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An empirical assessment of the “healthy prisoner hypothesis”

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  • Baćak, Valerio
  • Wildeman, Christopher

Abstract

Lower mortality among inmates, compared to the general population, is typically ascribed to access to health care during incarceration and the low risk of death due to homicide, accidents, and drug overdose. In this study, we test an alternative explanation based on selection of healthy individuals into jails and prisons–“the healthy prisoner hypothesis.” According to this hypothesis, inmates have to be healthy to commit crimes and become incarcerated, which explains why they experience lower mortality than comparable segments of the general population. Using ten waves of data from the National Longitudinal Survey of Youth 1997, we compare individuals who become incarcerated the following year to those who do not on four measures of health—depression, self-rated health, functional limitations, and injury or illness requiring medical attention. Results from matched samples indicate that future inmates are hardly ever in significantly better health the year prior to their incarceration. These findings strongly suggest that the paradoxical mortality advantage of inmates is not due to health selection.

Suggested Citation

  • Baćak, Valerio & Wildeman, Christopher, 2015. "An empirical assessment of the “healthy prisoner hypothesis”," Social Science & Medicine, Elsevier, vol. 138(C), pages 187-191.
    • Handle: RePEc:eee:socmed:v:138:y:2015:i:c:p:187-191
    DOI: 10.1016/j.socscimed.2015.05.039
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    References listed on IDEAS

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    2. Evelyn Patterson, 2010. "Incarcerating death: Mortality in U.S. state correctional facilities, 1985–1998," Demography, Springer;Population Association of America (PAA), vol. 47(3), pages 587-607, August.
    3. Honaker, James & King, Gary & Blackwell, Matthew, 2011. "Amelia II: A Program for Missing Data," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 45(i07).
    4. Ho, Daniel E. & Imai, Kosuke & King, Gary & Stuart, Elizabeth A., 2007. "Matching as Nonparametric Preprocessing for Reducing Model Dependence in Parametric Causal Inference," Political Analysis, Cambridge University Press, vol. 15(3), pages 199-236, July.
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    Cited by:

    1. Christopher Wildeman & Margaret E. Noonan & Daniela Golinelli & E. Ann Carson & Natalia Emanuel, 2016. "State-level variation in the imprisonment-mortality relationship, 2001−2010," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 34(12), pages 359-372.
    2. Sebastian Daza & Alberto Palloni & Jerrett Jones, 2020. "The Consequences of Incarceration for Mortality in the United States," Demography, Springer;Population Association of America (PAA), vol. 57(2), pages 577-598, April.

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