Long-term Consequences of Criminal Justice System Intervention: The Impact of Young Adult Arrest on Midlife Health Behaviors

While there is a growing literature on the relationship between incarceration and health, few studies have expanded the investigation of criminal justice system involvement and health to include the more common intervention of arrest. This study uses a quasi-experimental design to evaluate the long-term effect of arrest in young adulthood on health behaviors in midlife for African Americans. We use propensity score matching methods and gender-specific multivariate regression analyses to equate those who did and did not incur an arrest in young adulthood from a subsample ( n  = 683) of the Woodlawn cohort, an African American community cohort followed from childhood into midlife. The results suggest that, for men, having been arrested in young adulthood has a direct effect on smoking, daily drinking, and risky sexual behaviors into midlife while young adult arrest does not seem to impact midlife health risk behaviors for women. This study adds health risk behaviors to the growing list of detrimental outcomes, such as crime, drug use, education, and mental health that are related to criminal justice contact for African American men, in particular.

Research on premature mortality among African Americans often centers on homicide and firearm deaths due to their prevalence, yet premature mortality is also driven by high rates of chronic diseases including heart disease, diabetes, stroke, and obesity (Centers for Disease Control (CDC)  2013 ; Cary et al.,  2016 ; Hill et al.,  2015 ). Heart disease develops at a higher rate and younger age among African Americans than Whites and is 30% more likely to be fatal in African Americans (Levine & Crimmins,  2014 ; CDC,  2013 ). African American men are twice as likely to have a stroke and 60% more likely to die from stroke than Whites (American Heart Association,  2009 ). Moreover, the high mortality rates for young to mid-adult African Americans are related to HIV and substance use, with significant racial disparities for drug overdose deaths despite a recent decrease and HIV as one of the top ten causes of death for African American males aged 25–54 (Case & Deaton,  2015 ). These health disparities likely stem from disparities in health risk behaviors as “the behaviors themselves are highly stratified” (Carr,  2019 , 79).

For over 20 years, researchers have implicated harmful behaviors from social and behavioral sources as the “actual” causes of premature mortality related to chronic health outcomes (McGinnis & Foege,  1993 ). Specifically, the largest proportional contributions to premature death are diet and physical activity, tobacco use, alcohol consumption, drug use, firearm usage, motor vehicle usage, and sexual behavior such that “the single greatest opportunity to improve health and reduce premature deaths lies in personal behavior” (Schroeder,  2007 , 1222). Indeed, Carr ( 2019 , 77) has gone as far to say that health risk behaviors “are among the most powerful explanations for race and socioeconomic disparities in health and gender differences in mortality.” Thus, understanding the range of social and structural factors that impact these health behaviors among African American men and women is critical.

In this study, we examine the impact of young adult arrest, a prevalent life event among African Americans, as a potential contributor to engaging in poor health behaviors. A recent study using data from the National Longitudinal Survey of Youth 1997 (NLSY97) revealed that close to 50% of Black males (48.9%), and almost one-fifth of Black females (18.4%) are arrested by age 23 in the USA (Brame et al.,  2014 ). In line with these national estimates, Doherty and Ensminger ( 2014 ) found that 46% of the 589 males and 15% of the 628 females among a community cohort of African Americans were arrested by age 23. The extent to which health disparities and their related health behaviors may be related to the high rates of arrest among African Americans remains understudied.