The rise in mass incarceration since the 1960s in the United States—driven largely by growth in state prison incarceration—is unprecedented. The incarceration boom has disproportionately impacted Black Americans, who experience incarceration rates roughly four times higher than White individuals (National Research Council 2014; Sakala 2014). Research increasingly links racial disparities in incarceration to racial health inequities, with incarceration being associated with increased health risks for incarcerated and formerly incarcerated individuals as well as their families and communities. While state sentencing policies have contributed to racial disparities in incarceration rates, their impacts on racial health disparities are not known.  

This study will investigate the causal impacts of implementation—and, in more recent years, repeal—of state sentencing policies on racial disparities in health among infants and young adults, asking: 

  1. How did the initial implementation of state-level sentencing policies impact birth outcomes and young adult health, as well as racial (Black versus non-Hispanic White) disparities in these outcomes, over the period 1968-2005? 

  1. How did the repeal of state sentencing policies impact birth outcomes and markers of young adult health risk, as well as racial inequities in the outcomes (Black versus non-Hispanic White), over the period 2005-2018? 

Given historic levels of public interest in addressing structural racism and growing calls to reform incarceration policies, this research will provide new and critically-timed information for communities and policymakers seeking to mitigate racial disparities in health.