Mass Incarceration and Subsequent Preventive Health Care: Mechanisms and Racial/Ethnic Disparities.

Abstract

<i>Objectives.</i> To examine the associations and mechanisms between 2 indicators of mass incarceration and preventive health care use and whether these associations are moderated by race/ethnicity.<i>Methods.</i> We used 1997 to 2015-2016 data from the US National Longitudinal Survey of Youth 1997 (n = 7740) to examine the associations between arrest and incarceration at ages 18 to 27 years and cholesterol, blood sugar, and blood pressure screenings at age 29 years. Explanatory mechanisms included blocked access (health care coverage and medical checkup) and economic (education, employment, and income) factors. We used logistic regression to model main effects.<i>Results.</i> Arrest was associated with lower odds of getting blood cholesterol, blood sugar, and blood pressure tests; incarceration was associated with lower odds of getting cholesterol and blood sugar tests; blocked access and economic factors mediated 42% to 125% of these associations. These associations were mostly consistent across race/ethnicity.<i>Conclusions.</i> Mass incarceration contributes to decreases in preventive health care use, which are explained in part by blocked access and economic factors.<i>Public Health Implications.</i> The decreased use of preventive health care following mass incarceration may increase the prevalence of disease and the associated costs of treatment.