The U.S. Criminal Legal System and Population Health

A growing body of research has now identified the criminal legal system as a major social determinant of population health and health disparities in the United States. The current review provides a description of the U.S. criminal legal landscape, briefly summarizes recent research findings, and identifies new and needed directions for research.

Building on prior research first identifying direct contact with the prison system as a social determinant of health, recent research provides evidence of elevated risks for physical and mental morbidity and mortality among those with direct or indirect contact with the criminal legal system. This research has been expanded to include community supervision and contact with police as important drivers of health.While this evidence base has grown, our understanding of the role of the criminal legal system in population health has remained limited for several reasons: (1) prison and jail incarceration remain the primary forms of contact examined despite the existence of other relevant forms of carceral contact and control; (2) the longitudinal health consequences of contact with the criminal legal system have largely gone undocumented; (3) the majority of the research is descriptive and does not employ causal modeling approaches; and (4) relatedly, the mechanisms that link criminal legal system contact with health are not adequately measured.

The criminal legal system has emerged as a significant social determinant of health. While advances have been made in documenting the direct and indirect consequences of contact for population health and health disparities, more work is needed to better ascertain how and why this contact matters.