Undoing resilience: immigrant status and poor health following incarceration

Julie L. Kuper,Jillian J. Turanovic

doi:10.1186/s40352-021-00129-7

Abstract

BackgroundIn the United States, foreign-born persons often have better health outcomes than their native-born peers, despite exposure to adversity. Nevertheless, it is unclear whether this pattern extends to the consequences of life events, such as incarceration, that separate immigrants from their supportive networks and increase exposure to adversity. Accordingly, using four waves of data from the National Longitudinal Study of Adolescent to Adult Health, hierarchical generalized linear models were used to examine within-individual changes in self-rated health following first incarceration (N = 31,202 person-waves).ResultsThe results showed that incarceration was associated with modest health declines that were similar in magnitude for immigrant and native-born persons. Supplemental analyses revealed that these effects did not vary by immigrant race or ethnicity, or by age at immigration. The only exception was for immigrants from low- and middle-income countries, who were marginally less likely to experience health declines following incarceration.ConclusionsIn general, incarceration appears to be similarly health damaging for immigrants and non-immigrants. These findings raise important questions about how incarceration is linked to health declines for foreign- and native-born populations and emphasize the importance of access to healthcare for individuals released from correctional facilities. More research is needed, however, to further examine the cumulative impacts of incarceration on immigrants’ health across the life course, and to assess a broader spectrum of health outcomes.

Highlights

Growing literature illustrates that immigrants to the United States fare better when confronting adversity than native-born individuals
Model 1 indicates that immigrants report better health than non-immigrants, and this finding is consistent with the body of work on the immigrant paradox
The results show that incarceration is related to modest health declines, and that the association between incarceration and poor health is similar for immigrants and non-immigrants, for immigrants of different races, and those who immigrated at different ages

Summary

Introduction

Growing literature illustrates that immigrants to the United States fare better when confronting adversity than native-born individuals. In the United States, foreign-born persons often have better health outcomes than their native-born peers, despite exposure to adversity It is unclear whether this pattern extends to the consequences of life events, such as incarceration, that separate immigrants from their supportive networks and increase exposure to adversity. Infectious disease, and cardiovascular problems are higher among individuals who have been previously incarcerated (Pew Charitable Trusts, 2017), and health declines can occur both during confinement and after release (Schnittker & John, 2007) These negative health outcomes can be the result of exposure to stress and disease in correctional settings, to the limited access to adequate healthcare that incarcerated individuals face upon release from institutions (Semenza & Link, 2019), and to the proliferation of stigma and stressors over the life course following incarceration (Massoglia, 2008; Schnittker, 2014). Asthma, mental health disorders, HIV, and vitamin D deficiency are higher among those in confinement, and the worsening of these chronic conditions while incarcerated negatively affects lifetime health prospects (Fazel & Baillargeon, 2011)

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