Health Behaviors and Outcomes Associated With Personal and Family History of Criminal Justice System Involvement, New York City, 2017

Burden of diabetes in correctional facilities: A global systematic review and meta-analysis

Background

Diabetes mellitus presents significant public health challenges worldwide. While its prevalence and management in the general population have been extensively studied, comprehensive research on diabetes among incarcerated individuals is lacking. This study aims to conduct a systematic review and meta-analysis to determine the prevalence of diabetes within the prison population.

Methods

The systematic review included studies reporting on the prevalence of diabetes in prison populations. Searches were conducted in PubMed, Web of Science, and EMBASE from 2000 to November 4, 2023, with an update on December 15, 2023. Nested Knowledge web software was utilized for screening and data extraction. Quality assessment was conducted using the JBI tool. A meta-analysis was performed using a random-effects model in R software version 4.3.

Results

Thirty-three studies were included, encompassing 807,617 participants, with 67,291 reported as patients with diabetes. The pooled prevalence of diabetes in prison populations was found to be 7.1% (95% CI: 4.9% to 10.1%), exhibiting high heterogeneity (I2 = 100%). Subgroup analysis revealed significant geographical variability: the United States had a prevalence of 9% (95% CI: 4 %to 17 %), Italy 5% (95% CI: 0% to 40 %), Iran 10% (95% CI: 7 % to 15 %), and Egypt 21% (95% CI: 14% to 28 %). Notable variations in prevalence were also observed in countries like France, Australia, Taiwan, India, the UK, Spain, Brazil, and Sub-Saharan Africa. An LFK index of -3.3 indicated the presence of publication bias.

Conclusion

The study reveals that diabetes mellitus is a significant health concern in prisons, with a prevalence of 7.1%, comparable to that in the general population. The marked variability across studies indicates the challenges of diabetes management in correctional settings. These findings highlight the need for tailored healthcare strategies, considering prisons' unique challenges and risk factors.

County-level jail incarceration, community economic distress, rurality, and preterm birth among women in the US South

Introduction

The USA has higher rates of preterm birth and incarceration than any other developed nation, with rates of both being highest in Southern states and among Black Americans, potentially due to rurality and socioeconomic factors. To test our hypothesis that prior-year county-level rates of jail admission, economic distress, and rurality were positively associated with premature birth rates in the county of delivery in 2019 and that the strength of these associations is greater for Black women than for White or Hispanic women, we merged five datasets to perform multivariable analysis of data from 766 counties across 12 Southern/rural states.

Methods

We used multivariable linear regression to model the percentage of babies born premature, stratified by Black (Model 1), Hispanic (Model 2), and White (Model 3) mothers. Each model included all three independent variables of interest measured using data from the Vera Institute, Distressed Communities Index, and Index of Relative Rurality.

Results

In fully fitted stratified models, economic distress was positively associated with premature births among Black (F = 33.81, p < 0.0001) and White (F = 26.50, p < 0.0001) mothers. Rurality was associated with premature births among White mothers (F = 20.02, p < 0.0001). Jail admission rate was not associated with premature births among any racial group, and none of the study variables were associated with premature births among Hispanic mothers.

Conclusions

Understanding the connections between preterm birth and enduring structural inequities is a necessary scientific endeavor to advance to later translational stages in health-disparities research.

Losing Years Doing Time: Incarceration Exposure and Accelerated Biological Aging among African American Adults

Research suggests that incarceration exposure increases the prevalence of morbidity and premature mortality. This work is only beginning to examine whether the stressors of the incarceration experience become biologically embedded in ways that affect physiological deterioration. Using data from a longitudinal sample of 410 African American adults in the Family and Community Health Study and an epigenetic index of aging, this study tests the extent to which incarceration accelerates epigenetic aging and whether experiences with violence moderate this association. Results from models that adjust for selection effects suggest that incarceration exposure predicted accelerated aging, leaving formerly incarcerated African American individuals biologically older than their calendar age. Direct experiences with violence also exacerbated the effects of incarceration. These findings suggest that incarceration possibly triggers a stress response that affects a biological signature of physiological deterioration.

Cannabis Policy in the United States: Implications for Public Health

INTRODUCTION

As of January 2021, a total of 36 states and the District of Columbia (DC) have legalized medical cannabis use, and 14 states and DC have legalized adult nonmedical use. This manuscript qualitatively summarizes cannabis policies across states with legal adult use marketplaces.

METHODS

Data are from state laws and regulations, collected through January 2021, and have been verified with state officials as part of ongoing state policy tracking efforts.

RESULTS

State policies differ in how cannabis products are taxed, where revenues are allocated, restrictions on the types of available products, restrictions on additives and flavors, product packaging and labeling, advertising restrictions, where cannabis can be consumed, and approaches to social equity.

CONCLUSION

Timely, accurate, and longitudinal state and local cannabis policy data are needed to understand the implications of legalization. Careful study of policy differences across and within states is warranted, as differences may affect public health and consumer safety.

Stress Among Older Adults With an Incarcerated Family Member: Testing the Buffering Model of Social Support

OBJECTIVES

This study investigates whether levels of social support moderate the association between age and stress among a sample of individuals who have a family member incarcerated.

METHODS

Survey responses from individuals who are members of a nonprofit organization for individuals with a family member incarcerated in Texas were used (n = 376). Ordinary least squares regression analysis was conducted to assess the interaction between age and levels of social support on stress.

RESULTS

Findings demonstrated a negative interaction between social support and age (b = -0.040, p = .027), indicating that higher levels of social support buffer against stress for older adults.

DISCUSSION

The theoretical mechanisms linking social support to reductions in stress among older individuals experiencing highly stressful life events (i.e., familial incarceration), as well as the policy and practical implications for enhancing social support among older individuals with a family member incarcerated, are discussed.

Disparities in Social and Economic Determinants of Health by Sexual Identity, Gender, and Age: Results from the 2015-2018 National Survey on Drug Use and Health

Purpose: We characterize disparities between lesbian, gay, and bisexual (LGB) adults and heterosexual adults across multiple health determinants in a nationally representative sample. Methods: Data on 153,939 adults (including 11,133 LGB adults) were from the 2015-2018 National Survey on Drug Use and Health. Separate Poisson regression models were used to estimate the relative risk (RR) that gay/lesbian and bisexual adults, respectively, experienced each health determinant, relative to heterosexual adults of the same gender and age group (ages 18-25, 26-34, 35-49, and 50-64). Statistically significant RR estimates were interpreted as a disparity. Results: Bisexual females exhibited disparities on all economic/health care access factors (no college degree, household poverty, means-tested assistance, unemployment, and lacking health insurance) across nearly all age groups; lesbian/gay females exhibited disparities in means-tested assistance and health insurance for some age groups. Notably fewer economic disparities were observed among gay and bisexual males. LGB adults (across identity, gender, and age group) were more likely to live alone, to have never been married, and to report low religious service attendance. Bisexual and lesbian/gay females, across age groups, had 1.7-2.2 times the risk of a lifetime arrest for a criminal offense, relative to same-age heterosexual females. Conclusions: Our results highlight that LGB females, particularly bisexual females, experience significant disparities in economic determinants of health, and all LGB subgroups exhibited disparities in some of the examined social determinants of health. The observed disparities, which spanned across age groups, likely contribute to disparities in physical and mental health observed among LGB adults.

The body in isolation: The physical health impacts of incarceration in solitary confinement

We examine how solitary confinement correlates with self-reported adverse physical health outcomes, and how such outcomes extend the understanding of the health disparities associated with incarceration. Using a mixed methods approach, we find that solitary confinement is associated not just with mental, but also with physical health problems. Given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations. Drawing from a random sample of prisoners (n = 106) in long-term solitary confinement in the Washington State Department of Corrections in 2017, we conducted semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for these subjects. We also conducted a paper survey of the entire long-term solitary confinement population (n = 225 respondents) and analyzed administrative data for the entire population of prisoners in the state in 2017 (n = 17,943). Results reflect qualitative content and descriptive statistical analysis. BPRS scores reflect clinically significant somatic concerns in 15% of sample. Objective specification of medical conditions is generally elusive, but that, itself, is a highly informative finding. Using subjective reports, we specify and analyze a range of physical symptoms experienced in solitary confinement: (1) skin irritations and weight fluctuation associated with the restrictive conditions of solitary confinement; (2) un-treated and mis-treated chronic conditions associated with the restrictive policies of solitary confinement; (3) musculoskeletal pain exacerbated by both restrictive conditions and policies. Administrative data analyses reveal disproportionate rates of racial/ethnic minorities in solitary confinement. This analysis raises the stakes for future studies to evaluate comparative prevalence of objective medical diagnoses and potential causal mechanisms for the physical symptoms specified here, and for understanding differential use of solitary confinement and its medically harmful sequelae.