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Community behavioral health and the criminal legal systems are treated separately, which creates a competing demand to confront mass incarceration and expand available services. As a result, the relationship between behavioral health services, demographics and community factors, and incarceration rate has not been well addressed. Understanding potential drivers of incarceration, including access to community-based services, is necessary to reduce entry into the legal system and decrease recidivism. This study identifies county-level demographic, socioeconomic, healthcare services availability\/accessibility, and criminal legal characteristics that predict per capita jail population across the U.S. More than 10 million individuals pass through U.S. jails each year, increasing the urgency of addressing this challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The selection of variables for our model proceeded in stages. The study commenced by identifying potential descriptors and then using machine learning techniques to select non-collinear variables to predict county jail population per capita. Beta regression was then applied to nationally available data from all 3,141 U.S. counties to identify factors predicting county jail population size. Data sources include the Vera Institute\u2019s incarceration database, Robert Wood Johnson Foundation\u2019s County Health Rankings and Roadmaps, Uniform Crime Report, and the U.S. Census.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fewer per capita psychiatrists (z-score\u2009=\u2009-2.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.031), lower percent of drug treatment paid by Medicaid (-3.66;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), higher per capita healthcare costs (5.71;\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u2009.001), higher number of physically unhealthy days in a month (8.6;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), lower high school graduation rate (-4.05;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), smaller county size (-2.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.008; -2.71,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.007; medium and large versus small counties, respectively), and more police officers per capita (8.74;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) were associated with higher per capita jail population. Controlling for other factors, violent crime rate did not predict incarceration rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Counties with smaller populations, larger percentages of individuals that did not graduate high school, that have more health-related issues, and provide fewer community treatment services are more likely to have higher jail population per capita. Increasing access to services, including mental health providers, and improving the affordability of drug treatment and healthcare may help reduce incarceration rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-022-08306-6","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T06:04:33Z","timestamp":1659074673000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The relationship between community public health, behavioral health service accessibility, and mass incarceration"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8941-4696","authenticated-orcid":false,"given":"Niloofar","family":"Ramezani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex J.","family":"Breno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Mackey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2997-7942","authenticated-orcid":false,"given":"Jill","family":"Viglione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison Evans","family":"Cuellar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer E.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faye S.","family":"Taxman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"key":"8306_CR1","unstructured":"amfAR, The Foundation of Aids Research. 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No human subjects were used for this study, so no names or personal information were included in our data. No administrative permissions were required to access the raw data\/samples mentioned in the methods. Most of the data are publicly available. For variables extracted from Vera Institute of Justice, we sought permission from them via email.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate:"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"966"}}