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Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a "race" variable as part of a social process (racism) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect ("unobserved racism"), proportions attributable to interaction ("racial discrimination"), and pure indirect effects ("emergent discrimination"). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities. [ABSTRACT FROM AUTHOR]

Despite increased attention to the links between the criminal justice system and health, how criminal justice contacts shape health and contribute to racial health disparities remains to be better understood. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 5,488) and several analytic techniques-including a quasi-treatment-control design, treatment-weighting procedures, and mediation analyses-this study examines how criminal justice contacts shape inflammatory and depressive risk and contribute to black-white health gaps. Findings revealed that incarceration is associated with increased C-reactive protein and depressive risk, particularly for individuals who experienced long durations of incarceration. Arrests are also associated with mental health, and mediation analyses showed that racial disparities in arrests and incarceration were drivers of black-white gaps in depressive symptoms. Together, this study provides new evidence of the role of the criminal justice system in shaping health and patterning black-white health gaps from adolescence through early adulthood. [ABSTRACT FROM AUTHOR]