Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO.
School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO; Graduate School of Social Work, Yonsei University, Seoul, Republic of Korea.
Ann Epidemiol. 2019 Aug;36:55-61. doi: 10.1016/j.annepidem.2019.05.004. Epub 2019 Jun 7.
Diabetes is one of the most prevalent and fastest-growing adverse health conditions in the United States and disproportionately affects those demographic and socioeconomic groups that are also more likely to be involved with the criminal justice (CJ) system. This study examines the prevalence and correlates of diabetes among CJ-involved individuals in the United States.
Using traditional statistical modeling and modern machine learning methods, data from the National Study on Drug Use and Health were analyzed to compare the correlates and predictive interactions of diabetes diagnosis among those respondents on probation and parole to a sample, matched by age and gender, who were not.
Subjects involved in the CJ system were 15% more likely (1.66% vs. 1.44%, P = .015) to report a past-year diagnosis of diabetes than a sample of noninvolved individuals matched by age and sex, although this association was not statistically significant after adjusting for demographic and behavioral confounders. Similar trends in diabetes prevalence emerged for the non-CJ and CJ groups with regard to income, depression (OR of 2.38 and 1.65 for the CJ and non-CJ groups, respectively) and attainment of college education (OR of 0.64 and 0.30 for the CJ and non-CJ groups, respectively, compared with those with less than a high school education). Results also suggested that a generally high propensity toward risk taking had a negative effect on diabetes for the non-CJ group (OR 0.78; 95% CI 0.69-0.87), yet increased the odds of diabetes (OR 1.38; 95% CI 1.02-1.85) for the CJ group.
Involvement in the U.S. CJ system is correlated with a higher prevalence of diabetes and differing risk factors for diabetes diagnosis. Further research is necessary, however, to unpack the precise causal pathways that underlie the associational trends in the current analysis.
糖尿病是美国最普遍和增长最快的健康问题之一，且在那些更有可能与刑事司法（CJ）系统相关的人群中不成比例地存在，这些人群在人口统计学和社会经济学方面也处于劣势。本研究调查了美国与 CJ 相关的个体中糖尿病的流行率及其相关因素。
使用传统的统计建模和现代机器学习方法，分析了国家药物使用与健康研究的数据，以比较在缓刑和假释中的受访者中糖尿病诊断的相关因素和预测性相互作用，以及与年龄和性别相匹配的未参与的样本。
与年龄和性别相匹配的未参与样本相比，参与 CJ 系统的个体更有可能（1.66%比 1.44%，P=0.015）报告过去一年患有糖尿病，尽管在调整了人口统计学和行为混杂因素后，这种关联没有统计学意义。对于非 CJ 和 CJ 群体，在收入、抑郁（CJ 和非 CJ 群体的比值比分别为 2.38 和 1.65）和获得大学教育（CJ 和非 CJ 群体的比值比分别为 0.64 和 0.30，与未完成高中学业的个体相比）方面，糖尿病的流行率也出现了类似的趋势。结果还表明，非 CJ 群体中普遍存在的冒险倾向对糖尿病有负面影响（比值比 0.78；95%置信区间 0.69-0.87），而对 CJ 群体则增加了糖尿病的几率（比值比 1.38；95%置信区间 1.02-1.85）。
参与美国 CJ 系统与糖尿病的高流行率以及不同的糖尿病诊断风险因素相关。然而，为了解当前分析中关联趋势的基础的确切因果途径，还需要进一步研究。
