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Three main findings emerge from the analysis. First, incarceration is a powerful predictor of mid-life mental and physical health functioning. Second, these effects are evident in models that account for the non-random nature of incarceration. That is, even when models are employed to correct for sample heterogeneity, the significant physical and mental health effects remain. Finally, the results indicate that incarceration contributes to racial inequalities in physical health. When incarceration is included in models estimating physical health functioning, racial differences in health become non-significant.

A variety of factors come together to explain these findings. First, incarceration fractures social bonds associated with health functioning. Additionally, incarceration lowers the likelihood of gainful wages and depresses wages. Furthermore, incarceration exposes individuals to high levels of infectious diseases and stress. Finally, most ex-inmates find themselves near the bottom of the social hierarchy, making it difficult for them to fully control their lives and participate in society upon release.

These factors, with two additional considerations, also explain how incarceration contributes to racial inequalities in physical health. First, relative to whites, blacks are much more likely to be incarcerated and, therefore, more likely to be exposed to the negative health effects of the penal system. Second, it appears more difficult for blacks than whites to reestablish social bonds to social institutions that protect or enhance physical health.