Racial Disparities in Health Outcomes Across Criminal Legal System Contacts: A Systematic Literature Review

Abstract

Objective: This systematic literature review identifies studies that found racial disparities in health consequences associated with the criminal justice system contact and analyzes the magnitude of inequities in health outcomes related to those racial disparities.Methods: Following the PRISMA 2020 Statement, research articles were identified using the Web of Science database through the search terms “crim* and health and race.” Published original research articles, early access reports, and review articles published in the US, in English, from January 2000 through June 2024 were included. Snowball referencing of selected studies was used to identify additional studies along with non-peer reviewed (“grey”) literature sources to search. Analysis of selected studies reported the time-period of data collection, study type, data source, population, covariates, health outcome, contact with the criminal legal system, racial groups considered in analysis, and information on racial disparity results/conclusions for each selected study. Results: The Web of Science search returned two thousand and ninety-six (2096) articles after deleting duplicates. Of these, fifty-one (51) were considered eligible for full text review and twelve (12) met all inclusion criteria. Snowball referencing yielded an additional six (6) peer-reviewed articles. The grey literature database search yielded an additional two (2) articles for inclusion. In total, twenty (20) articles are included in this review. Included articles identify racial disparities associated with criminal legal system contact across physical health outcomes (8), mental health outcomes (6), general self-rated health (3), and mortality (4). Discussion: Racial disparities in health outcomes associated with criminal legal system contact were reported across disease, injury, chronic conditions, cardiovascular risk, cellular aging, mental health conditions, depressive symptoms, and general self-rated health with black people tending to be more affected than white people. Limitations: Limitations of the evidence include unconsidered covariates, failure to distinguish between multiple racial groups, limited generalizability, a lack of female participants, a reliance on the same national datasets, and an underrepresentation of certain health conditions. Implications: Understanding the racial disparities in health outcomes linked to criminal legal system contact—across various health impacts and types of contact—can help better inform and target interventions that both reduce criminal legal system involvement and improve health among the populations most at risk.