Media Center
For any media inquiries, contact Jeff Simmons (Anat Gerstein, Inc.) at jeff@anatgerstein.com.
For more information about our monthly television program, Both Sides of the Bars, click here.
The Public Health Impacts of Youth Incarceration
Executive Summary
Public health is the science of protecting and improving health among at-risk populations.1 It investigates how environments, policies, and systems either protect or endanger community well- being.2 Youth incarceration is a public health issue because it undermines healthy development, causes lifelong harm, and imposes heavy costs on communities. Emerging adults, aged 19–25, continue to undergo critical neurological and psychological development, yet current New York penal
laws treat them as fully culpable adults who may be subjected to lengthy periods of incarceration. Incarcerating these young people during this critical stage, however, disrupts healthy development by exposing them to conditions that undermine mental and physical health while creating barriers to care. When emerging adults develop these adverse health conditions, the impacts extend beyond jail and prison settings. Once released, they carry these conditions with them back into their communities, affecting families, neighborhoods, and society as a whole; these health problems pose significant costs, including diminishing workforce participation, straining emergency services and healthcare resources, and undermining community well-being, leaving society to contend with higher rates of illness and neighborhood instability.
The Youth Justice and Opportunities (YJ&O) Act provides a public health solution to this crisis by creating a new “Young Adult” (YA) legal status for people aged 19–25, which recognizes the emerging adult age group as unique. YJ&O also provides several protections to those who qualify for
YA status: it limits the amount of time to which courts can sentence them for qualifying felonies, seals their records, and empowers judges to divert them away from jail or prison and into community- based, developmentally appropriate Alternative to Incarceration (ATI) programming. ATI programs are community-based services in which people participate, instead of being detained or sentenced to incarceration; examples include trauma-informed care, education, and workforce development as well as other group and individual sessions that build coping skills, resilience, and stability. In providing emerging adults with the opportunity to participate in such programs, the Act not only prioritizes rehabilitation over punishment, but fosters healthier communities.
Problem Statement: The Public Health Impact of Youth Incarceration
Neuroscience demonstrates that while cognitive reasoning matures by the late teens, the brain regions that regulate emotions and risk-taking do not completely develop until age 25.7 Researchers refer to this developmental period during which emerging adults struggle to effectively regulate their emotions and resist impulses as “transient immaturity.”8 However, despite this scientific evidence, New York State’s current laws automatically treat all people aged 18 and older who are alleged to have committed criminal acts as adults, subjecting them to the same court processes and range of potential penalties as people who are older. These penalties include the stigma of a criminal conviction and lengthy periods of incarceration. Subjecting young people to adult court processing, including the risk of adult terms of incarceration, runs contrary to the science of emerging adulthood. Incarcerating emerging adults disrupts healthy development and increases their risk of experiencing adverse physical and mental health outcomes, while reducing their chances of receiving care upon release. This is a public health issue because emerging adults who are subject to incarceration represent an at-risk population that are susceptible to negative health outcomes that impact their communities and thus society at large.
Mental Health Impacts
Several longitudinal studies, which are studies that follow and collect data from a group over an extended time period, reveal that a higher “dose” of incarceration is associated with poor long-term psychiatric and psychosocial outcomes. Researchers define dose of incarceration as both depth (type of facility: juvenile, adult jail, or prison) and duration of incarceration. According to Barnet et al., higher cumulative exposure to incarceration, especially in more severe prison settings, is associated with lower rates of achieving positive mental health and interpersonal function.
In addition to the adverse mental health conditions that emerging adults develop as a result of incarceration, many had already experienced Adverse Childhood Experiences (ACEs) prior to their contact with the criminal legal system. ACEs are traumatic or stressful events that occur during childhood (defined as before age 18) and are typically classified into three broad categories: abuse, neglect, and household challenges. Abuse can include physical, emotional, or sexual harm. Neglect involves a child’s caregiver failing to meet their basic physical or emotional needs, such as consistent food, shelter, safety, or emotional support. Household challenges refer to experiences such as living with a parent who struggles with substance use, witnessing domestic violence, parental incarceration, or growing up in an environment that exposes them to constant conflict. A substantial body of research has found that ACEs are associated with higher risks of depression, post-traumatic stress disorder (PTSD), and suicidal ideation in adulthood. Many of the stressful circumstances that emerging adults may have encountered as children, such as violence, neglect, and unstable living environments are present within jail and prison. Exposure to similar or identical stressors during incarceration is linked to long-term adverse mental health outcomes, such as PTSD, depression, anxiety, and suicide. In these instances, incarceration acts as a retraumatizing experience, which intensifies these symptoms and causes further mental health deterioration.
Emerging adults also face limited access to mental health care in jails and prisons, which exacerbates these conditions. Despite the high prevalence of trauma and psychological distress among incarcerated young people, correctional institutions fail to provide consistent mental health services. Moreover, the stigma surrounding mental illness can deter individuals from seeking help, leading many to conceal their symptoms out of fear of judgement or perceived weakness.
This combination of unmet clinical needs and social stigma compounds existing trauma and hinders recovery during a critical stage of psychosocial development.
Physical Health
Youth incarceration also leads to premature decline in physical health. Research shows that older adults who were incarcerated between the ages of 14 and 24 exhibit pronounced functional limitations, mobility impairments, chronic inflammatory responses, elevated hypertension, and cardiometabolic conditions compared to those who were never incarcerated. The phenomenon of incarceration producing chronic health conditions is explained by the “toxic stress pathway.” This transpires when young people experience severe and/or prolonged periods of stress, which disrupts the body’s biological systems. Incarceration exposes young people to violence, isolation, uncertainty, and fails to provide them with access to resources to help regulate their stress response. These conditions prompt the body to produce stress response hormones over prolonged periods, which damage the cardiovascular, immune, and metabolic systems. The continual production of these hormones then leads to high blood pressure, inflammation, and suppressed immune function that causes long-term physiological damage.
New York State and local jails also frequently fail to provide young people with adequate food in terms of caloric intake and nutritional quality. Meals often contain insufficient calories and are heavy in refined carbohydrates, salt, and sugar, which undermine metabolic and cardiovascular health and exacerbate chronic illnesses. In addition, correctional facilities typically fail to provide young people with sufficient recreation, outdoor time, and physical exercise, depriving them of the physical activity that supports healthy development and physical well-being. The combined failure to meet dietary and exercise needs compound the adverse health effects of incarceration, further impairing long-term physical health outcomes.
Furthermore, incarcerated individuals often do not receive adequate medical care to address physiological health conditions. One of the reasons for this is that incarcerated people typically distrust medical staff. This distrust stems from a long history of staff delaying or denying incarcerated people treatment, dismissing their claims of illness as dishonest, and witnessing medical personnel act in the interests of institutional security over patient care, and failing to advocate for patients or intervene during incidents of brutality. As a result, many individuals, particularly young people, avoid seeking medical attention and attempt to manage health concerns themselves, which can worsen preventable conditions and lead to poorer overall health outcomes. This is also problematic because emerging adults face barriers to healthcare once they are released.
Barriers to Health Care Upon Release
Research reveals that individuals who were incarcerated under the age of 26 face dangerous gaps in care upon release and lower rates of health insurance coverage. In New York State, like many others, Medicaid coverage is suspended during incarceration. To reinstate coverage after their release, individuals must go through a reactivation process, which presents several bureaucratic challenges, including providing proof of address, submitting documentation, and possessing the technological skills and devices to complete these steps. This is particularly challenging for formerly incarcerated young people, many of whom lack stable housing, financial resources, and experience navigating administrative systems. As a result, recently released young adults often remain uninsured, allowing untreated medical conditions to worsen to such an extent that they force them to rely on emergency departments. This creates a strain on hospitals and reduces their capacity to treat actual emergencies. Diminished physical and mental health also interferes with young people’s ability to work, go to school, find stable housing, build strong social ties and participate in their community, which are critical components of successful reentry. Given the mental and physical conditions that incarceration exacerbates and produces, and lack of adequate medical care, an effective way to protect the health of emerging adults is to provide a public health solution that reduces or prevents their exposure to incarceration.
Conclusion: The YJ&O Act as a Public Health Solution
Public health solutions are evidence-based policies, programs, or interventions that prevent harm, reduce exposure to risk, and promote well-being among vulnerable populations. The YJ&O Act functions in this capacity because it interrupts the pathway between incarceration and disease. By reducing young adults’ exposure to correctional environments during a critical stage of brain and psychosocial development, the Act prevents the onset of mental and physical health harm that incarceration produces in individuals and thus prevents the collateral damage to communities as described above.
By empowering judges to divert eligible young adults away from confinement, YJ&O prevents the onset of mental health conditions that develop as a result of incarceration. Rather than exposing emerging adults to isolation, violence, and chronic stress, the law would allow this population to access community-based trauma-informed care and other supports – including individual and family counseling and other mental health supports – while shielding them from the conditions that fuel depression, anxiety, and suicide. The Act reduces or even prevents exposure to conditions that produce biological stress responses that accelerate physical decline and undermine physical and mental health.
The bill also strengthens continuity of care by keeping young adults in community settings, which prevents the disruption of health insurance coverage and medical treatment that incarceration so often causes. Maintaining Medicaid eligibility and ongoing provider relationships ensures consistent access to mental health services, medications, and preventive health care in general. The bill thus protects both immediate and long-term health by keeping young adults connected to systems of care.
YJ&O also reframes youth justice from a public health injury prevention perspective. By limiting young adults’ exposure to incarceration during a critical stage of development, it prevents them from experiencing psychological and physiological harm. In protecting a developmentally
distinct group from avoidable harm, the bill would fulfill public health’s core mission, which is to safeguard the health of at-risk populations by addressing the causes of disease. The YJ&O Act does more than reform sentencing; it prevents harm before it begins, advancing both justice and health for New York’s emerging adults and their communities.