Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan Medical School, Ann Arbor, Michigan;
Division of Academic General Pediatrics and.
Pediatrics. 2018 Sep;142(3). doi: 10.1542/peds.2017-4314. Epub 2018 Jul 9.
To determine if longitudinal associations exist between parental incarceration (PI) and health care use or health behaviors among a national sample of young adults.
We used the National Longitudinal Survey of Adolescent to Adult Health to examine associations between history of mother incarceration (MI) and father incarceration (FI), health care use, and 3 dimensions of health behaviors (eg, general health behaviors, substance use, and other risky behaviors) ( = 13 084). Multivariable logistic regression models accounted for individual, family, and geographic factors and generated adjusted odds ratios (aORs).
Over 10% of the sample had a history of PI before the age of 18. History of MI and FI were both associated with forgone health care (aOR = 1.65 [95% confidence interval (CI), 1.20-2.27], aOR = 1.22 [95% CI, 1.02-1.47], respectively), prescription drug abuse (MI aOR = 1.61 [95% CI, 1.02-2.55], FI aOR = 1.46 [95% CI, 1.20-1.79]), and 10 or more lifetime sexual partners (MI aOR = 1.55 [95% CI, 1.08-2.22], FI aOR = 1.19 [95% CI, 1.01-1.41]). MI was associated with higher likelihood of emergency department use (aOR = 2.36 [95% CI, 1.51-3.68]), and FI was associated with illicit injection drug use (aOR = 2.54 [95% CI, 1.27-5.12]).
The effects of incarceration extend beyond incarcerated individuals. PI histories are associated with lower health care use and unhealthy behaviors in young adulthood. By addressing barriers to health care and health-harming behaviors, health care providers and policy makers may reduce health disparities among this population.
在全国范围内的年轻成年人样本中,确定父母监禁(PI)与医疗保健使用或健康行为之间是否存在纵向关联。
我们使用全国青少年至成人健康纵向调查来研究母亲监禁史(MI)和父亲监禁史(FI)与医疗保健使用以及健康行为的 3 个维度(即一般健康行为、物质使用和其他危险行为)之间的关联(=13084)。多变量逻辑回归模型考虑了个体、家庭和地理因素,并生成了调整后的优势比(aOR)。
超过 10%的样本在 18 岁之前有过 PI 史。MI 和 FI 史均与放弃医疗保健有关(aOR=1.65[95%置信区间(CI),1.20-2.27],aOR=1.22[95%CI,1.02-1.47]),滥用处方药物(MI aOR=1.61[95%CI,1.02-2.55],FI aOR=1.46[95%CI,1.20-1.79])和 10 个或更多的终身性伴侣(MI aOR=1.55[95%CI,1.08-2.22],FI aOR=1.19[95%CI,1.01-1.41])。MI 与急诊室使用的可能性增加有关(aOR=2.36[95%CI,1.51-3.68]),FI 与非法注射药物使用有关(aOR=2.54[95%CI,1.27-5.12])。
监禁的影响超出了被监禁者。PI 史与年轻人的医疗保健使用率较低和不健康行为有关。通过解决医疗保健和健康危害行为的障碍,医疗保健提供者和政策制定者可以减少这一人群中的健康差距。