Self-identified Race and Ethnicity and How this is Perceived: Associations with the Physical and Mental Health of Incarcerated Individuals.

OBJECTIVES: The singular focus on self-identified race and ethnicity in health disparities research may not fully convey the individual and structural components of experiencing race in society, or in a racialized context such as prison. Processes of racialization create boundaries between incarcerated individuals and regulate their daily interactions and access to resources, with possible effects on well-being. However, the relationship between perceived race and health has not been examined within the imprisoned population. DESIGN: We used data from the 2016 Survey of Prison Inmates (n = 23,010) to assess how self-identified race, perceived race, and the discordance between racial self-identification and perception were associated with the physical (number of chronic conditions) and mental health (psychological distress) of American Indian and Alaska Native, Asian, Black, Latino, White, and multiracial incarcerated individuals. RESULTS: Reported perception as Latino was associated with better mental and physical health relative to perception as White. Perceived Latino identity was more strongly associated with physical and mental health than a Latino self-identity. Reported perception as Black was associated with less psychological distress than perception as White, but this relationship dissipated after accounting for self-identified race. In contrast, perceived and self-identified multiracial incarcerated individuals reported worse health than their White counterparts. Having a discordant (vs. concordant) racial identity was associated with worse physical and mental health among imprisoned persons regardless of race. CONCLUSION: The use of a single, unidimensional measure of race and ethnicity in health disparities research does not fully reveal racialization's influence on health, specifically for those experiencing incarceration.

Does the immigrant health advantage extend to incarcerated immigrants?

•Existing immigrant health research does not include institutionalized populations.•The immigrant health advantage does not extend to all incarcerated immigrant groups.•Differences in health exist by race/ethnicity, U.S. citizenship, and health outcome.•The incarcerated immigrant population has unique health profiles and needs.

Structural Inequality and COVID-19 Mortality in Chicago: An Ecological Analysis.

BACKGROUND: Prior studies establish that Black neighborhoods and older persons experience higher rates of COVID-19 death than white neighborhoods and younger persons. However, such works point to the effect of age on COVID-19 mortality and the racial and ethnic inequalities present in COVID-19 deaths as independent vectors of inequality, neglecting to consider the multiplicative impact of structural conditions. METHODS: Using weekly ZIP code counts of deaths from March 2020 through July 2021 from the Chicago Department of Public Health (n = 4168) and measures of structural characteristics derived from the 5-year estimates of the 2019 American Community Survey, the current study examined how place, racial composition, and the age structure of communities act in tandem to shape the number of deaths due to COVID-19. We used STATA to estimate negative binomial models predictive of COVID-19 mortality. RESULTS: Findings from our statistical analysis revealed that in predominately Black neighborhoods, racial composition amplified the association of age structure (65 +) on COVID-19 mortality by 40%. Neighborhoods that were not predominately black did not show this multiplicative risk of death. Our findings underscore that the elevated risk of death in in older Black communities is attributed to historic and contemporary structural inequality. CONCLUSIONS: Although society typically frames pandemics as natural disasters, doing such undermines dimensions of marginalization that amplify vulnerability among select populations. To begin eliminating such inequalities, the USA must deal with the entrenched limitations of institutions that render unequal attention and care to sectors of its population.

Risk and implications of COVID-19 among the community supervised population.

RESEARCH SUMMARY: Despite growing national awareness that COVID-19 in jails and prisons constitutes a public health emergency in the United States, remarkably little attention has been paid to understanding how the virus affects people under community supervision. We used data from the National Survey on Drug Use and Health (NSDUH) to explore differences in the extent to which men under community supervision are vulnerable to COVID-19 and have access to care during the pandemic, relative to men who are not involved with the U.S. criminal legal system. Results from this study highlight the greater levels of risk for serious illness or death from COVID-19 and the disproportionate lack of health insurance among men under community supervision. POLICY IMPLICATIONS: Jurisdictions across the United States are currently relying on decarceration to contain the spread of COVID-19 in jails and prisons. Decarceration efforts alone, however, are insufficient for addressing the spread of COVID-19 among people involved with the U.S. criminal legal system. People released from jails and prisons or diverted from incarceration during the pandemic must be given the opportunity to receive the COVID-19 vaccination upon their transitions. Likewise, individuals under community supervision must be prioritized for immediate vaccination against COVID-19. People involved with the U.S. criminal legal system should also be eligible for emergency Medicaid during the COVID-19 crisis, and their health insurance coverage should remain available beyond the pandemic.

Examining Ethnic Variation in Life Expectancy Among Asians in the United States, 2012-2016.

As the fastest growing racial group in the United States, understanding the health patterns of Asians is important to addressing health gaps in American society. Most studies have not considered the unique experiences of the ethnic groups contained in the Asian racial group, implying that Asians have a shared story. However, we should expect differences between the ethnic groups given the differences in their timing and place of migration, socioeconomic status, and racialized experiences in the United States. We estimate the life expectancy of the six largest Asian ethnic groups-Chinese, Asian Indians, Filipinos, Vietnamese, Koreans, and Japanese-analyzing data from the Multiple Cause of Death File (2012-2016) and the American Community Survey (2012-2016) in the United States at the national and regional levels. Nationally, Chinese had the highest life expectancy (males e0 = 86.8; females e0 = 91.3), followed by Asian Indians, Koreans, Japanese, Filipinos, and Vietnamese, generally reflecting the pattern expected given their educational attainment, our primary indicator of socioeconomic status. We also found regional differences in life expectancy, where life expectancy for Asians in the West was significantly lower than all other regions. These findings suggest the presence of underlying selection effects associated with settlement patterns among new and traditional destinations. Our results underline the necessity of studying the experiences of the different Asian ethnic groups in the United States, permitting a better assessment of the varying health needs within this diverse racial group.

Imprisoned by Empathy: Familial Incarceration and Psychological Distress among African American Men in the National Survey of American Life.

The stress process model predicts that current incarceration of a family member should damage the health status of the inmate's relatives. We address this prediction with data from the National Survey of American Life, focusing exclusively on African American men (n = 1,168). In survey-adjusted generalized linear models, we find that familial incarceration increases psychological distress, but its effect attenuates ostensibly after controlling for other chronic strains. Familial incarceration remains statistically insignificant with the introduction of mastery and family emotional support and their respective interactions with familial incarceration. However, a statistical interaction between familial incarceration and former incarceration reveals that levels of psychological distress are significantly higher among never-incarcerated respondents whose family members are incarcerated but significantly lower among formerly incarcerated respondents whose family members are incarcerated. We conclude that familial incarceration's influence on black men's mental health status may be more complex than extant theory predicts.

Placing a Health Equity Lens on Non-communicable Diseases in sub-Saharan Africa.

Deaths from non-communicable diseases are increasing worldwide. Low and middle-income countries, particularly those in sub-Saharan Africa (SSA), are projected to see the most rapid increase over the next two decades. While non-communicable diseases such as diabetes and cardiovascular disease increasingly contribute to mortality in SSA, communicable diseases such as malaria and HIV/AIDS remain major causes of death in this region, leading to a double burden of disease. In this paper, we use World Health Organization data and life table techniques to: (1) delineate the magnitude and toll of the double burden of disease in four SSA countries: Ghana, Gabon, Botswana, and Kenya, and (2) scrutinize assumptions linking changes in disease patterns to economic development and modernization. Our findings suggest that non-communicable and communicable diseases warrant equal research attention and financial commitment in pursuit of health equity.

Mass imprisonment and the life course revisited: Cumulative years spent imprisoned and marked for working-age black and white men.

Over the last 40 years, imprisonment has become a common stage in the life-course for low-skilled and minority men, with implications not only for inequality among adult men but also for inequality more broadly. Unfortunately, all research documenting how increases in imprisonment have transformed the life-course of poor, minority men has neglected to estimate how much time black and white men on average spend imprisoned or marked as an ex-prisoner. In this article, we fill this gap by using multistate life tables to estimate what share of their working lives (18-64) black and white men will spend imprisoned and marked as ex-prisoners. Our estimates imply that white men spend on average 0.33 years of their working lives imprisoned and 2.31 years marked, while black men spend on average 1.79 years of their working lives imprisoned and 11.14 years marked. This implies that black men spend on average one-third of their working lives either imprisoned or having been freed but marked by the penal system. For the 32.2% of black men who ever experience imprisonment (Bonczar, 2003), moreover, these estimates imply that they spend on average 5.56 years imprisoned, corresponding to 13.4% of their working lives. Taken together, these findings imply a dramatic reorientation of the life course for black men, as one-third of the black male population will spend one-seventh of their working life in prison.

The dose-response of time served in prison on mortality: New York State, 1989-2003.

OBJECTIVES: I investigated the differential impact of the dose-response of length of stay on postprison mortality among parolees. METHODS: Using 1989-2003 New York State parole administrative data from the Bureau of Justice Statistics on state correctional facilities, I employed multinomial logistic regression analyses and formal demographic techniques that used the life table of the populations to deduce changes in life expectancy. RESULTS: Each additional year in prison produced a 15.6% increase in the odds of death for parolees, which translated to a 2-year decline in life expectancy for each year served in prison. The risk was highest upon release from prison and declined over time. The time to recovery, or the lowest risk level, was approximately two thirds of the time served in prison. CONCLUSIONS: Incarceration reduces life span. Future research should investigate the pathways to this higher mortality and the possibilities of recovery.

Incarcerating death: mortality in U.S. state correctional facilities, 1985-1998.

Using data from the U.S. Bureau of Justice Statistics and Census Bureau, I estimate death rates of working-age prisoners and nonprisoners by sex and race. Incarceration was more detrimental to females in comparison to their male counterparts in the period covered by this study. White male prisoners had higher death rates than white males who were not in prison. Black male prisoners, however consistently exhibited lower death rates than black male nonprisoners did. Additionally, the findings indicate that while the relative difference in mortality levels of white and black males was quite high outside ofprison, it essentially disappeared in prison. Notably, removing deaths caused by firearms and motor vehicles in the nonprison population accounted for some of the mortality differential between black prisoners and nonprisoners. The death rates of the other groups analyzed suggest that prison is an unhealthy environment; yet, prison appears to be a healthier place than the typical environment of the nonincarcerated black male population. These findings suggest that firearms and motor vehicle accidents do not sufficiently explain the higher death rates of black males, and they indicate that a lack of basic healthcare may be implicated in the death rates of black males not incarcerated.