It’s widely accepted that incarceration—with its inherent violence, poor medical care, inadequate nutrition and exposure to infectious diseases— can be a life-threatening experience for anyone who’s forced to endure it. But a new study says incarceration has a long-term impact on mortality, as well—especially on males—that makes them more than twice as likely to suffer a premature death after they've been released from prison.
The study, published online in May 2014 in the Journal of Health and Social Behavior by Georgia State University criminologist William Pridemore, says that the causes of this "mortality penalty" include increased exposure to diseases like tuberculosis, hepatitis and HIV, but also factors related to stress and the loss of familial bonds that have been rarely considered before in terms of the health of ex-convicts.
"Earlier research looked at the collateral consequences of mass imprisonment that started in the 1970s, when the U.S. went on an incarceration binge," Pridemore writes. "Most focused on incarceration's limits on job prospects and earnings, marriages and its impact on communities. Now research is turning to its impact on health."
Pridemore's study used data from a Russian study of families in the city of Izhevsk, examining deaths of males aged 25 to 54, who had a prevalence of incarceration. Rates of incarceration in Russia and the U.S. are among the highest in the world, with Russia imprisoning 519 per 100,000 residents and the U.S. imprisoning 730 per 100,000 residents.
Both countries have resorted to mass-incarceration, Pridemore notes, "without concomitant structures to reintegrate inmates back into society or to mitigate the impact of incarceration on other negative outcomes."
According to Bureau of Justice Statistics data, about 1 in 10 male state prisoners in the U.S. has a confirmed case of tuberculosis, while about 5% have hepatitis, and another 1.5% of both state and federal prisoners are HIV-positive.
"Inmates are not only disproportionately exposed to infectious diseases," Pridemore writes, "but exposure occurs in an environment where group quarters and prison culture create efficient conditions for disease transmission, including overcrowding, poor health care, poor nutrition, and a host of risky behaviors like sharing hygienic facilities and personal hygiene items, amateur tattooing and piercing, practicing unprotected sex, and using unsterilized drug injection equipment."
But just as harmful to a prisoner's overall health—especially on his longevity—is stress, which "can weaken immune systems," Pridemore notes.
The shock of incarceration, as other studies have noted, can be just as traumatic, if not more so, as marital separation or the death of a close family member. And, according to Pridemore, incarceration "is both an acute and an enduring stressor."
"One element of incarceration's enduring nature is that it is not an isolated event but can last for years, thereby presenting chronic stress on top of the initial shock," Pridemore says.
Some of the "ongoing consequences" of incarceration, according to Pridemore, are poor job prospects, less earnings, family problems and social stigma. A "simple yet often overlooked fact," he says, "is that ex-inmates' employment opportunities are often limited to jobs that do not provide health insurance," thereby diminishing access to adequate medical care.
Since other studies have shown that men in committed relationships, including marriage, live longer lives, Pridemore also notes the negative effects incarceration has on maintaining stable relationships after one's release.
"Being in prison imposes a separation—exacerbated because inmates are often institutionalized far from home—that makes it difficult to maintain the friendship and trust required of a stable relationship," he writes. "Similarly, the social and psychological adaptations required for life in prison are not easily discarded upon release, making it difficult to reintegrate and to maintain healthy relationships with family and friends.
"Following release," Pridemore says, "the stigma of incarceration and the inability to provide for one's family due to the employment effects of prison make an ex-inmate less desirable as a mate. These effects are manifested in lower marriage and higher divorce rates among formerly incarcerated men."
All of these negative byproducts of incarceration on ex-prisoners made them "more than twice as likely to die prematurely," according to Pridemore, and the risk of death is "heightened further by incarceration within the past year."
"In light of the collateral consequences of mass imprisonment to individuals, communities, and society," Pridemore concludes, "the size and the mission of the penal system require fundamental reconsideration. The mortality penalty of incarceration should be part of the debate."
Source: ”The Mortality Penalty of Incarceration: Evidence from a Population- based Case-control Study of Working Age Males," by William Alex Pridemore, Georgia State University, the Journal of Health and Social Behavior May 2014; www.jhsb.sagepub.com
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