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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Tung EL, Wroblewski KE, Makelarski JA, Glasser NJ, Lindau ST. Childhood Parental Incarceration and Adult-Onset Hypertension and Cardiovascular Risk. JAMA Cardiol 2023; 8:927-935. [PMID: 37647038 PMCID: PMC10469273 DOI: 10.1001/jamacardio.2023.2672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/30/2023] [Indexed: 09/01/2023]
Abstract
Importance Parental incarceration is an adverse childhood experience that disproportionately affects racially minoritized individuals and has been associated with long-term health risks. Although cardiovascular disease remains the primary cause of mortality differences between Black and White individuals in the US, the association between parental incarceration and cardiovascular risk remains poorly understood. Objective To examine the association between parental incarceration during childhood and incident cardiovascular risk in adulthood. Design, Setting, and Participants This population-based cohort study included data from waves IV (2008-2009) and V (2016-2018) of the US National Longitudinal Study of Adolescent to Adult Health. Participants represented US adults transitioning from young adulthood to adulthood. Data were analyzed from October 28, 2021, to May 1, 2023. Main Outcomes and Measures Parental incarceration was defined as a parent or parent-like figure going to jail or prison when participants were aged younger than 18 years. Outcome measures included self-reported diagnoses of obesity, hyperlipidemia, hypertension, diabetes, or heart disease as well as serum elevations in non-high-density lipoprotein cholesterol (≥160 mg/dL) and high-sensitivity C-reactive protein (hsCRP >3 mg/L), a marker of inflammation used to estimate risk of future coronary events. Using sampling weights, incident development of each outcome was modeled as a function of parental incarceration, adjusting for participant- and neighborhood-level characteristics. Results This study included 9629 participants representing 16 077 108 US adults. Approximately half of participants were women (5498 [weighted 50.3%]) and the majority (5895 [weighted 71.4%]) were White. The mean participant age was 37.8 years (95% CI, 37.5 to 38.0 years) in wave V compared with 28.9 years (95% CI, 28.6 to 29.1 years) in wave IV. In wave V, those with childhood exposure to parental incarceration had lower educational attainment (91 [weighted 8.2%] vs 245 [weighted 4.2%] completing less than high school), had higher rates of public insurance (257 [weighted 20.6%] vs 806 [weighted 11.0%]), and were disproportionately Black (374 [weighted 22.5%] vs 1488 [weighted 13.6%]). Parental incarceration was associated with 33% higher adjusted odds (95% CI, 1.05 to 1.68) of developing hypertension and 60% higher adjusted odds (95% CI, 1.03 to 2.48) of developing elevated hsCRP. Associations between childhood parental incarceration and other diagnoses (ie, obesity, hyperlipidemia, diabetes, or heart disease) and serum lipid levels were not observed. Conclusions and Relevance In this cohort study of US adults transitioning from young adulthood to adulthood, an increased incidence of hypertension and high-risk hsCRP, but not other cardiovascular risk factors, was observed among those exposed to parental incarceration during childhood. These findings suggest possible transgenerational health consequences of mass incarceration.
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Affiliation(s)
- Elizabeth L. Tung
- Section of General Internal Medicine, University of Chicago, Chicago, Illinois
- Center for Health and the Social Sciences, University of Chicago, Chicago, Illinois
| | | | | | | | - Stacy Tessler Lindau
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
- Department of Medicine-Geriatrics, MacLean Center on Clinical Medical Ethics and Comprehensive Cancer Center, University of Chicago, Chicago, Illinois
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Wang EA, Shavit S. For Health Equity, We Must End Mass Incarceration. JAMA 2023:2806497. [PMID: 37327003 DOI: 10.1001/jama.2023.8206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This Viewpoint discusses the health harms to individuals and communities because of mass incarceration in the US and proposes interventions to ensure health equity for all individuals.
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Affiliation(s)
- Emily A Wang
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, Connecticut
- Transitions Clinic Network, San Francisco, California
| | - Shira Shavit
- Transitions Clinic Network, San Francisco, California
- Department of Family and Community Medicine, University of California, San Francisco
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1205] [Impact Index Per Article: 1205.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Berg MT, Rogers EM, Riley K, Lei MK, Simons RL. Incarceration exposure and epigenetic aging in neighborhood context. Soc Sci Med 2022; 310:115273. [PMID: 35994877 DOI: 10.1016/j.socscimed.2022.115273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/08/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Research has implicated incarceration exposure as a social determinant of health, with recent work suggesting incarceration may trigger a stress response that accelerates physiological deterioration. The objective of the current study is to assess whether neighborhood stressors intensify the health consequences of incarceration exposure. METHODS We test whether two neighborhood context measures - socioeconomic disadvantage and perceived crime - moderate the association between incarceration exposure and a measure of accelerated epigenetic aging based on the GrimAge index. Our sample included 408 African American young adults from the Family and Community Health study. RESULTS Results from regression analyses with inverse probability of treatment weights suggest that incarceration exposure and neighborhood disadvantage are independently associated with accelerated biological aging. The results also show that the impact of incarceration exposure on accelerated aging is amplified for individuals in neighborhoods with higher levels of perceived crime. CONCLUSIONS These findings indicate that the neighborhood contexts where formerly incarcerated individuals return have a substantial impact on their pace of biological aging. Policies aimed at reducing ambient stressors after release may promote healthy aging among formerly incarcerated African American adults.
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Healthy lifestyle changes favourably affect common carotid intima-media thickness: the Healthy Lifestyle Community Programme (cohort 2). J Nutr Sci 2022; 11:e47. [PMID: 35754985 PMCID: PMC9201878 DOI: 10.1017/jns.2022.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/05/2022] Open
Abstract
Common carotid intima-media thickness (ccIMT) progression is a risk marker for cardiovascular disease (CVD), whereas healthy lifestyle habits are associated with lower ccIMT. The objective of the present study was to test whether a healthy lifestyle intervention can beneficially affect ccIMT progression. A community-based non-randomised, controlled lifestyle intervention was conducted, focusing on a predominantly plant-based diet (strongest emphasis), physical activity, stress management and social health. Assessments of ccIMT were made at baseline, 6 months and 1 year. Participants had an average age of 57 years and were recruited from the general population in rural northwest Germany (intervention: n 114; control: n 87). From baseline to 1 year, mean ccIMT significantly increased in both the intervention (0⋅026 [95 % CI 0⋅012, 0⋅039] mm) and control group (0⋅045 [95 % CI 0⋅033, 0⋅056] mm). The 1-year trajectory of mean ccIMT was lower in the intervention group (P = 0⋅022; adjusted for baseline). In a subgroup analysis with participants with high baseline mean ccIMT (≥0⋅800 mm), mean ccIMT non-significantly decreased in the intervention group (-0⋅016 [95 % CI -0⋅050, 0⋅017] mm; n 18) and significantly increased in the control group (0⋅065 [95 % CI 0⋅033, 0⋅096] mm; n 12). In the subgroup, the 1-year trajectory of mean ccIMT was significantly lower in the intervention group (between-group difference: -0⋅051 [95 % CI -0⋅075, -0⋅027] mm; P < 0⋅001; adjusted for baseline). The results indicate that healthy lifestyle changes may beneficially affect ccIMT within 1 year, particularly if baseline ccIMT is high.
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Testa A, Fahmy C, Jackson DB, Ganson KT, Nagata JM. Incarceration exposure during pregnancy and maternal disability: findings from the Pregnancy Risk Assessment Monitoring System. BMC Public Health 2022; 22:744. [PMID: 35418044 PMCID: PMC9009053 DOI: 10.1186/s12889-022-13143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/31/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Extant research reveals that currently and formerly incarcerated individuals exhibit higher rates of disability. Moreover, recent research highlights that women exposed to incarceration during pregnancy -either personally or vicariously through a partner- face poorer health. However, prior research has not detailed the connection between incarceration exposure and risk for maternal disability. METHODS The aim of this study is to evaluate the association between a women's exposure to incarceration during pregnancy and disability including difficulty with: communication, hearing, remembering, seeing, self-care, or walking. Data are from Pregnancy Risk Assessment Monitoring System (PRAMS), 2019 (N = 12,712). Logistic and negative binomial regression were used to assess the relationship between incarceration exposure and maternal disability. RESULTS Among the sample of women who delivered a recent live birth, approximately 3.3% of the sample indicated they were personally or vicariously exposed to incarceration in the 12 months before birth. Compared to those who did not have incarceration exposure, women with incarceration exposure have elevated odds of several disabilities, including difficulty remembering (Adjusted Odds Ratio [AOR] = 1.971; 95% Confidence Interval [CI] = 1.429, 2.718), difficulty seeing (AOR = 1.642, 95% CI = 1.179, 2.288), difficulty walking (AOR = 1.896, 95% CI = 1.413, 2.544), and a greater number of cumulative disabilities (Incidence Risk Ratio [IRR] = 1.483; 95% CI = 1.271, 1.731). CONCLUSIONS Women personally or vicariously exposed to incarceration during pregnancy endure greater odds of having a disability. Considering both incarceration and disability are important public health issues with implications for maternal and child well-being, these findings highlight the need for further research that can better understand the connection between incarceration and disability.
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Affiliation(s)
- Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, US
| | - Chantal Fahmy
- Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, Texas, US
| | - Dylan B Jackson
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, US
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, US.
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2425] [Impact Index Per Article: 1212.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Popovic D, Lavie C. Stress, cardiovascular diseases and exercise – A narrative review. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Transitioning into the Community: Perceptions of Barriers and Facilitators Experienced By Formerly Incarcerated, Homeless Women During Reentry-A Qualitative Study. Community Ment Health J 2021; 57:609-621. [PMID: 33387178 PMCID: PMC8514107 DOI: 10.1007/s10597-020-00748-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
Formerly incarcerated, homeless women on parole or probation experience individual-and structural-level barriers and facilitators as they prepare to transition into the community during reentry. A qualitative study was undertaken using focus group methods with formerly incarcerated, currently homeless women (N = 18, Mage = 37.67, SD 10.68, 23-53 years of age) exiting jail or prison. Major themes which emerged included the following: (1) access to resources-barriers and facilitators during community transition, (2) familial reconciliation and parenting during community transition, and (3) trauma and self-care support during community transition. These findings suggest a need to develop multi-level interventions at the individual, program and institutional/societal level with a gender-sensitive lens for women who are transitioning to community reentry. It is hoped that providing such resources will reduce the likelihood of homelessness and reincarceration.
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Koeder C, Hahn A, Englert H. Effect of a 6-Month Controlled Lifestyle Intervention on Common Carotid Intima-Media Thickness. J Nutr Health Aging 2021; 25:869-877. [PMID: 34409964 DOI: 10.1007/s12603-021-1628-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The intima-media thickness of the common carotid artery (ccIMT) is an established risk marker for cardiovascular disease (CVD). However, it is unclear whether lifestyle interventions can easily demonstrate an improvement in ccIMT. The objective was to test if our intervention would beneficially affect ccIMT (among other CVD markers). DESIGN Non-randomized controlled trial. SETTING Rural northwest Germany. PARTICIPANTS Middle-aged and elderly participants from the general population (intervention: n = 114; control: n = 87). INTERVENTION A community-based, 6-month controlled lifestyle intervention focusing on four areas of lifestyle change: a plant-based diet, physical activity, stress management, and an improved social life. A strong emphasis was on dietary change. MEASUREMENTS We tested whether ccIMT change from baseline to 6 months was different between groups. RESULTS With all participants included, no significant difference in mean ccIMT change between groups was observed (p = 0.708). However, in a subgroup analysis with participants with high baseline mean ccIMT (≥0.800 mm) a significant difference in mean ccIMT change between intervention (-0.023 [95% CI -0.052, 0.007] mm; n = 22; baseline mean ccIMT: 0.884 ± 0.015 mm) and control (0.041 [95% CI 0.009, 0.073] mm; n = 13; baseline mean ccIMT: 0.881 ± 0.022 mm) was observed (p = 0.004). Adjusting for potential confounders did not substantially alter the results. CONCLUSION The results indicate that healthy lifestyle changes can beneficially affect ccIMT within 6 months and that such a beneficial effect may be more easily demonstrated if participants with high baseline ccIMT are recruited. The observed effect is of relevance for the prevention of CVD events, including myocardial infarction and stroke.
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Affiliation(s)
- C Koeder
- Christian Koeder, Department of Nutrition, University of Applied Sciences Münster, Corrensstr. 25, 48149 Münster, Germany;
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Testa A, Jackson DB. Incarceration Exposure During Pregnancy and Infant Health: Moderation by Public Assistance. J Pediatr 2020; 226:251-257.e1. [PMID: 32590000 DOI: 10.1016/j.jpeds.2020.06.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/02/2020] [Accepted: 06/18/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To assess the relationship between exposure to incarceration during pregnancy and adverse infant health outcomes: low birth weight (<2500 g), very low birth weight (<1500 g), preterm birth (<37 weeks), and very preterm birth (≤33 weeks), and to evaluate the moderating role of receiving public assistance benefits (Special Supplemental Nutrition Program for Women, Infants, and Children and Medicaid) during pregnancy in this process. STUDY DESIGN The current study employs data from the Pregnancy Risk Assessment Monitoring System, 2009-2017. Logistic regression models were used to assess the association between incarceration of a woman or her partner in the year before birth, the receipt of public assistance during pregnancy, and postpartum infant health. Moderation analyses were conducted by interacting forms of public assistance and incarceration exposure. RESULTS Exposure to incarceration either personally or vicariously through a partner increased all 4 adverse infant health outcomes. However, moderation analyses demonstrated that public assistance benefits and incarceration have a negative interaction, indicating that public assistance might buffer against the harmful effects of incarceration exposure during pregnancy on infant health. CONCLUSIONS Incarceration exposure during pregnancy poses a significant risk for adverse infant health outcomes. However, the receipt of public assistance benefits including Special Supplemental Nutrition Program for Women, Infants, and Children and Medicaid may mitigate this risk. Expanded access to public assistance for women exposed to incarceration during pregnancy holds promise to improve infant health outcomes.
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Affiliation(s)
- Alexander Testa
- Department of Criminology & Criminal Justice, The University of Texas at San Antonio, San Antonio, TX.
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins University, Baltimore, MD
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