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Epidemiology of incarceration

Characterizing jail incarceration for public health research

Camplain, Ricky1; Warren, Meghan2; Baldwin, Julie A.1,3; Camplain, Carolyn1; Fofanov, Viacheslav Y.4; Trotter, Robert T. II5

doi: 10.1097/EDE.0000000000001021
Original Article: PDF Only

Background: Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to re-incarceration.

Methods: We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001-2018 from jail intake and release records.

Results: The median number of incarcerations during the study period was 1 (Interquartile range (IQR) 1, 2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR 0, 5). The median total days incarcerated was 3 (IQR 1, 23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been re-incarcerated.

Conclusion: Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research.

1.Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ

2.Department of Athletic Training and Physical Therapy, Northern Arizona University, Flagstaff, AZ

3.Department of Health Sciences, Northern Arizona University, Flagstaff, AZ

4.School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ

5.Department of Anthropology, Northern Arizona University, Flagstaff, AZ

Conflicts of Interest: None declared.

Acknowledgments: The authors would like to acknowledge the members of the Coconino County Criminal Justice Coordinating Council (CJCC), with especial thanks to Toby B. Olvera (CJCC Coordinator), Matthew Figueroa (Commander, Coconino County Detention Facility), Elizabeth C. Archuleta (Coconino County Supervisor, District 2), Sarah Douthit (Chief Probation Officer, Coconino County), and James Driscoll (Coconino County Sherriff) as well as the Criminal Justice Coordinating Council board for their dedication and support during this project; James Brett (Program Coordinator for the Coconino County Detention Facility) for key access to data and advice; Scott George (Information Technology for the Coconino County Detention Facility) for building the database; and William Wilson and Clint Baker (Systems Administrators Sr., Northern Arizona University) for IT support.

Sources of Funding: The Health Disparities in Jail Populations study is funded by The NARBHA Institute, Flagstaff Arizona, with additional support from the Northern Arizona University (NAU) Center for Health Equity Research (CHER) and the NAU Southwest Health Equity Research Collaborative (NIH/NIMHD U54, Grant #NIH U54MD012388).

Data Acquisition: Data and code are not available. The data required creation of a memorandum of understanding (MOU) and a complex data sharing protocol. The MOU includes data acquisition and data protection procedures that are IRB and HIPAA approved.

Corresponding Author: Ricky Camplain, PhD, Email:, Phone: 928-523-5165, Physical Address: 1395 S. Knoles Drive, ARD Building, Suite 140 Flagstaff, AZ, Mailing Address: PO Box 4065, Northern Arizona University, Flagstaff, AZ 86011-4065

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