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Primary Submission Category: Structural factors
Association Between Residential Proximity to Carceral Facilities and Asthma ED Visits in California
Authors: Beier Li, Yiran Liu,
Presenting Author: Beier Li*
Background: The U.S. operates roughly 6,300 correctional facilities, with new facility construction ongoing. While research has documented health harms associated with high community-level incarceration rates, less is known about the health effects of living near prisons and jails.
Methods: This ecological, census tract-level analysis examined cross-sectional associations between residential proximity to jail/prison and asthma ED visits (age-adjusted rate per 10,000) in California, 2015-2017. Tracts overlapping 0.5-, 1-, or 2-mile radii around facilities were classified as proximate. Multivariable linear models adjusted for urbanicity, sociodemographic characteristics, healthcare access, and air pollution measures including ozone, particulate matter (PM) 2.5, and diesel PM.
Findings: At a 1-mile radius, 563 census tracts (7.0%) with about 2.8 million residents were proximate to a jail, while 457 tracts (5.7%) were proximate to a prison. Increasing jail proximity was positively associated with asthma ED rates in a dose-response manner (0.5-mile: β=5.06, p = 0.001; 1-mile: β=3.29, p = 0.003; 2-mile: β=1.40, p = 0.08). Prison proximity showed negative associations at close range (0.5-mile: β=-4.51, p = 0.012; 1-mile: β=-2.54, p = 0.048) but a positive association at 2 miles (β=2.10, p = 0.018). In a sensitivity analysis excluding census tracts containing a prison or jail, negative associations with prison proximity at 0.5 and 1 mile radii diminished; other effects were consistent.
Conclusions: Millions of Californians living near jails experience higher asthma ED rates than explained by measured covariates, with effects stronger at closer distances. Associations with prison proximity were inconsistent and may reflect census enumeration practices for incarcerated individuals. Findings suggest that residential proximity to carceral facilities is an additional understudied pathway through which mass incarceration may harm community health.