Date of Award

January 2020

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Danya Keene




To estimate the effect of openings jail in rural counties on county-level chlamydia, gonorrhea, and syphilis prevalence rates.


We used county-level data from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (2005-2017) to obtain chlamydia, gonorrhea, and syphilis rates, and the American Correctional Association’s National Jail and Adult Detention Directory (2013-2014) to locate rural jail openings. Using a generalized synthetic control method, we estimated the effect of opening jails in 41 rural counties between 2010 and 2012 across the United States on sexually-transmitted infections.


We found an average treatment effect for chlamydia prevalence rates in the years following rural jail openings to be increased by 30.6% (p=0.019). For gonorrhea, this effect was 43.3% (p=0.0015). Our sensitivity analysis highlights that gonorrhea may also have spillover effects on nearby rural counties without jails (57.2%; p>0.001). Our results for syphilis rates were inconclusive as we found a significant effect in the years following rural jail openings 25.4%; p=0.036), but sensitivity analyses suggest that this association was driven by one county with high prevalence rate.


Opening a jail in rural counties is associated with increased rates of chlamydia and gonorrhea in the surrounding county in which it is sited.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/27/2022