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Primary Submission Category: Health equity
The Threshold of Toxicity: Compounding Carceral Exposures and Black Reproductive Health
Authors: Emma Blackson,
Presenting Author: Emma Blackson*
Research Question: Does the co-location of punitive school environments and lethal police violence escalate the risk of adverse birth outcomes for Black birthing people beyond the impact of independent institutional exposures?
Background: While population health science often frames education as a protective asset, this study interrogates educational carcerality, the embedding of surveillance and criminalization within school systems, as a structural pathogen. By shifting the analytical gaze from individual behavior to state behavior, this research challenges traditional silos, conceptualizing the carceral state as an integrated, multi-system determinant of health.
Methods: This stage of a multi-stage investigation links 2015-2018 federal Civil Rights Data Collection and Mapping Police Violence data to restricted-use U.S. natality records (approx 2.2 million singleton live births to non-Hispanic Black individuals). A novel district-level latent measure of the school-to-prison pipeline (STPP) was developed to empirically define the STPP using law enforcement referrals and arrests. Using multivariable Poisson regression with robust standard errors, we tested for a toxicity threshold in High/High districts where punitive schooling and lethal policing converge.
Results: Findings reveal a distinct threshold of compounding harm. Residing in a district characterized by both high STPP exposure and high police lethality was associated with a 7.5% higher risk of preterm birth (IRR=1.075, p=0.022) and a 5.6% higher risk of low birth weight (IRR=1.056, p=0.039) compared to low-exposure districts. Single-domain high exposures were not statistically significant, suggesting that the carceral air only reaches critical biological mass through the convergence of punitive systems. Sensitivity analyses restricted to term-only births attenuated associations to the null, identifying prematurity as the primary biological pathway.
Conclusion: To reimagine population health science as a vehicle for building trust, our field must first confront the geographies of silence produced by federal data suppression, which render the carceral experiences of marginalized communities invisible to oversight. By establishing a threshold of toxicity where punitive schooling and lethal policing converge, this study shifts the analytical lens from individual risk to institutional harm. Ultimately, this work builds influence by providing the evidentiary basis for a public health abolitionism that demands the dismantling of the carceral archipelago as a prerequisite for reproductive justice and family flourishing.