Are tattoos associated with negative health-related outcomes and risky behaviors?

Background Tattoos have reached broadening mainstream acceptance. Medical professional societies have noted that tattoos may co-occur with high risk behaviors. Methods Using a variety of statistical models applied to a sample of 2,008 adults residing in the United States via Amazon's Mechanical Turk, we estimate the associations between tattoo characteristics, three health-related outcomes (overall health status, ever diagnosed with a mental health issue, sleep problems), and three risky behaviors (current smoking, ever spent time in jail or prison, and number of sex partners). Results We find that the presence, number, and specific features of tattoos are positively correlated with two of the health-related outcomes (ever diagnosed with a mental health issue and trouble sleeping) and all three of the risky behaviors (P < .05). Magnitudes are larger for those with multiple, visible, and offensive tattoos. Conclusions Our results suggest that individuals with tattoos are more likely to engage in risky behaviors relative to their non-tattooed counterparts, which may lead to health consequences. Dermatologists, healthcare providers, and public health advocates should recognize that having a tattoo(s) is a potential marker for mental health issues and risky behaviors.