from a setback like incarceration," Bovell-Ammon said.
Criminal justice reform is needed to protect non-violent offenders against these long-term health effects, Bovell-Ammon and Sykes said.
Policymakers and legislators need to "review whether or not all the people who are in confinement actually need to be in confinement, because there are other diversionary options than incarcerating them in a local jail or a state prison," Sykes said.
Bovell-Ammon agreed that these findings should prompt the public and policymakers to think more critically about public safety and what it means.
"If our policies to address crime and to try and promote safety are actually reducing the health and safety of some individuals, are there ways to address crime that don't disproportionately cause undue harm to various communities, particularly communities that are already marginalized?" Bovell-Ammon asked.
Health Affairs has more about incarceration and health.
SOURCES: Benjamin Bovell-Ammon, MD, MPH, visiting fellow, general internal medicine, Boston Medical Center; Bryan Sykes, PhD, MA, assistant professor, criminology, law and society, University of California-Irvine; JAMA Network Open, Dec. 23, 2021