102 Mass incarceration spillover effects: Exploring neighborhood premature mortality through demographic subgroups and spatial relationships

Objectives/Goals: Mass incarceration, i.e., extremely high rates of incarceration concentrated in impoverished racially segregated communities, is associated with poor neighborhood health, but it is unclear if this is due solely to formerly incarcerated individuals. We examine these population health effects through neighborhood premature mortality rates. Methods/Study Population: We calculated census tract-level overall, gender-, and race-specific age-adjusted premature mortality rates using mortality data (2010-2014) from the New York City Department of Health. We excluded tracts with subgroup population <800. Exposure was the NY State imprisonment rate (2010), modeled as quintiles. As covariates, we included % non-Hispanic Black; poverty, education, and violent crime rates; and population density. We used GLM regression models with the census tract as the unit of analysis. To test if spatial clustering of incarceration (i.e., high-incarceration census tracts surrounded by high-incarceration census tracts) was associated with premature mortality rate independent of covariates and tract incarceration rate, we used LISA cluster values and proximity to high-high clusters. Results/Anticipated Results: Across 1985 tracts, incarceration rate ranged from a median of 19 (quintile 1) to 698 (quintile 5) per 100,000 people. In unadjusted models, neighborhoods in Q5 of incarceration rate had 2.4x higher rate ratios of premature mortality versus Q1. In fully adjusted models, Q5 tracts had 62% higher rate ratios (aOR 1.62, 95% CI 1.50-1.75; P<0.001), sex-specific findings were similar for males and females, Black and Hispanic (aOR 1.36; 95% CI 1.04-1.78 and aOR 1.49, 95% CI 1.24-1.79, specifically) rate ratios were both P<0.001 but Asian and White were NS. Being in a high-high cluster was significantly associated with premature mortality independent of covariates and tract incarceration rate (aOR 1.13, 95% CI 1.06-1.20), whereas low-low clusters were protective (aOR 0.90, 95% CI 0.85-0.94), both P<0.001. Discussion/Significance of Impact: Premature mortality rates are substantially higher in high-incarceration neighborhoods even accounting for confounders. Sex-specific findings suggest spillover to never-incarcerated people, and race-specific findings suggest concentration in social networks of the incarcerated. Spatial analyses suggest true neighborhood-level effects.