Felony disenfranchisement laws and racial inequities in women's self-rated health

Abstract

Objectives: To determine if more strict state-level felony disenfranchisement laws, which are a form of structural racism, are associated with worse self-rated health, and if this association is stronger for Black women compared to white women. Methods: Using Behavioral Risk Factor Surveillance System (BRFSS) 2021, American Community Survey 2017–2021, and State Felony Disenfranchisement Laws in 2020 from the “Locked Out Report” by the Sentencing Project, we fit hierarchical linear models to estimate changes in self-rated health with state felony disenfranchisement laws for 185,833 Black and white women, stratified by race, in 49 states (excluding Florida). Results: We found a significant positive association between more restrictive disenfranchisement and worse self-rated health for Black women (b = 0.08, SE = 0.03, p < 0.01), but not white women, in the fully adjusted model. Conclusions: Stricter state-level felony disenfranchisement laws were associated with worse self-rated health for Black women but not white women suggesting that policies of disenfranchisement may exacerbate racial inequities in health.