Parental Incarceration and Child Health in the United States

Racial Differences in the Relationship between Neighborhood Disorder, Adverse Childhood Experiences, and Child Behavioral Health

The neighborhood and family context in which children grow profoundly influences their development. Informed by ecological systems theory and social disorganization theory, we hypothesized that adverse childhood experiences (ACEs) mediate the relationship between neighborhood disorder and child externalizing and internalizing behaviors, and that these pathways vary by race/ethnicity. We conducted secondary data analysis using Fragile Families and Child Well-being study data. To test hypothesized pathways, we performed a mediation path analysis on a sample of 3001 mothers of children (ages 3 and 5) living in 20 U.S. cities. A moderated mediation path analysis was used to test racial/ethnic differences in hypothesized pathways. We found that living in disordered neighborhoods increased children's likelihood of exhibiting externalizing and internalizing behaviors through childhood ACEs. Compared to Black and Hispanic children, White children's ACEs were more susceptible to negative neighborhood environment effects, suggesting that White children's behavioral health may be more indirectly affected by neighborhood disorder. The finding that ACEs mediated the pathway from neighborhood disorder to child behavior problems provides opportunity for child psychiatrists and pediatricians to interrupt negative pathways by providing interventions for children and families. Our findings on racial/ethnic differences highlight the need for culturally sensitive programming to address children's behavior problems.

Family Member Incarceration, Psychological Stress, and Subclinical Cardiovascular Disease in Mexican Women (2012-2016)

Objectives. To examine the association between family member incarceration, psychological stress, and subclinical cardiovascular disease (CVD).Methods. Between 2012 and 2016, 1849 CVD-free women from the Mexican Teachers' Cohort responded to questions on family incarceration from the Life Stressor Checklist. Perceived stress and hair cortisol levels were measured in a subset of participants. Carotid intima-media thickness was measured, and carotid atherosclerosis was determined in all participants. We used multivariable quantile, linear, and logistic regression models to evaluate the association between family member incarceration, stress, and subclinical CVD.Results. Among women with a mean age of 49.7 years (SD ±5.2), 15.3% reported family member incarceration. We found that both perceived stress and hair cortisol levels were significantly higher in women with an incarcerated family member relative to women without one. After multivariable adjustment, women who reported family member incarceration had 41% (95% confidence interval = 1.04, 2.00) higher odds of carotid atherosclerosis compared with those who did not.Conclusions. Family member incarceration was associated with robust markers of stress and cardiovascular risk. Mass incarceration may have a long-lasting impact on physical health of affected families.

Global Prison Health Care Governance and Health Equity: A Critical Lack of Evidence

The large and growing population of people who experience incarceration makes prison health an essential component of public health and a critical setting for reducing health inequities. People who experience incarceration have a high burden of physical and mental health care needs and have poor health outcomes. Addressing these health disparities requires effective governance and accountability for prison health care services, including delivery of quality care in custody and effective integration with community health services.Despite the importance of prison health care governance, little is known about how prison health services are structured and funded or the methods and processes by which they are held accountable. A number of national and subnational jurisdictions have moved prison health care services under their ministry of health, in alignment with recommendations by the World Health Organization and the United Nations Office on Drugs and Crime. However, there is a critical lack of evidence on current governance models and an urgent need for evaluation and research, particularly in low- and middle-income countries.Here we discuss why understanding and implementing effective prison health governance models is a critical component of addressing health inequities at the global level.

Beyond the Classroom: The Intergenerational Effect of Incarceration on Children's Academic and Nonacademic School-Related Outcomes in High School

The author uses strategic comparison regression and the Longitudinal Study of Adolescent to Adult Health (n = 11,767) to explore the effect of parental incarceration on academic and nonacademic outcomes in high school. This method compares youth whose parents were incarcerated before the outcomes are measured with those whose parents will be incarcerated after. The author examines most recent grades and a range of nonacademic outcomes, such as truancy, involvement in school activities, and suspension. Results indicate that the associations between parental incarceration and grades are largely accounted for by selection, but associations between parental incarceration and nonacademic processes persist. Maternal incarceration holds particular importance for behavioral outcomes (fighting and truancy), and paternal incarceration holds particular importance for behavioral, connectedness, and disciplinary outcomes. Researchers examining the intergenerational consequences of incarceration should examine school contexts beyond the classroom and explore the pathways through which this disadvantage occurs.

Incarceration as a unique social stressor during pregnancy: Implications for maternal and newborn health

RATIONALE

Exposure to incarceration during pregnancy is a stressful life event that poses risk for both maternal and newborn health.

OBJECTIVE

We conducted a pooled, cross-sectional analysis of the link between incarceration exposure of mothers during pregnancy - personally or vicariously through a romantic partner - and maternal and newborn health using data from the Pregnancy Risk Assessment Monitoring System from years 2012-2015.

METHOD

We applied a novel approach that compares mothers who were exposed to incarceration to the strategic comparison group of mothers who were not exposed to incarceration, but experienced varying numbers of stressors.

RESULTS

The initial findings indicated that respondents exposed to incarceration exhibited reductions in maternal and newborn health relative to respondents not exposed to incarceration. However, these differences were substantially attenuated when comparing the incarceration-exposed group to a more comparable stressor-exposed reference group.

CONCLUSIONS

While incarceration exposure has adverse consequences for health outcomes of mothers and newborns, incarceration exposure may not carry unique implications for maternal and newborn wellbeing beyond the clustering of other stressful life events. Policies targeting incarceration exposure as a means of promoting health must also provide adequate attention to co-occurring stressors.

Does Having a Minor Child Affect Criminal Charges and Sanctions Imposed on Female Defendants?

This study examined effects of having a minor child(ren) on the probability of being prosecuted, convicted, and if convicted, the sanctions that were imposed. Data were state-wide court and birth records of criminally-charged women in North Carolina, a state with sentencing guidelines. We hypothesized that (a) prosecutors would be less likely to prosecute and more likely to lower an offense class and (b) judges (when they had discretion) would be more lenient for women in sentencing with minor children than without. Having a minor child(ren) reduced the probability of prosecution; given prosecution, conviction rates fell. When the judge had discretion, having minor children reduced the probability of an active sentence. Having a minor child had no effect on minimum sentence length for women with active sentences. Presence of a minor child affects prosecutorial and judicial decisions affecting women charged with a criminal offense.

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

The world prison population is growing at a rate that exceeds the rate of population growth. This issue of Epidemiologic Reviews comprises articles in which researchers summarize what is known about some of the key health issues facing people in prison, particularly in relation to human immunodeficiency virus and other blood-borne viral infections. A key recurring theme is that addressing the health needs of people in prison is important to reducing health inequalities at the population level—that prisoner health is public health. The reviews also highlight some critical evidence gaps, notably the lack of evidence from low- and middle-income countries, and the limited number of longitudinal studies in which health behaviors, health outcomes, or health service experiences after release from prison are documented. Despite growing evidence of the poor health of detained adolescents, none of the included reviews considered this population. Further research on the health of young people who cycle through juvenile detention should be a priority. Despite a rapidly growing literature on the health of people who experience incarceration, some critical health issues remain poorly understood, and there has been insufficient attention devoted to co-occurring health conditions and the consequent need for coordinated care. Key populations in custodial settings remain understudied, limiting capacity to develop targeted, evidence-based responses to their health needs. The quality of many studies is suboptimal, and although rigorous, independent research in correctional settings can be challenging, it is not impossible and is critical to laying the groundwork for evidence-based reform.

Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors

This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.

Access to healthy food retailers among formerly incarcerated individuals

Objective

To assess access to healthy food retailers among formerly incarcerated individuals.

Design

Using linked data from the National Longitudinal Study of Adolescent to Adult Health and the Modified Retail Food Environment Index, the present study applies multivariate logistic regression to assess the association between incarceration and (i) living in a food desert and (ii) having low access to healthy food retailers. To account for unobserved heterogeneity, additional analyses are performed comparing formerly incarcerated individuals with persons arrested or convicted for a crime but not previously incarcerated.

Setting

Sample of respondents living in urban census tracts in the USA.

Subjects

Adults (n10390) aged 24–34 years.

Results

In adjusted logistic regression models, prior incarceration was not significantly associated with living in a food desert (OR=1·097; 95% CI 0·896, 1·343). Prior incarceration significantly increased the likelihood of living in a census tract with low access to healthy food retailers (OR=1·265; 95% CI 1·069, 1·498). This significant association remained when comparing formerly incarcerated individuals with those who had been arrested or convicted of a crime, but not previously incarcerated (OR=1·246; 95% CI 1·032, 1·503).

Conclusions

Formerly incarcerated individuals are more likely to live in areas with low access to healthy food retailers compared with their non-incarcerated counterparts. Because lower access healthy food retailers may be associated with worse health and dietary behaviour, disparities in local food retail environments may exacerbate health inequalities among formerly incarcerated individuals.

Parental Incarceration and Child Well-being: Conceptual and Practical Concerns Regarding the Use of Propensity Scores

The aim of the current investigation was to examine the appropriateness of propensity score methods for the study of incarceration effects on children by directing attention to a range of conceptual and practical concerns, including the exclusion of theoretically meaningful covariates, the comparability of treatment and control groups, and potential ambiguities resulting from researcher-driven analytic decisions. Using data from the Fragile Families and Child Wellbeing Study, we examined the effects of maternal and paternal incarceration on a range of child well-being outcomes, including internalizing and externalizing problem behaviors, Peabody Picture Vocabulary Test scores, and early juvenile delinquency. Our findings suggested that propensity scores and treatment effect estimates are highly sensitive to a number of decisions made by the researcher, including aspects where little consensus exists. In light of the conceptual underpinnings of propensity score analysis and existing data limitations, we suggest the potential utility of different identification methods and specialized data collection efforts.