Incarceration exposure is associated with early mortality. Research documents a dose-response association such that more time served in prison corresponds to greater reductions in life span. Mortality excesses associated with incarceration translate to losses of life expectancy of 4 to 5 years, or roughly 13% of the average US life expectancy at the age of 45 years. Numerous mechanisms have been shown to link incarceration to early mortality, including greater risk for violent victimization and homicide, substance use and overdose, and higher incidence of chronic and infectious disease.
A smaller body of research documents the association of incarceration exposure with early mortality specifically among youths, legally defined as children younger than 18 years. Youths with a history of incarceration have an all-cause mortality rate roughly 5.9 times higher than observed in nonincarcerated Medicaid-enrolled youths of the same age, associated largely with exposure to violence and homicide victimization. Incarcerated youths face greater risk for early death than nonincarcerated youths as involvement in the criminal legal system becomes more protracted and severe. Youths who are incarcerated experience health challenges related to dental care, sexual and reproductive health, risk-taking behaviors, and mental well-being that heighten the likelihood of early death.
In most US states, youths can be transferred and sentenced in adult court, resulting in detention in adult prison facilities. Incarceration in juvenile vs adult correctional facilities represents vastly different experiences. Adult facilities are often much larger, have higher resident to staff ratios, and place less emphasis on treatment, counseling, and education. Even though only approximately 1% of formally processed juvenile delinquency cases are transferred to an adult criminal court, research documents serious extralegal consequences for youths incarcerated in adult facilities. Youths incarcerated in adult facilities report substantially greater rates of post-traumatic stress disorder and depression compared with those in juvenile facilities. In Texas, youths in adult facilities reported more distress and higher rates of psychiatric symptoms than those in juvenile centers. Most salient to the present study, researchers have observed that detention in jail and transfer to adult court were associated with early mortality among a sample of youths in Indiana.
Young people housed in adult correctional facilities report being more afraid for their safety. Youths incarcerated in adult facilities are more likely to engage with antisocial adult peers in prison environments, exposing them to greater risk for sexual and physical assault. Youths in adult facilities often struggle to adjust to prison life and display heightened rates of disciplinary misconduct and violence, which can lead to further isolation and loss of socialization during critical developmental periods. Incarceration among adults is likely to have damaging iatrogenic effects for youths as a result of more harmful exposures in prison and disruption to key social, psychological, and developmental processes. Poorer mental and physical health, greater risk for violence and victimization, and higher engagement in risky behaviors, such as substance abuse, may be associated with early mortality after release for those who have been incarcerated as a youth in an adult facility.
Read the study at JAMA Network
