History of Incarceration and Dental Care Use Among Older Adults in the United States.

INTRODUCTION: Dental care is a critical component of healthy aging; however, emerging evidence suggests that having been previously incarcerated is a risk factor for not using dental care services. This study investigates the relationship between prior incarceration and dental care among older adults and assesses whether wealth and dental insurance explain this relationship. METHODS: Data are from the Health and Retirement Study, a nationally representative sample of community-dwelling older adults in the United States, collected in 2012 and 2014. Multivariable logistic regression is used to assess the relationship between a history of incarceration and dental care. Mediation analyses were conducted using the Karlson-Holm-Breen method of indirect effects in non-linear models. Statistical analyses were conducted from February to April 2024. RESULTS: Adjusting for potential confounding variables, a respondent's prior incarceration is associated with a 25% lower odds of dental care use (adjusted odds ratio [aOR] = 0.748, 95% CI = 0.624, 0.896). The relationship between incarceration and dental care use is fully mediated-over 90% is explained by-wealth and having dental care insurance. Prior incarceration decreased the likelihood of dental care only among non-Hispanic White respondents. CONCLUSIONS: The findings offer new evidence that prior incarceration is a risk factor for lacking the ability to utilize dental care among older adults and suggest that broader consequences of incarceration for wealth accumulation and access to dental insurance underpin this relationship. These results suggest the urgent need to expand access to affordable dental care services for older adults with a history of incarceration.

Depression among incarcerated persons following the death of a loved one: Does social support mitigate grief?

The death of a loved one generates adverse and potentially damaging consequences for surviving family members and friends. The challenges of bereavement can be especially severe when experienced by incarcerated persons who must cope with and grieve the death while incarcerated. Yet, limited research evaluates bereavement among incarcerated persons and whether factors such as social support buffer against health-related consequences. Using data from the LoneStar Project-a study of 802 incarcerated men in Texas-we examine depressive symptoms among currently incarcerated persons with differential exposure to a loved one's death (i.e., immediate family, friends, extended family). Importantly, a high rate of death exists among incarcerated persons' loved ones, with 41% in the sample losing someone on the outside during their final year of incarceration. However, we find that external social support from family and friends and in-prison social cohesion from peers, significantly mitigate the harms of bereavement on depressive symptoms.

The Patient Protection and Affordable Care Act and oral health care use among formerly incarcerated people in the United States.

BACKGROUND: Formerly incarcerated people report less frequent oral health care use, despite having more substantial oral health problems. This study aimed to determine whether the adoption of the Patient Protection and Affordable Care Act (ACA) has improved oral health care use among formerly incarcerated people in the United States. METHOD: Data were from Wave I (1994-1995), Wave IV (2008), and Wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (n = 9,108), a nationally representative cohort study in the United States. RESULTS: On the basis of the results of multiple logistic regression analysis with interaction terms, the authors found a positive and statistically significant interaction between prior incarceration and living in a state with ACA adoption on past-year oral health care use, net of potential confounding variables (incarceration × ACA: odds ratio, 1.587; 95% CI, 1.043 to 2.414). Substantively, the findings suggest that people with a history of incarceration are less likely to use oral health care, and this disparity is more likely to occur in states without ACA adoption. CONCLUSIONS: ACA adoption corresponds with improvements in the receipt of oral health care among formerly incarcerated people. PRACTICAL IMPLICATIONS: This study builds on prior evidence highlighting that the ACA is beneficial in connecting formerly incarcerated people to health care services and suggests that these benefits may extend to improving access to and use of oral health care.

Traumatic brain injury and mental health outcomes among recently incarcerated men.

This study examined the association between experiencing a traumatic brain injury (TBI) before or during incarceration and several postrelease negative mental health consequences in a cohort of men recently released from prison. The goal of the study was to explicate the variety of mental health-related issues incurring a TBI has on one's ability to successfully reintegrate back into society following incarceration. Using data from the LoneStar Project, we used ordinary least squares regression and logistic regression to assess the prevalence of depressive symptoms, stress, trauma flashbacks, and psychosis in a representative sample of men released from Texas prisons (N = 498) approximately 9 months post-prison release. Recently released men with a history of head injury exhibited higher levels of depression, B = 0.204, 95% CI [.071, .337]; stress, B = 0.266, 95% CI [.116, .416]; experiencing trauma-related flashbacks, odds ratio (OR) = 2.950, 95% CI [1.740, 5.001]; and psychosis, OR = 3.093, 95% CI [1.601, 5.975], compared to their non-head-injured counterparts. TBIs-whether sustained before or during incarceration-pose significant risks for adverse mental health outcomes, particularly for recently released individuals during the already challenging and strained period of reintegration.

Male Sexual Dysfunction and the Perpetration of Intimate Partner Violence.

We contribute to our understanding of the social epidemiology of intimate partner violence (IPV) by developing a mediation model that frames IPV as an outcome of male sexual dysfunction (performance anxiety and erectile dysfunction) and the mechanisms of masculine discrepancy stress (the perceived failure to conform to internalized normative expectations of masculinity) and anger. Our mediation analyses of recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 792 men, confirmed that sexual dysfunction was indirectly associated with the perpetration of any IPV, physical IPV, and sexual IPV through the compound path of masculine discrepancy stress and anger.

Incarceration exposure and women's oral health experiences during pregnancy.

RATIONALE: Prior research has documented an association between incarceration and poor oral health outcomes. Likewise, recent scholarship has also detailed that women exposed to incarceration either directly or vicariously through a partner during pregnancy incur worse health outcomes. However, no previous research has assessed the connection between incarceration exposure and oral health during pregnancy. OBJECTIVE: The current study assesses the link between maternal incarceration exposure and oral health during pregnancy. METHODS: Data are from the Pregnancy Risk Assessment Monitoring System (PRAMS) from years 2016-2019 (N = 60,342). Logistic regression was used to assess the relationship between incarceration and oral health. RESULTS: Women exposed to incarceration exhibited worse oral health outcomes in the form of being more likely to report not knowing the importance of oral care, not having an oral health discussion with a provider, not getting a teeth cleaning, as well as being likely to report needing to see a dental provider, having visited a dental provider for a problem during pregnancy, and having more unmet dental care needs. CONCLUSIONS: These findings add to a burgeoning literature that demonstrates a woman's prenatal exposure to incarceration poses risk for overall health and wellbeing. Given the influence of both incarceration exposure and oral health during pregnancy for maternal and infant health, the findings suggest that coordination between criminal justice, public health, and oral health experts can develop programmatic efforts that expand access to oral health care and improve oral health literacy among incarceration-exposed pregnant women.

Coping with incarceration: examining the longitudinal relationship between individual coping styles and mental health outcomes.

BACKGROUND: Experiencing incarceration leads to increased rates of stress that result in a variety of negative physical, mental, and emotional outcomes. However, little research focuses on how individuals vary in their coping responses to stressful life events, like imprisonment. AIMS: This study extends prior research by examining whether changes in coping styles throughout the first year of incarceration influence mental health symptomology at 6- and 12-months post placement. METHODS: Using longitudinal data collected via semi-structured interviews with incarcerated men, this study measures changes in coping strategies and their effect on psychological well-being using the SCL-90-R. Ordinary least squares regression models were used to regress mental health symptomology on residual change scores of coping strategies. RESULTS: Changes in dysfunctional coping during the first 6- and 12-months of placement were associated with increased levels of adverse mental health symptoms. Changes in emotion- and problem-focused coping were not associated with mental health symptomology. CONCLUSIONS: This research illustrates the need to continue exploration into individual responses to stressful events, such as initial incarceration, and suggests that prison systems should be designed in ways that decrease the need to adapt in dysfunctional ways, while providing opportunities for incarcerated people to cope in more productive ways.

Incarceration exposure during pregnancy and maternal disability: findings from the Pregnancy Risk Assessment Monitoring System.

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.

Incarceration exposure and prescription opioid use during pregnancy.

BACKGROUND: Prior research demonstrates a high prevalence of substance use, including opioid use, among those who have had personal or vicarious contact with the correctional system. Relatedly, alongside patterns of rising opioid use in general, opioid use during pregnancy is becoming a growing public health concern. Still, risk factors for prescription opioid use during pregnancy remain understudied. This study is the first to assess the connection between a women's personal or vicarious exposure to incarceration in the 12 months prior to birth and patterns of prenatal opioid use. METHODS: Data are from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2019 (N = 17,551 mothers). Logistic and multinomial logistic regression are used to assess the association between incarceration exposure and patterns of opioid use during pregnancy. RESULTS: Incarceration-exposed women were more likely to use all eight types of prescription opioids assessed in this study (Hydrocodone, Codeine, Oxycodone, Tramadol, Hydromorphone/Meperidine, Oxymorphone, Morphine, and Fentanyl). After adjustment for control variables, incarceration-exposed women were significantly more likely to report any prescription opioid use during pregnancy (OR = 1.745, 95% CI = 1.194, 2.554). Furthermore, relative to no opioid use, incarceration exposure was also associated with illicit prescription opioid use (RRR = 2.979, 1.533, 5.791). CONCLUSIONS: Incarceration exposure in the year prior to birth is associated with higher odds of prescription opioid use. These findings add to the burgeoning literature that details a women's exposure to incarceration is a risk marker for substance use and engagement in health risk behaviors that can jeopardize maternal and infant wellbeing.

COVID-19 Mitigation Compliance and Vaccination Status Among Formerly Incarcerated Individuals in the United States.

BACKGROUND: To examine the relationship between incarceration history and an individual's compliance toward COVID-19 mitigation strategies and vaccination status/intentions. METHOD: Data are from the Crime, Health, and Politics Survey (N = 1,735), a national probability sample of community-dwelling adults aged 18 and above living in the United States. Data were collected from May 10, 2021 to June 1, 2021. Multinomial logistic regression models were used to assess the relationship between incarceration history and COVID-19 mitigation strategies and vaccination status/intentions. RESULTS: Individuals with a history of incarceration reported approximately twice the relative risk of rarely/never using hand sanitizer and rarely/never wearing a mask compared with always/very often. Incarceration history was associated with more than 3 times greater relative risk of reporting not being vaccinated and not planning to get vaccinated compared with currently being vaccinated. CONCLUSION: Formerly incarcerated individuals are less likely to abide by key COVID-19 mitigation protocols and exhibit higher levels of vaccine hesitancy. These findings suggest that formerly incarcerated individuals, as well as their families and communities, may therefore be at greater risk of accelerated spread of COVID-19 because of these factors.

Perceptions of neighborhood dangerousness and changes in sleep quality during the COVID-19 pandemic: Assessing the mediating role of changes in health behaviors.

Numerous studies have demonstrated that neighborhood context contributes to variations in morbidity and mortality. This body of work includes a burgeoning literature that links adverse neighborhood characteristics (e.g., neighborhood poverty and perceptions of disorder and dangerousness) with poorer sleep outcomes. During the COVID-19 pandemic, many neighborhoods exhibited socioeconomic downturns and escalations in crime and violence. The question is the extent to which these changes in neighborhood conditions have impacted the sleep quality of residents. In this paper, we use original survey data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of adults living in the U.S., to formally test whether changes in perceptions of neighborhood dangerousness during the pandemic are associated with sleep quality during the same period. Regression analyses show that while reports of a neighborhood becoming safer during the pandemic are associated with better sleep quality, reports of a neighborhood becoming more dangerous are associated with worse sleep quality. Mediation analyses also indicate that the association between increased neighborhood dangerousness and poorer sleep quality is partially explained by a concurrent deterioration in diet quality, but not increases in alcohol or cigarette consumption. We conclude with a discussion of the implications of our findings for research and policy on neighborhood context and sleep.

An Assessment of Prisoner Reentry, Legal Financial Obligations and Family Financial Support: A Focus on Fathers.

Scholars have found that family support is an important facilitator of successful reentry from prison to the community. At the same time, they have argued that owing court-ordered fines or fees, also called legal financial obligations (LFOs), can act as an additional barrier to reentry, especially for parents. There remains a need to test how LFOs impact the financial support formerly incarcerated parents receive from their families. The current study responds to this gap by employing logistic regression analyses of the Serious and Violent Offender Reentry Initiative (SVORI) data to test whether owing court fees is associated with formerly incarcerated fathers' (1) perceptions of available financial support from family and (2) receipt of financial support from family. We find that owing court fees is not associated with perceptions of available financial support. However, owing court fees has a positive, statistically significant association with receiving financial support from family during the first three months after prison release. This relationship remains after accounting for whether the person owes child support or sees their children monthly. Our results suggest that LFOs may create a greater need for financial support among formerly incarcerated fathers, making the financial challenges of reentry a consequence not just for those who were incarcerated but for their loved ones as well.

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.

Family member incarceration and coping strategies during the COVID-19 pandemic.

BACKGROUND: The disproportionately high rate of incarceration and COVID-19 cases during the summer of 2020 in the United States contributed to a set of circumstances that has produced considerable public health concerns as correctional facilities have emerged as significant COVID-19 hot spots. During the COVID-19 pandemic, having a family member incarcerated can be an especially stressful experience. This study assesses how concern about an incarcerated family member contracting COVID-19 impacts diverse coping strategies. RESULTS: Data are from a survey of individuals who have a family member incarcerated in Texas (N = 365). Ordinary least squares regression is used to examine the association between concern about an incarcerated family member contracting COVID-19 and coping strategies. Findings demonstrate that higher levels of concern for an incarcerated person's wellbeing during the COVID-19 pandemic is associated with dysfunctional coping mechanisms, but not adaptive or functional coping strategies. CONCLUSIONS: Results suggest appropriate systemic responses by correctional administrations and public health practices can help mitigate dysfunctional coping mechanisms by family members during infectious disease outbreaks in correctional facilities.

First weeks out: Social support stability and health among formerly incarcerated men.

RATIONALE: Social support has a lasting and robust impact on individuals' health, wellness, and longevity. Having social support and a reliable social network is especially important for individuals returning from prison. Upon release, individuals are often left with fragmented, if any, interpersonal relationships, which influences their overall health. When a released person's support network becomes erratic or unstable, they may be unlikely to successfully reintegrate. Additionally, the impediments and stressors associated with community reentry-particularly after a long prison sentence-impact released persons' ability to preserve their physical and mental health. OBJECTIVE: The current study examines the effects of the stability of social support on physical and mental health in a sample of recently released men in Texas. METHODS: Data are from the LoneStar Project, a longitudinal study of men released from prison, to examine the crucial nature of social support stability on health in a unique sample of reentering persons. Regression models are employed to examine the effect of diverse domains of social support stability on self-rated physical and mental health in the first few weeks after prison release. RESULTS: Findings indicate that emotional and instrumental social support stability from family and friends is essential to positive self-assessments of mental health, but not physical health, among a group of recently incarcerated men. CONCLUSIONS: Results regarding the intricacies of the pathway between various stable support types and mental health are discussed. Relevant practical implications include the need for quality mental health care that must begin during the prison term to minimize stressors associated with psychological health upon reentry. Policy-related ramifications comprise a push to establish support programs for families to develop positive support outcomes for the released person during the reentry process, enabling family members to attain practical skills to increase family and individual well-being long term.

What if They Are All High-Risk for Attrition? Correlates of Retention in a Longitudinal Study of Reentry from Prison.

Longitudinal data are essential to research in criminology and criminal justice. Despite attrition's implications for validity, understanding its sources is underexplored empirically. We examine the correlates of retention using covariates organized into domains of prediction, prevention, and projection. Data from the LoneStar Project, a three-wave longitudinal reentry study of 802 males recently released from prisoners in Texas, were analyzed to examine the correlates of proximal, distal, and any study retention. The best correlates of study retention are prevention techniques used by researchers to reduce attrition. In contrast, only a few covariates traditionally associated with attrition and no covariates used for attrition projection were related to retention. What researchers do matters more for retention than the characteristics of individuals they are trying to retain. The findings underscore how researchers can improve study retention in longitudinal research while also correcting for non-random attrition in current longitudinal data sources.

Oral health status and oral health care use among formerly incarcerated people.

BACKGROUND: Incarceration carries adverse consequences for health, yet there is limited research on the association between incarceration and oral health outcomes. The authors examined the relationship between former incarceration and 2 self-reported oral health outcomes-periodontal disease and oral health care use-and assessed the degree to which postrelease factors mediate the relationship between former incarceration and oral health outcomes. METHODS: The authors analyzed nationally representative observational data from the National Longitudinal Study of Adolescent to Adult Health by using multivariate logistic regression. Karlson-Holm-Breen mediation analysis was used to assess how much former incarceration and oral health outcomes are confounded by material hardship, health insurance coverage, and poor health behaviors. RESULTS: Incarceration history is associated with periodontal disease (odds ratio [OR], 1.454; 95% confidence interval [CI], 1.042 to 2.029) and oral health care use (OR, 1.433; 95% CI, 1.248 to 1.646) after control variables are taken into account. However, the confounding variables fully mediate the association between incarceration and periodontal disease (OR, 1.143; 95% CI, 0.815 to 1.605) and oral health care use (OR, 1.133; 95% CI, 0.980 to 1.309). CONCLUSIONS: Formerly incarcerated people in the United States have worse oral health outcomes than their never-incarcerated counterparts, and much of this relationship can be explained by socioeconomic status and health behaviors. PRACTICAL IMPLICATIONS: Formerly incarcerated people have scarce resources and lack knowledge about oral health care. Health care professionals should encourage formerly incarcerated people to focus on oral health care. Because modifiable risk behaviors confound much of this relationship, targeted interventions may provide benefits for improving oral health care among this vulnerable population.

Police Stops Among At-Risk Youth: Repercussions for Mental Health.

PURPOSE: The aim of the study was to examine the proximate mental health consequences of stressful and emotionally charged interactions with police officers among a national sample of at-risk youth who have been stopped by the police. METHODS: A sample of 918 youth (average age 15 years) in the U.S. who reported being stopped by police in the most recent wave (2014-2017) of the Fragile Families & Child Wellbeing Study was used in the present study. RESULTS: Although age at first stop was not associated with mental health outcomes, youth stopped by police more frequently were more likely to report heightened emotional distress and posttraumatic stress symptoms. Findings also indicate that being stopped at school and officer intrusiveness were potent predictors of these adverse emotional and mental health responses to the stop. CONCLUSIONS: Under certain circumstances, the police stop can result in feelings of stigma and trauma among at-risk youth. Youth may benefit when school counselors or social workers provide mental health screenings and offer counseling care after police encounters, particularly when such encounters are intrusive and/or occur at school.

Examining the Role of Familial Support During Prison and After Release on Post-Incarceration Mental Health.

A significant number of prisoners experience mental health problems, and adequate social support is one way that facilitates better mental health. Yet, by being incarcerated, social support, particularly family support, is likely to be strained or even negative. In this study, we examine whether familial support--either positive or negative--in-prison and after release affects mental health outcomes post-release. Using the Serious and Violent Offender Reentry Initiative (SVORI) dataset, we regress post-release mental health on in-prison familial support, post-incarceration familial support, and changes in familial support. We find that while in-prison family support does not affect mental health, post-release familial support does. Also, experiencing an increase in negative familial support is associated with lower post-incarceration mental health. We conclude with a discussion of policies which may facilitate better familial support environments.