Stuck in the cycle? Assessing a reciprocal model of incarceration, health, and relative risk over twenty-five years

Abstract

Purpose: Researchers have chronicled a complex relationship between incarceration exposure and health, yet prior studies do not account for reciprocal dynamics or cycles of reentry over time. Methods: We analyzed bi-directional relationships between incarceration exposure and mental and general health over twenty five years using data from the National Longitudinal Study of Youth - 1997. We employed lagged autoregressive panel and lagged latent growth models to assess between- and within-individual dynamics of incarceration, health, and reentry. We then tested for differences in patterns of incarceration exposure and health among two high relative health risk groups, Black men and those with limited access to health insurance. Results: Symptoms of depression and anxiety predict subsequent incarceration exposure in both between- and within- individual change models. Within-individual change in self-rated general health is positively and reciprocally associated with incarceration exposure. This relationship is substantially greater for Black men and those with limited access to health insurance. Conclusions: The findings underscore key issues of relative health risk that influence the dynamics of incarceration exposure and health inequities. Programmatic efforts to address mental health concerns like depression and anxiety in the community and within correctional settings may be useful in reducing cycles of incarceration.