Funded on September 1, 2022

In 2020, 5.2 million people, or 2.3 percent of the voting age population, were denied the right to vote, a critical component of health and well-being, because of a felony conviction. The number of people disenfranchised varies with state laws, but research suggests 1 in 16 Black Americans of voting age is prevented from voting in the US. Elected officials create policies and programs that shape known social determinants of health, including housing assistance, food support, and Medicaid expansion. Though scholarship has theoretically linked political and felony disenfranchisement to health disparities, no empirical analyses have tested the link between felony disenfranchisement policies and health.  

In the US, Black people are twice as likely to deliver a preterm baby and three times more likely to deliver a low-birthweight infant compared with white people. The pathways through which voter suppression influences birth outcomes include unequal distribution of resources, exposure to environmental risks, and stress. Research has linked civil rights expansions with improvements in birth outcomes and attacks on civil rights with worse outcomes, especially for people of color.  

The objectives of this research are the following: 

  • determine if state felony disenfranchisement policies are associated with higher rates of preterm birth and low birthweight at the county level, distinguishing majority white and majority Black counties  

  • determine if the association between state felony disenfranchisement policies and county-level birth outcomes is different for Black infants compared with white infants