Incarceration rates and hospital beds per capita: A cross-national study of 36 countries, 1971-2015.

RATIONALE: Incarceration carries several negative ramifications for population health, while diverting scarce resources from other public goods. At a time when health care systems around the world are strained, the current study investigates the long-term relationship between incarceration and health care infrastructure. OBJECTIVE: We investigated the longitudinal association between incarceration rates and hospital beds per capita for 36 countries between 1971 and 2015. METHOD: Fixed effects regression analyses were employed to examine the effect of within-country changes in incarceration rates on hospital beds per capita. RESULTS: Findings demonstrated that increases in national incarceration rates over time were associated with declines in hospital beds per capita, net of controls for socio-demographic and economic factors. CONCLUSIONS: Increased incarceration negatively impacts hospital bed availability at the cross-national level.

The contribution of age structure to the international homicide decline.

BACKGROUND: Since 1990, the world's homicide rate has declined by nearly 20%. While prior research has documented parallel homicide declines across many individual countries, the causes of a shared international homicide decline remain unknown. Drawing on a worldwide process of population ageing, and on research linking age to criminal activity, this study investigates the contribution of global demographic shifts to the international homicide decline. METHODS: We draw from (1) a High Coverage Sample of 126 countries since 1990, and (2) a Long Series Sample of 26 countries since 1960 and utilize fixed-effect regressions to evaluate the impact of age structure on homicide trends. In addition, we use a quantile regression to explore variations in the relationship between age structure and homicide conditional on homicide levels. FINDINGS: Results using the High Coverage Sample suggest no relationship between age structure and homicide. However, results from the Long Series Sample suggest that changes in the relative size of countries' youth population is a major predictor of homicide trends since 1960. In exploring this divergence, we find that the influence of age structure on homicide becomes less evident as other risk factors for violence gain prominence. Thus, while high homicide countries had the most to gain from falling homicide rates, the safety benefits of an ageing population have been concentrated among the least violent countries. INTERPRETATION: While the homicide declines of individual countries have often been attributed to domestic policies, the universality of international homicide trends suggests the influence of broader global phenomenon. We find that countries' homicide trends are strongly associated with changes in the size of their youth populations, particularly where there are few competing criminogenic forces. Based on these results, we propose an explanation for the international homicide decline, while highlighting the importance of demographic patterns in explaining homicide trends.