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“The place where danger waits”: Ten years of the 1994 Crime Bill incarceration on cognitive function in older adults racialized as Black
Paris AJ Adkins‐Jackson, Ariana N. Gobaud, Boeun Kim, César Higgins Tejera, Zinzi Bailey, Rachel R. Hardeman, Tiffany N Ford, Meies‐Amor Blagburn Matz et al.. Alzheimer s & Dementia, 2023-12-01
Topic: Risk, prevention and care in population studies
Abstract Background Structural racism may drive the constellation of structural determinants that increase racialized disparities in the risk for Alzheimer’s disease related dementias (ADRD). Structural racism via adverse policing increases exposure to negative police encounters that produce heightened vigilance, anxiety, and depressed mood in persons racialized as Black. Seminal research suggests high‐police contact and disparities in Black‐White incarceration are positively associated with risk for other health conditions. It is feasible that cumulative stress from anticipatory and recurrent police encounters disrupts the body’s homeostasis leading to accelerated cognitive aging. Method We used US county‐level incarceration data to compute the Black‐White difference in prison and jail rates for US counties between 1995‐2005 (succeeding the 1994 Crime Bill). We then averaged the decade and linked said data by county to individual‐level health data for participants racialized as Black >50 years in the Health and Retirement Study (N = 2,300) who completed the core interview between 2006‐18 (mean observation of 3.4 per participant). Cognitive function was assessed using a 27‐item global cognitive score from the modified Telephone Interview for Cognitive Status. A mixed effects model was used to estimate the cognitive effect of a one‐unit change in incarceration (1,000 additional persons racialized as Black compared to White) with covariates of age at baseline, gender, education, and living arrangement. Result Greater Black‐White 10‐year difference in prison population was significantly associated with worse 2006 cognitive function (β ‐1.08, SE .45, 95% CI ‐1.96,‐.22). The adjusted model was significant for Black‐White difference in prison population with cognitive decline starting in 2006 (β .011, SE .006, 95% CI ‐.001, .023). The Black‐White difference in jail population was not significant. Conclusion Ten‐year Black‐White disparities in prison population are associated with cognitive decline among people racialized as Black starting one year later. While the 1994 Crime Bill is a decades‐old federal policy, it put into place a fiscal infrastructure which local governments continue to use to fund prisons, increase average prison time, and implement adverse policing quotas. These findings suggest structural racism via adverse policing is meaningful to explore in the context of ADRD.
Key findings
- Seminal research suggests high‐police contact and disparities in Black‐White incarceration are positively associated with risk for other health conditions.
- A mixed effects model was used to estimate the cognitive effect of a one‐unit change in incarceration (1,000 additional persons racialized as Black compared to White) with covariates of age at baseline, gender, education, and living arrangement.
- Result Greater Black‐White 10‐year difference in prison population was significantly associated with worse 2006 cognitive function (β ‐1.08, SE .45, 95% CI ‐1.96,‐.22).
- The adjusted model was significant for Black‐White difference in prison population with cognitive decline starting in 2006 (β .011, SE .006, 95% CI ‐.001, .023).
- The Black‐White difference in jail population was not significant.
Why it matters
This study examined whether county-level Black-White incarceration differences were linked to cognitive function in older adults racialized as Black. It does not test any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Participants2,300
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,300 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.6 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 2 / 6 | Cited 1.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Jennifer J. Manly: h-index 101 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 44 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Adkins‐Jackson, P. A. J., Gobaud, A. N., Kim, B., Tejera, C. H., Bailey, Z., Hardeman, R. R., et al. (2023). “The place where danger waits”: Ten years of the 1994 Crime Bill incarceration on cognitive function in older adults racialized as Black. Alzheimer s & Dementia. https://doi.org/10.1002/alz.079398
Vancouver
Adkins‐Jackson PAJ, Gobaud AN, Kim B, Tejera CH, Bailey Z, Hardeman RR, et al. “The place where danger waits”: Ten years of the 1994 Crime Bill incarceration on cognitive function in older adults racialized as Black. Alzheimer s & Dementia. 2023. doi:10.1002/alz.079398.
BibTeX
@article{adkinsjackson2023-64d3be84,
author = {Adkins‐Jackson, Paris AJ and Gobaud, Ariana N. and Kim, Boeun and Tejera, César Higgins and Bailey, Zinzi and Hardeman, Rachel R. and Ford, Tiffany N and Matz, Meies‐Amor Blagburn and others},
title = {{“The place where danger waits”: Ten years of the 1994 Crime Bill incarceration on cognitive function in older adults racialized as Black}},
journal = {Alzheimer s \& Dementia},
year = {2023},
doi = {10.1002/alz.079398},
url = {https://doi.org/10.1002/alz.079398}
}
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