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• LEGAL STUDIES RESEARCH PAPER SERIES •

Research Paper No. 2008-53

Title:

Date: 02-27-2008

Years of Life Lost to Prison: Racial and
Gender Gradients in the United States of
America

Author: Robert S. Hogg, Eric F. Druyts, Scott Burris,
Ernest Drucker and Steffanie A. Strathdee

Cite: Harm Reduction Journal 2008, 5:4 (January 2008)
This paper can be downloaded without charge from the
Social Science Research Network Electronic paper Collection:
http://ssrn.com/abstract=1094043

Harm Reduction Journal
This Provisional PDF corresponds to the article as it appeared upon acceptance. Fully formatted
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Years of life lost to prison: racial and gender gradients in the United States of
America
Harm Reduction Journal 2008, 5:4

doi:10.1186/1477-7517-5-4

Robert S Hogg (rhogg@sfu.ca)
Eric F Druyts (edruyts@cfenet.ubc.ca)
Scott Burris (scott.burris@temple.edu)
Ernest Drucker (drucker@aecom.yu.edu)
Steffanie A Strathdee (sstrathdee@ucsd.edu)

ISSN
Article type

1477-7517
Research

Submission date

18 May 2007

Acceptance date

25 January 2008

Publication date

25 January 2008

Article URL

http://www.harmreductionjournal.com/content/5/1/4

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© 2008 Hogg et al., licensee BioMed Central Ltd.
This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Electronic copy available at: http://ssrn.com/abstract=1094043

Years of life lost to prison: racial and gender
gradients in the United States of America
Robert S. Hogg*1,2,3, Eric F. Druyts2, Scott Burris3, Ernest Drucker5
and Steffanie A. Strathdee3
1

Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia,
Canada; 2British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital,
Vancouver, British Columbia, Canada; 3Division of International Health and Cross
Cultural Medicine, San Diego School of Medicine, University of California, California,
USA; 4Beasley School of Law, Temple University, Philadelphia Pennsylvania, USA;
5
Montefiore Medical Center, New York, New York, USA
*Corresponding author
Robert S. Hogg, PhD
Faculty of Health Sciences
Simon Fraser University
8888 University Drive
Burnaby, British Columbia, CANADA
V5A 1S6
+1 778 782 7629
RSH – rhogg@sfu.ca
EFD – edruyts@cfenet.ubc.ca
SB – scott.burris@temple.edu
ED – emdrucker@earthlink.net
SAS – sstrathdee@ucsd.edu

1
Electronic copy available at: http://ssrn.com/abstract=1094043

Abstract
Background: The United States has the highest rate of imprisonment of any country in
the world. African Americans and Hispanics comprise a disproportionately large share of
the prison population. We applied a “prison life expectancy” to specify differences in
exposure to imprisonment by gender and race at the population level.
Methods: The impact of imprisonment on life expectancy in the United States was
measured for each year from 2000 to 2004, and then averaged. Using the Sullivan
method, prison and prison-free life expectancies were estimated by dividing the years
lived in each age range of the life table into these two states using prevalence of
imprisonment by gender and race.
Results: African American males can expect to spend on average 3.09 years in prison
or jail over their lifetime and Hispanic and Caucasian males can spend on average 1.06
and 0.50 years, respectively. African American females, on the other hand, can expect
to spend on average 0.23 years in these institutions and Hispanic and Caucasian
females can expect to spend on average 0.09 and 0.05 years, respectively. Overall,
African American males, the highest risk group, can expect to spend on average 61.80
times longer in prison or jail as compared to Caucasian women, the lowest risk group.
Conclusion: There are clear gender and racial gradients in life expectancy spent in
prison in the United States. Future research needs to examine how current
imprisonment practice in the United States may influence population health and health
disparities.

2

Introduction
The United States has the highest rate of incarceration in the developed world. Nearing
the end of the 1990s, over two million people were behind bars and another four and half
million people were on probation or parole. The number of people imprisoned almost
doubled in the 1990s, increasing from one in every 218 residents in 1990 to one in every
145 in 2001 [1]. Imprisonment has not been evenly distributed throughout the population.
Prison populations are comprised of disproportionate numbers of African Americans and
Hispanics. The lifetime probability of being imprisoned in 2001 was six times higher for
males than females – 11.3% versus 1.8%. Among males, African Americans have a one
in three chance of being imprisoned during their lifetime, whereas Hispanics and
Caucasians have a one in six and a one in 17 chance, respectively [1,2].

Life expectancy is an essential indicator of population health. It may be refined by
techniques that assess the quality of expected life years, such as the disability-free life
expectancy. The high rate of imprisonment in the United States may translate to a
significant proportion of time being spent in prison, especially for certain sub-groups of
the population. If imprisonment influences life expectancy, time spent in prison becomes
a matter of public health importance. The goal of the present study was to determine the
differences in the number of years of life lost to imprisonment in the United States
population by gender and race.

3

Methods
The number of years of life lost to imprisonment in the United States was measured for
each year from 2000 to 2004, and then averaged for this time period. Population data
were derived from the US Census Bureau, National Population Estimates [3], and the
proportion of the total population imprisoned at mid-year in jails and prisons were
estimated from data obtained from the US Department of Justice for the years 2000 to
2004 [4-8]. Life tables were obtained from US Census Bureau, National Population
Projections [9].

To provide context, rates of imprisonment and person-years of life lost to imprisonment
were first calculated. Rates were calculated for each year, 2000 through 2004, for the
age group 18 to 44 years. Rates of imprisonment in this age group were the average of
the number of persons in prison per 100,000 population. Person-years of life lost to
imprisonment were calculated by multiplying the number of persons imprisoned in a
specific age group by years left to 45 years.

Person years were then totaled for each

gender and racial group and expressed as person years lost per 100,000 population.

The Sullivan method [10] was used to estimate the impact of imprisonment on life
expectancy in the United States. Sullivan’s method involves using the prevalence of
health states at each age in the current population (at a given point of time) to divide the
hypothetical years of life lived by a period life table cohort at different ages into years
with and without disability. In our example, prison (disability) and prison-free life
expectancies were estimated by dividing the years lived in each age range of the life

4

table into these two states using prevalence of imprisonment by gender and race.
These figures were then used to compute the life table value of the total remaining years
of life and the corresponding life expectancy in each state for each age group. Total life
expectancy at birth or any other age group by race and gender was the sum of life
expectancy in the prison and prison-free states.

Results
There was on average 1.75 million persons between the ages of 18 and 44 in prison in
the United States between 2000 and 2004. The vast majority of prisoners over this time
period were male (92.5%). African American males comprised the largest percentage of
the male prison population (45.2%). Caucasian and Hispanic males constituted 34.3%
and 18.4% of the total male prison population, respectively.

Among the female

imprisoned population, Caucasian and African American females comprised the largest
percentages (40.9% and 41.7%, respectively) followed by Hispanic females (14.5%)
(Table 1).

Table 2 shows rates of imprisonment and years of life lost to prison in the United States,
2000-2004, by race and gender, for those aged 18-44. Rates of imprisonment were
consistently highest among African Americans for either gender in all years.

The

average rate of imprisonment for ages 18 to 44 years ranged from 9,800 per 100,000
population in African American males to 165 per 100,000 population in Caucasian
females over the time period. African American males also consistently lost the most
person years of life between 18-44 years due to imprisonment over this time period. The

5

average was nearly 140,000 years of life lost per 100,000 population compared to 1,229
years of life lost per 100,000 population for Caucasian females. In both males and
females, there was a consistently clear gradient with rates for Hispanics being
intermediate between those of African Americans and Caucasians for all years.

Table 3 shows years of life lost to imprisonment in the United States, 2000-2004, by race
and gender. Males spent a greater proportion of their life in prison or jail than females.
Considering either gender, African Americans spent much more of their life imprisoned
than Hispanics and Caucasians.

Based on these data, African American males can

expect to spend on average 3.09 years in prison or jail over their lifetime and Hispanic
and Caucasian males can spend on average 1.06 and 0.50 years, respectively. African
American females, on the other hand, can expect to spend on average 0.23 years in
these institutions and Hispanic and Caucasian females can expect to spend on average
0.09 and 0.05 years, respectively. Overall, African American males, the highest risk
group, can expect to spend on average 61.80 times longer in prison or jail as compared
to Caucasian women, the lowest risk group.

Discussion
Our study contributes to evidence that the burden of imprisonment is not evenly
distributed across gender and race in the United States population. Males spend a
greater proportion of their life in prison or jail than females. Considering either gender,
African Americans spend much more of their life in prison or jail than Hispanics or
Caucasians. The burden, if not the disparity, would be even larger if we considered

6

people confined under the jurisdiction of local authorities and people that were on parole
or probation, since the latter group is currently twice the size of those imprisoned [11].
Furthermore, the percentage of time spent in prison is conservative in our study because
the estimate of life expectancy is from birth, even though most people who are
imprisoned are between 18 and 44 years of age.

Although data are limited, there is a growing concern that imprisonment can have
serious negative health consequences [12,13]. Prison populations exhibit an elevated
prevalence of communicable disease [14]. High levels of violence, including sexual
violence, have been reported among imprisoned populations [15,16]. Consensual sex
without condoms as well as drug injection and tattooing without sterile equipment are
reported to occur at dangerous levels and to result in transmission of diseases, such as
HIV [12,17-21]. Additionally, imprisonment may have life altering health consequences
mediated by factors such as a decline in socio-economic status [22].

Our findings, and the growing literature on the negative health consequences of
imprisonment, suggest that the extensive reliance on incarceration to control behavior in
the United States has social costs that have not been fully recognized [22]. These social
costs are not evenly distributed and may be contributing to population health disparities
[23]. These health consequences may be reduced to some degree by making prisons
more salubrious—by introducing better health, addiction treatment and mental health
care, distributing condoms and needles, preventing violence and coordinating services
as inmates move back into the community [12]. The most direct way to reduce these

7

consequences would be to reduce the number of people who go to prison. One way to
accomplish this would be by reducing the number of behaviors subject to imprisonment.
Because laws criminalizing drug possession are the major driver of the imprisonment of
the non-violent offenders in the United States, changes in these laws could be expected
to have a significant impact. Other steps would include investing more in drug treatment,
mental health care and other services that can forestall offending, reduce recidivism or
serve as alternatives to imprisonment.

The use of mid-year sample data from the Bureau of Justice Statistics to measure the
number of persons imprisoned may represent a limitation in our analyses. These data
are based on sample estimates and do not reflect a complete census of prisoners. We
must also recognize that these data exclude persons confined in locally administered
facilities who are under the jurisdiction of local authorities and those who are on parole
or probation [4]. Additionally, the Sullivan method does not reflect transitions in and out
of prison. However, regardless of prison term or transitions in and out of prison, the
potential health consequences identified above are still of concern.

More research on the health effects of imprisonment and new interventions to reduce
them should be an urgent priority within both corrections and public health. Even in the
absence of additional data, our study suggests that health consequences should be
given greater weight in discussions of law enforcement strategies generally and drug
policy in particular.

8

Competing interests
The authors declare no competing interests.

Author contributions
RSH, SB, ED, and SAS initiated the study. RSH and EFD collected and analyzed the
data. All authors contributed to the writing of the manuscript. All authors reviewed the
final manuscript for important intellectual content.

Acknowledgements
We acknowledge the support from the Michael Smith Foundation for Health Research
through a Senior Scholar Award to Dr. Hogg. Dr. Strathdee is supported through the
foundation for the Harold Simon Chair, as well as grants from the National Institute on
Drug Abuse (DA12568, DA14499 and DA09225). We would like to thank Justin Barer,
Anna McGuire, and Patricia Kretz for their research assistance.

9

References
1. Bonczar TP, Beck AJ: Lifetime likelihood of going to state or federal prison.
Washington, DC: US Department of Justice, Bureau of Justice Statistics, 1997.
2. Bonczar TP: Prevalence of imprisonment in the US population, 1974-2001.
Washington, DC: US Department of Justice, Bureau of Justice Statistics, 2003.
3. US Census Bureau, Population Division: National Population Estimates, April
1, 2000 to July 1, 2005. [http://www.census.gov/popest/national/asrh/NCEST2005-asrh.html]. Accessed 14 February 2007.
4. Beck AJ, Karberg JC: Prison and jail inmates at midyear 2000. Washington,
DC,

US

Department

of

Justice,

Bureau

of

Justice

Statistics,

2001.

[http://www.ojp.usdoj.gov/bjs/pub/pdf/pjim00.pdf]. Accessed 9 February 2007.
5. Beck AJ, Karberg JC: Prison and jail inmates at midyear 2001. Washington,
DC,

US

Department

of

Justice,

Bureau

of

Justice

Statistics,

2002.

[http://www.ojp.usdoj.gov/bjs/pub/pdf/pjim00.pdf]. Accessed 9 February 2007.
6. Beck AJ, Karberg JC: Prison and jail inmates at midyear 2002. Washington,
DC,

US

Department

of

Justice,

Bureau

of

Justice

Statistics,

2003.

[http://www.ojp.usdoj.gov/bjs/pub/pdf/pjim00.pdf]. Accessed 9 February 2007.
7. Beck AJ, Karberg JC: Prison and jail inmates at midyear 2003. Washington,
DC,

US

Department

of

Justice,

Bureau

of

Justice

Statistics,

2004.

[http://www.ojp.usdoj.gov/bjs/pub/pdf/pjim00.pdf]. Accessed 9 February 2007.

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8. Beck AJ, Karberg JC: Prison and jail inmates at midyear 2004. Washington,
DC,

US

Department

of

Justice,

Bureau

of

Justice

Statistics

2005.

[http://www.ojp.usdoj.gov/bjs/pub/pdf/pjim00.pdf]. Accessed 9 February 2007.
9. US Census Bureau, Population Division: National Population Projections.
[http://www.census.gov/population/projections/nation/detail/lt99_10.a]. Accessed
15 February 2007.
10. Sullivan DF: A single index of mortality and morbidity. HSMHA Health
Reports 1971, 86:347-354.
11. Department of Justice Office of Justice Programs: Correctional Populations in
the United States - Statistical Tables, 2002.
12. World Health Organization (Regional Office for Europe): WHO Guidelines on HIV
infection and AIDS in prison. HIV in prisons: a reader with particular
relevance to the Newly Independent States. WHO Regional Office for Europe,
2001.
13. World Health Organization (Regional Office for Europe): Health in Prisons Project
and Pompidou Group of the Council of Europe. Prisons, drugs and society: a
consensus statement on principles, policies and practices. Berne, WHO
(Regional Office for Europe) and the Council of Europe, 2001.
14. Hammett TM, Harmon P, Rhodes W: The burden of infectious disease among
inmates of and releasees from US correctional facilities, 1997. American
Journal of Public Health 2002, 92(11):1789-94.
15. Robertson JE: Rape among incarcerated men: sex, coercion and STDs. Aids
Patient Care and Stds 2003, 17(8):423-30.

11

16. Struckman-Johnson C, Struckman-Johnson D: Sexual coercion reported by
women in three Midwestern prisons. Journal of Sex Research 2002,
39(3):217-27.
17. Mahon N: New York inmates' HIV risk behaviors: the implications for
prevention policy and programs. American Journal of Public Health 1996,
86(9):1211-5.
18. Mutter RC, Grimes RM, Labarthe D: Evidence of intraprison spread of HIVinfection. Archives of Internal Medicine 1994, 154(7):793-5.
19. Krebs CP, Simmons M: Intraprison HIV transmission: as assessment of
whether it occurs, how it occurs, and who is at risk. AIDS Education &
Prevention 2002, 2(5):363-367.
20. Brewer TF, Vlahov D, Taylor E, Hall D, Munoz A, Polk BF: Transmission of HIV1 within a statewide prison system. AIDS 1988, 2(5):363-7.
21. Choopanya K, Des Jarlais DC, Vanichseni S, Kitayaporn D, Mock PA, Raktham
S, Hireanras K, Heyward WL, Sujarita S, Mastro TD: Incarceration and risk for
HIV infection among injection drug users in Bangkok. Journal of Acquired
Immune Deficiency Syndromes 2002, 29(1):86-94.
22. Iguchi MY, London JA, Forge NG, Hickman L, Fain T, Riehman K. Elements of
well-being affected by criminalizing the drug user. Public Health Reports
2002, 117(Supplement 1):S146-S150.
23. Freudenberg, N: Jails, prisons, and the health of urban populations: a
review of the impact of the correctional system on community health.
Journal of Urban Health 2001, 78(2):214-35.

12

Table 1:

Number of persons in prison in the United States, 2000-2004, by race and
gender, age 18-44

Year

Total*

Caucasian

African American

Hispanic

n (%)

n (%)

n (%)

Female
2000

141,100

56,300 (39.9)

64,200 (45.5)

17,600 (12.5)

2001

146,500

60,100 (41.0)

64,200 (43.8)

18,100 (12.4)

2002

146,600

59,700 (40.7)

58,500 (39.9)

22,800 (15.6)

2003

152,500

65,100 (42.7)

58,100 (38.1)

24,800 (16.3)

2004

157,900

69,700 (44.1)

58,400 (37.0)

25,300 (16.0)

2000-2004

148,920

62,180 (41.7)

60,680 (40.9)

21,720 (14.5)

Male
2000

1,559,900

556,300 (35.7)

716,100 (45.9)

260,900 (16.7)

2001

1,592,200

578,000 (36.3)

729,600 (45.8)

257,500 (16.2)

2002

1,614,200

526,600 (32.6)

731,700 (45.3)

308,200 (19.1)

2003

1,612,000

534,800 (33.2)

719,700 (44.7)

322,000 (20.0)

2004

1,638,100

555,400 (33.9)

722,100 (44.1)

324,000 (19.8)

2000-2004

1,603,280

550,220 (34.3)

723,840 (45.2)

294,520 (18.4)

SOURCE: AJ Beck, JC Karberg. Prison and Jail Inmates at Midyear 2000, 2001, 2002,
2003, 2004.
*Includes Indians, Alaska Natives, Asians, Native Hawaiians, and other Pacific Islanders;
totals for Caucasian, African American, and Hispanic will not equal to 100 percent.

13

Table 2:

Rates of imprisonment and years of life lost to prison in the United States, 2000-2004,
by race and gender, age 18-44 (per 100,000 population)
Caucasian

Year

African American

Hispanic

Rate of

Years of life

Rate of

Years of life

Rate of

Years of life

imprisonment

lost to Prison

imprisonment

lost to Prison

imprisonment

lost to Prison

Female
2000

152

1,983

811

10,341

225

3,186

2001

164

2,147

808

10,343

224

3,172

2002

163

2,073

732

8,898

275

3,843

2003

181

2,239

726

8,814

281

3,656

2004

165

1,738

726

8,823

289

3,917

2000-2004

165

2,036

761

9,444

260

3,555

Male
2000

1,481

19,812

9,885

141,108

2,952

44,211

2001

1,549

20,865

9,975

141,602

2,795

42,259

2002

1,420

18,836

9,887

141,929

3,212

48,094

2003

1,454

18,961

9,656

136,808

3,238

47,659

2004

1,521

19,852

9,605

136,089

3,163

46,607

2000-2004

1,485

19,665

9,800

139,507

3,078

45,766

14

Table 3:

Years of life lost to imprisonment in the United States, 2000-2004, by race and gender
Caucasian

Year

Total

African American

Non-prison

Prison

component

component

Total

Hispanic

Non-prison

Prison

component

component

Total

Non-prison

Prison

component

Component

Female
2000

79.78

79.73

0.05

74.79

74.55

0.24

82.13

82.06

0.08

2001

79.89

79.84

0.05

74.98

74.74

0.24

82.13

82.06

0.07

2002

80.00

79.94

0.05

75.16

74.93

0.23

82.25

82.16

0.09

2003

80.10

80.05

0.06

75.34

75.11

0.23

82.31

82.21

0.10

2004

80.21

80.15

0.05

75.52

75.29

0.23

82.35

82.25

0.10

2000-2004

80.00

79.94

0.05

75.16

74.92

0.23

82.23

82.15

0.09

Male
2000

74.92

74.42

0.50

68.58

65.50

3.08

76.66

75.62

1.05

2001

75.02

74.50

0.52

68.76

65.73

3.04

76.66

75.72

0.94

2002

75.12

74.65

0.47

68.95

65.86

3.09

76.85

75.75

1.09

2003

75.23

74.73

0.50

69.14

66.03

3.11

76.94

75.82

1.12

2004

75.33

74.81

0.52

69.33

66.22

3.11

77.03

75.94

1.09

2000-2004

75.13

74.62

0.50

69.00

65.91

3.09

76.83

75.77

1.06

Note: Standard errors for estimates range from <0.001 to 0.003.

15