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Objectives. To better understand jail mental health services entry, we analyzed diagnosis timing relative to solitary confinement, nature of diagnosis, age, and race/ethnicity. Methods. We analyzed 2011 to 2013 medical records on 45 189 New York City jail first-time admissions. Results. Of this cohort, 21.2% were aged 21 years or younger, 46.0% were Hispanic, 40.6% were non-Hispanic Black, 8.8% were non-Hispanic White, and 3.9% experienced solitary confinement. Overall, 14.8% received a mental health diagnosis, which was associated with longer average jail stays (120 vs 48 days), higher rates of solitary confinement (13.1% vs 3.9%), and injury (25.4% vs 7.1%). Individuals aged 21 years or younger were less likely than older individuals to receive a mental health diagnosis (odds ratio [OR] = 0.86; 95% confidence interval [CI] = 0.80, 0.93; P < .05) and more likely to experience solitary confinement (OR = 4.99; 95% CI = 4.43, 5.61; P < .05). Blacks and Hispanics were less likely than Whites to enter the mental health service (OR = 0.57; 95% CI = 0.52, 0.63; and OR = 0.49; 95% CI = 0.44, 0.53; respectively; P < .05), but more likely to experience solitary confinement (OR = 2.52; 95% CI = 1.88, 3.83; and OR = 1.65; 95% CI = 1.23, 2.22; respectively; P < .05). Conclusions. More consideration is needed of race/ethnicity and age in understanding and addressing the punishment and treatment balance in jails.

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Documenting and Addressing the Health Impacts of Carceral SystemsN o other industrialized democracy has a carceral system that is as expansive, puni-sociostructural driver of health inequities in our field by devoting an entire supplement to this topic in a premier journal.This supplement includes original research and essays that portray the myriad pathways through which carceral systems imperil the health of individuals, families, neighborhoods, and the population by compromising social determinants of health. Collectively, it also offers visionary ideas and practical guidance for addressing these harms. We hope it inspires public health scholars, advocates, and practitioners to continue devoting their intellect and energy to the topics covered.We are thankful to everyone who submitted and contributed to this issue. We are especially fortunate to have powerful pieces written by formerly incarcerated people who are working tirelessly to help those still locked down to find hope and dismantle carceral systems for future generations. In addition, we thank the editors and staff at AJPH and the Robert Wood Johnson Foundation for supporting this supplement and ensuring that the articles are available in an open-access format. The aim was to ensure that the content finds its way beyond academic discourse and proves useful to all people fighting for health equity, decarceration, and racial justice.