Examining the Relationship Between Incarceration and Population Health: The Roles of Region and Urbanicity

Among the myriad collateral consequences of the high level of incarceration in the United States is its detrimental effects on public health. Just as there are geographic variations in level of incarceration within the United States, so too are there variations in health outcomes. This study examines the relationship between incarceration rates and population health for a national sample of counties from 2015, with a focus on how this relationship is influenced by both region (South vs. non-South) and whether a jurisdiction is rural. To obtain unbiased estimates of the effect of incarceration rates on two alternate health outcomes, it employs two-stage least-squares modeling, which accounts for the endogeneity of incarceration rates when determining their effect on population health. Results indicate that level of incarceration has a detrimental effect on both mortality (i.e., premature death) and morbidity (i.e., self-reported health), and that these effects are more pronounced in rural and Southern counties. Implications of these findings for both policy and research are considered.