BACKGROUND A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. METHODS We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. RESULTS There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. CONCLUSION Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

中文翻译：

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大规模监禁与公共卫生：路易斯安那州黑监狱监禁与黑人妇女不良分娩结果之间的关联。

背景 越来越多的证据开始强调大规模监禁如何造成人口健康方面的不平等。非西班牙裔黑人受到监禁和刑事执法的影响尤为严重，这是带有种族偏见的刑事司法系统的持久遗产，对黑人家庭和社区的健康产生了广泛的影响。路易斯安那州一直是全国黑人监禁率最高的州之一。与此同时，人口健康方面的巨大种族差异仍然存在。方法 我们对 2014 年路易斯安那州非西班牙裔黑人妇女的所有出生进行了横断面分析，以确定黑人人口中教区级别（相当于县）的监狱监禁率与不良出生结果之间的关联（N = 23,954）。我们使用广义估计方程拟合对数泊松模型，以估算与监禁四分位数范围增加相关的早产和低出生体重的相对风险，并控制混杂因素。在敏感性分析中，我们还对教区级指数犯罪率进行了调整，并分析了回归模型，其中白人监禁被用来预测不良出生结果的风险，以便量化大规模监禁可能对健康造成的损害程度。犯罪率高的地区。结果 黑人妇女的早产风险显着增加 3%，这与黑人教区一级监禁率四分位数范围的增加有关，而与其他因素无关。对指数犯罪的发生率进行调整并没有实质性改变模型的结果。结论 由于路易斯安那州监狱中黑人囚犯的患病率与估计的早产风险之间存在显着正相关，大规模监禁可能是路易斯安那州黑人妇女生殖健康结果持续不平等的根本原因。大规模监禁不仅会产生经济和社会影响，还可能对人口健康和健康不平等产生影响，包括早产和低出生体重方面持续存在的种族差异。