Incarceration of a household member and Hispanic health disparities: childhood exposure and adult chronic disease risk behaviors

Racial Disparities in the Relationship between Parental Incarceration and Childhood Obesity

Despite a developing literature on the consequences of parental incarceration, its effects on childhood obesity are not evident. Our research project fills this knowledge gap by describing the relationship between parental incarceration and childhood obesity among children aged 3 to 15 and determining if and how this association differs across race. We use four consecutive waves of data on 3,302 children from the Fragile Families and Child Wellbeing Study. Our analysis finds little evidence that parental incarceration influences the probability of obesity among all children as a group. Moreover, our findings reveal critical racial disparities in the relationship between parental incarceration and childhood obesity. In particular, parental lifetime incarceration is not associated with risks of obesity for White or Hispanic children but is associated with a significantly decreased chance of obesity for Black children. This research effort can initiate an interdisciplinary conversation on the important intersection of family and corrections in order to alleviate the intergenerational erosion of physical health and well-being.

Partner incarceration, maternal substance use, and the mediating role of social support: A longitudinal analysis using the future of families and child wellbeing study

INTRODUCTION

The United States is responsible for the highest incarceration rate globally. This study aimed to explore the impact of partner incarceration on maternal substance use and whether social support mediates the relationship between partner incarceration and maternal substance use.

METHODS

Using data from the Future of Families and Child Wellbeing Study, a longitudinal cohort following new parents and children, this analysis quantifies the relationship between paternal incarceration and maternal substance use (N = 2823). We analyzed maternal responses in years 3 (2001-2003), 5 (2003-2006), 9 (2007-2010), and 15 (2014-2017). We explored the role of financial support and emergency social support as potential mediators. Confirmatory factor analysis (CFA) was employed to construct support-related mediators. We modeled the impact of partner incarceration and maternal substance use using generalized estimating equations (GEE) to account for repeated measures, adjusting for appropriate confounders (age of mother at child's birth, race, education, employment, and history of intimate partner violence).

RESULTS

Nearly half (44.2%, N = 1247) of participants reported partner incarceration. Among mothers who experienced partner incarceration, the odds of reporting substance use were 110% greater than those who reported no partner incarceration (adjusted Odds Ratio [aOR]: 2.10; 95% Confidence Interval (CI):1.67-2.63). Financial support at year 5 accounted for 19.5% (95% CI: 6.03-33.06%) of the association between partner incarceration at year 3 and substance use at year 9; emergency social support at year 5 accounted for 6.4% (95% CI: 0.51-12.25%) of the association between partner incarceration and substance use at year 9. Neither financial nor emergency social support at year 9 were significant mediators between partner incarceration at year 3 and substance use at year 15.

CONCLUSIONS

These findings demonstrate that partner incarceration impacts maternal substance use. Financial and emergency support may partially mediate this relationship in the short term, which has important implications for families disrupted by mass incarceration.

Parental imprisonment, delinquent behavior, and BMI gain in a U.S. nationally representative cohort study of adolescents and adults ages 12-32

Children who experience parental imprisonment report greater mental and physical health adversities in adolescence and adulthood relative to comparable individuals whose parents did not serve time in prison. Research has linked BMI gain with parental imprisonment among females, but other studies have shown null or negative associations between parental imprisonment and weight increases for their offspring. Using longitudinal data from the National Longitudinal Study of Adolescent to Adult Health, this study attempts to resolve these differential findings by examining the interrelationship between delinquent behavior and BMI associated with parental imprisonment as individuals progress from adolescence into adulthood (ages 12-32). We show that higher delinquency levels are associated with lower BMI among men and women. With the transition from adolescence to adulthood, parental imprisonment is linked with increased BMI gain and obesity among females who are not delinquent. These findings highlight the need to consider how the decline in delinquent behavior and increasing health disparities between adolescence and adulthood may intersect as individuals experiencing parental imprisonment transition from adolescence to adulthood.

Cultural and psychosocial moderators of the association between adverse childhood experiences and alcohol and marijuana use among Latinx college students on the U.S./Mexico border

BACKGROUND

Adverse childhood experiences (ACEs) have been historically associated with negative life outcomes among the general population.

OBJECTIVE

With limited research among Latinx college students, this study assessed how specific constructs moderate the association between ACEs and alcohol and marijuana use.

PARTICIPANTS AND SETTING

Latinx participants recruited from a large U.S./Mexico border region university (Females: N = 283, Males: N = 168) completed an online survey which included: demographics, the Center for Youth Wellness Adverse Childhood Experience Questionnaire (CYW ACE-Q) Teen Self-Report, Drug Use Frequency (DUF), Experiences in Close Relationships Scale (ECR), General Self-Efficacy Scale (GSE), Attitudinal Familism Scale (AFS), The Machismo Measure or The Marianismo Beliefs Scale (MBS), and The Bicultural Self-Efficacy Scale (BSE).

METHODS

Hierarchical linear regressions were conducted to test for main and interactive effects and to determine if the individual moderators (i.e., attachment style, self-efficacy, familism, traditional gender norms, bicultural self-efficacy) affect the relationship between ACEs and alcohol and marijuana use.

RESULTS

Results indicated that among females, attachment style (β = 0.04, p = .03), MBS (β = -65.57, p = .01), and BSE (β = 0.34, p = .04) moderate the relationship between ACEs and alcohol and marijuana use. No moderation analyses were statistically significant among males.

CONCLUSIONS

Clinical implications include, for both substance use and trauma treatment among Latinx college students, the assessment of ACEs and attachment style to promote greater insight into the client's inner struggles and emotional processing in relation to marianismo beliefs and bicultural self-efficacy.

Culturally Responsive Trauma-Informed Services: A Multilevel Perspective from Practitioners Serving Latinx Children and Families

Using a multilevel ecological framework, we take a qualitative approach to examining important cultural considerations that support successful implementation of trauma-informed services within the Latinx community. We conducted key informant interviews with community practitioners recruited primarily in the Phoenix, AZ metro area. Themes that emerged from interviews captured societal, community, and individual barriers to effective implementation of a culturally responsive trauma-informed approach. Specifically, multilevel barriers included socioeconomic circumstances, normalization of trauma exposure, and the transgenerational impact of trauma. Practitioners also reported approaching their work using relationship-focused and family-centered frameworks as facilitators to service engagement. We highlight the critical need for a culturally responsive trauma-informed approach that stresses the importance of context, recognizes transgenerational vulnerabilities, and promotes equity and the utilization of cultural humility in order to lessen the multilayered disparities in service accessibility experienced by minoritized communities.

The Effects of Individual and Dual ACE Domains on Binge Drinking: Comparisons by Gender

BACKGROUND

Adverse Childhood Experiences (ACEs) show predictive utility concerning binge drinking. However, the literature is limited by 1. a focus on cumulative ACEs with little regard to specific domains, 2. a focus on those with the highest ACE scores, and 3. little consideration for gender differences. These approaches are problematic as ACE categories are fundamentally different, yet little distinction is given to specific ACE domains. The current study investigates which individual and dual ACE domain combinations are associated with binge drinking.

METHODS

Data were obtained from the Behavioral Risk Factor Surveillance System (2011-2017; N = 80,391). A series of ANCOVAs were conducted to determine the association between single and dual combination ACE domains and binge drinking.

RESULTS

Results show gendered effects of ACEs on binge drinking such that at 0, 1, and 2 ACEs, males reported statistically higher rates. For males with exactly two ACEs, combinations of either sexual abuse or family incarceration presented the highest levels of binge drinking- with the highest mean binge drinking score being the exact combination of the two. This contrasts with males with 1 ACE, where experiencing family incarceration or sexual abuse, as a single domain, did not represent significant risk above the average of having a single ACE.

CONCLUSIONS

Results suggest that males may be resilient to either of these domains as singular events, yet when found in combination, may present a synergistic effect that increases the likelihood of binge drinking. Due to lower overall binge drinking rates, no significant patterns were found among females.

Is exposure to family member incarceration during childhood linked to diabetes in adulthood? Findings from a representative community sample

Objectives:

Diabetes is a prevalent and serious public health problem, particularly among older adults. A robust literature has shown that adverse childhood experiences contribute to the development of health problems in later life, including diabetes. Family member incarceration during childhood is an under-investigated yet increasingly common adverse childhood experience in the United States. The purpose of this study was to investigate the relationship between family member incarceration during childhood and diabetes in adulthood, while considering the role of gender as well as the impact of a range of potential confounds.

Methods:

A large representative community sample of adults aged 40 and older (n = 8790 men, 14,255 women) was drawn from the Behavioral Risk Factor Surveillance System 2012 optional adverse childhood experiences module to investigate the association between family member incarceration during childhood and diabetes. For each gender, nine logistic regression analyses were conducted using distinct clusters of variables (e.g. socioeconomic status and health behaviors).

Results:

Among males, the odds of diabetes among those exposed to family member incarceration during childhood ranged from 2.00 to 1.59. In the fully adjusted model, they had elevated odds of 1.64 (95% confidence interval = 1.27, 2.11). Among women, the odds of diabetes was much lower, hovering around 1.00.

Conclusion:

Findings suggest that family member incarceration during childhood is associated with diabetes in men, even after adjusting for a wide range of potential risk factors (e.g. sociodemographics, health behaviors, healthcare access, and childhood risk factors). Future research should explore the mechanisms linking family member incarceration during childhood and long-term negative health outcomes in men.

Assessing within- and between-family variations in an expanded measure of childhood adversity

Previous measures of childhood adversity have enabled the identification of powerful links with later-life wellbeing. The challenge for the next generation of childhood adversity assessment is to better characterize those links through comprehensive, fine-grained measurement strategies. The expanded, retrospective measure of childhood adversity presented here leveraged analytic and theoretical advances to examine multiple domains of childhood adversity at both the microlevel of siblings and the macrolevel of families. Despite the fact that childhood adversity most often occurs in the context of families, there is a dearth of studies that have validated childhood adversity measures on multiple members of the same families. Multilevel psychometric analyses of this childhood adversity measure administered to 1,194 siblings in 500 families indicated that the additional categories of childhood adversity were widely endorsed, and increased understanding of the sources and sequalae of childhood adversity when partitioned into within- and between-family levels. For example, multilevel confirmatory factor analyses (MCFAs) indicated that financial stress, unsafe neighborhood, and parental unemployment were often experienced similarly by siblings in the same families and stemmed primarily from family wide (between-family) sources. On the other hand, being bullied and school stressors were often experienced differently by siblings and derived primarily from individual (within-family) processes. Multilevel structural equation modeling (MSEM) further illuminated differential criterion validity correlations between these categories of childhood adversity with midlife psychological, social, and physical health. Expanded, multidomain, and multilevel measures of childhood adversity appear to hold promise for identifying layered causes and consequences of adverse childhood experiences. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015

Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.

Impact of parental incarceration on neonatal outcomes and newborn home environments: a case-control study

OBJECTIVES

Parental incarceration (PI) is a prevalent adverse childhood experience (ACE) that has been linked to numerous social, emotional, and health problems in childhood and adulthood. A growing body of research has emphasized the importance of the timing of parent's incarceration on developmental outcomes.

STUDY DESIGN

The present study uses case-control matching to examine the impact of recent PI on newborn health and home safety outcomes.

METHODS

Neonatal health and newborn sleep and home safety data, including rates of premature birth, low birth weight (LBW), neonatal intensive care unit admittance, breastfeeding initiation, safe sleep, and home environment (e.g. working smoke alarm, proper firearm storage), were collected from 108 women who completed the Virginia Pregnancy Risk Assessment Monitoring survey. Half of these women (n = 54) had experienced the incarceration of themselves or their partner during the previous 12 months. Participants were matched by age, race, income, and the education level with those of 54 women who completed the survey and who had not experienced incarceration in the previous year.

RESULTS

Controlling for nicotine and alcohol consumption during pregnancy and other stressors, path analyses show that the women who experienced incarceration of themselves or their husband/partner were significantly less likely to deliver an LBW infant and more likely to live in a home with a loaded firearm in the home. No other significant differences emerged between the two matched groups among neonatal health or newborn sleep and home safety outcomes.

CONCLUSIONS

This result is considered from a public health perspective, as PI is an ACE which can be impacted by policy, particularly policies that promote practices that healthcare workers can use in correctional and other environments to encourage healthy pregnancies and home environments for newborns.

Maternal Incarceration, Children's Psychological Adjustment, and the Mediating Role of Emotion Regulation

Children who live in the context of maternal incarceration (MI) are exposed to both general environmental risk and incarceration-specific risk increasing the probability of their developing externalizing and internalizing behaviors problems. Little research has examined the socio-emotional mechanisms that account for the psychological effects of MI. This research examined children's anger and sadness regulation as mediators between environmental and incarceration-specific risk and psychological functioning. Participants were 117 children (60% Black; 52% boys; M age = 9.85 years, SD = 1.65 years), their incarcerated mother, and current caregiver. All informants completed questionnaires assessing children's anger and sadness regulation as well as externalizing and internalizing behaviors. Mothers and caregivers provided information concerning children's exposure to environmental risk and all three reporters provided information on incarceration-specific risk experiences (ISRE). Structural equation modeling was used to test indirect effects of risk variables (ISRE, environmental) on psychological functioning (externalizing, internalizing behaviors) via emotion regulation (anger, sadness). Gender, age, and race were covariates. The analyses revealed significant indirect effects of incarceration-specific risk on both externalizing and internalizing behavior problems via anger regulation but not via sadness regulation. The findings highlight the centrality of emotion regulation as a mechanism that helps explain the negative psychological outcomes experienced by children exposed to ISRE with implications for preventive interventions.

The Complex Interplay of Adverse Childhood Experiences, Race, and Income

An extensive research base shows evidence of racial disparities in health outcomes, and a growing body of evidence points to associations between adverse childhood experiences (ACEs) and poor health. This study uses data from the 2011 and 2012 Wisconsin Behavioral Risk Factor Surveillance System surveys to identify the relative contributions of ACEs, race, and adult income to predicting three sets of adverse adult health outcomes. The authors found that controlling for demographic factors, ACEs strongly predict health risk behaviors, indicators of poor general health, and chronic health conditions. Adult low-income status is associated with poor general health and chronic health conditions, but not health risk behaviors. African American race is marginally associated only with indicators of poor general health, and this association is attenuated when ACEs and adult income are controlled. These findings suggest a complex interplay among ACEs, race, and income.

Perceived Neighborhood Safety Better Predicts Risk of Mortality for Whites than Blacks

AIM

The current study had two aims: (1) to investigate whether single-item measures of subjective evaluation of neighborhood (i.e., perceived neighborhood safety and quality) predict long-term risk of mortality and (2) to test whether these associations depend on race and gender.

METHODS

The data came from the Americans' Changing Lives Study (ACL), 1986-2011, a nationally representative longitudinal cohort of 3361 Black and White adults in the USA. The main predictors of interest were perceived neighborhood safety and perceived neighborhood quality, as measured in 1986 using single items and treated as dichotomous variables. Mortality due to all internal and external causes was the main outcome. Confounders included baseline age, socioeconomic status (education, income), health behaviors (smoking, drinking, and exercise), and health (chronic medical conditions, self-rated health, and depressive symptoms). Race and gender were focal effect modifiers. Cox proportional hazard models were ran in the pooled sample and stratified by race and gender.

RESULTS

In the pooled sample, low perceived neighborhood safety and quality predicted increased risk of mortality due to all causes as well as internal causes, net of all covariates. Significant interaction was found between race and perceived neighborhood safety on all-cause mortality, indicating a stronger association for Whites compared to Blacks. Race did not interact with perceived neighborhood quality on mortality. Gender also did not interact with perceived neighborhood safety or quality on mortality. Perceived neighborhood safety and quality were not associated with mortality due to external causes.

CONCLUSION

Findings suggest that single items are appropriate for the measurement of perceived neighborhood safety and quality. Our results also suggest that perceived neighborhood safety better predicts increased risk of mortality over the course of 25 years among Whites than Blacks.

Perceived Neighborhood Safety During Adolescence Predicts Subsequent Deterioration of Subjective Health Two Decades Later; Gender Differences in a Racially-Diverse Sample

BACKGROUND

Current study aimed to investigate whether perceived neighborhood as unsafe during adolescence predicts the subsequent perceived health two decades later.

METHODS

In a prospective study of an ethnically diverse urban sample (83.2% Black), conducted from 1994 to 2012, 851 adolescents were enrolled at 9(th) grade. Three hundred and seventy-eight participants were followed from 9(th) grade for 18 years. The outcome was subjective health (feeling as healthy as other people of the same age) measured at baseline (mean age 15 years) and end of follow-up (mean age 33 years). The independent variable was neighborhood perceived as unsafe measured at 9(th) grade. Baseline age, family structure, and parental employment were control variables. We ran logistic regressions in the pooled sample and also specific to each gender.

RESULTS

Perceived neighborhood as unsafe at 9(th) grade predicted deterioration of subjective health over the next 18 years (unadjusted odds ratio = 1.742, 95% confidence interval = 1.042-2.911). This association remained significant in a multivariable model that controlled for baseline subjective health, family structure, and parental employment. The association between perceived neighborhood safety at 9(th) grade and subsequent deterioration of perceived health during the next 12 years was significant for females but not males.

CONCLUSIONS

Our findings suggest that perception of unsafe neighborhoods during adolescence has negative consequences years later for the health of females. Further research is needed to replicate the findings using objective measures of health.

Appreciative inquiry with nurses who work with children of incarcerated parents

An appreciative inquiry study was conducted with 12 nurse-mentors who worked with children of incarcerated parents. The aim was to generate best practice knowledge for working with these children. The nurse-mentoring program, based on theorists Peplau and Erickson and colleagues, was implemented to promote optimum health outcomes among children at high risk for incarceration. Through this study method, nurse mentors discovered what was effective as they created a collective vision for future practice. An action plan was implemented, evaluated, and conclusions were drawn. Data from this study imply that nurse-mentoring can be used with other vulnerable populations. Nurses should use appreciative inquiry to transform healthcare, particularly in situations with seemingly intransigent solutions.

Adverse childhood events: incarceration of household members and health-related quality of life in adulthood

BACKGROUND

Incarceration of a household member has been associated with adverse outcomes for child well-being.

METHODS

We assessed the association between childhood exposure to the incarceration of a household member and adult health-related quality of life (HRQOL) in the 2009/2010 Behavioral Risk Factor Surveillance System controlling for age, race/ethnicity, education, and additional adverse childhood experiences.

RESULTS

Adults who lived in childhood with an incarcerated household member had higher risk of poor HRQOL compared with adults who had not (adjusted relative risk [ARR] 1.18; 95% CI 1.07, 1.31). Among Black adults the association was strongest with the physical health component of HRQOL (ARR 1.58 [95% CI 1.18, 2.12]); among White adults, the association was strongest with the mental health component of HRQOL (ARR 1.29, [95% CI 1.07-1.54]).

CONCLUSIONS

Living with an incarcerated household member during childhood is associated with higher risk of poor HRQOL during adulthood, suggesting that the collateral damages of incarceration for children are long-term.