Incarceration and health

Mass incarceration is a major problem in the United States. People who have been incarcerated or are currently incarcerated face many challenges including challenges with their health. This Wikipedia article highlights some of the health problems that can come with incarceration by looking at the relationship between children being incarcerated and the health outcomes they have as adults, the health effects of incarcerated people with HIV, the effect of aging on people with a history of incarceration, the effect that the Affordable Care Act has on the health insurance status of people who have been incarcerated, and the mental health of prisoners.

Youth incarceration and adult health

The number of people being incarcerated in the U.S. has been rapidly increasing over the years. The United States has more children incarcerated than the rest of the world, and in 2015 had 920,000 people arrested under the age of 18. Some people are even arrested when they are younger than 14 and do not get released until well into their adult years. In regards to race it is a fact that African American children are 5 times more likely to be arrested than compared to white children. High proportions of children and adolescents who have been incarcerated have their physical, mental, developmental, and social health needs not being met. These needs being ignored will play a role in the child's future success. Reproductive health needs are also struggling to be met. This will eventually effect the role that HIV plays within incarcerated people and young girls facing teen pregnancy.
The goal was to research the connection between children who have been incarcerated in the United States and the health outcomes they have when they become adults. To do that they analyzed the National Longitudinal Study of Adolescent to Adult Health data from 1727 adults who were first incarcerated at less than 25 years old. They chose four different health outcomes to compare: these were the general health of adults, mobility limitations, depressive symptoms, and suicidal thoughts.
The researchers used chi-squared tests and multivariate logistic regression models and compared the health outcomes between the subjects whose age at first incarceration fell in the following ranges: less than 14 years old; 15 to 17; 18 to 20; 21 to 24. The sociodemographic data showed that those in the youngest age group included a higher proportion of black or Hispanic people compared to the other age groups. It was also found that there were fewer white participants who were incarcerated as children.
The results for the health outcomes were that child incarceration predicted more adult mobility limitations, adult depression, and adult suicidal thoughts compared to people incarcerated when they were 21 to 24. The negative health effects that incarceration can have, especially on children, is a social problem that more people need to focus on. With these suffering conditions in mind it is important to note that they do not always go unnoticed. Treatment while incarceration can be provided by medication or therapy within the prison. Along with the negative health effects that incarceration can have on children, it also impacts those with HIV.

Incarceration and HIV

Incarceration has negative effects on the overall health of people outside or within prison. HIV is a virus that attacks the immune system which can be life threatening. Every year, around 15% of people with HIV go through a correctional facility in the United States, and 1 in 7 people with HIV are incarcerated every year. The article studied the relationship between incarceration and the health of people with HIV and the mediators present in this relationship. The first mediator that the article studied was substance use. The leading cause of death for people who have been recently released from prison is substance use. The other mediators chosen included the overall health of the people taking part in this study, the decreased adherence to the antiretroviral therapy used to suppress HIV symptoms and the narrow engagement in medical care. The article conducts research on 1,591 patients with HIV, 47% had previously been incarcerated and evidence shows they were low income African Americans with less than a high school education.
The researchers used data from the Veterans Aging Cohort Study and found 1,591 HIV-infected veterans and collected data about their overall health and unhealthy drug and alcohol use. They compared these participants with and without a history of incarceration and by their sociodemographic characteristics such as age, gender, education level, housing, and income and the four mediators discussed previously using chi square tests and t tests.
Out of the 1,591 people surveyed 47% of them had a history of incarceration and that having been incarcerated was independently associated with a 4.2-point higher VACS index score, equivalent to approximately 15% higher risk of mortality in 5 years. The researchers found that the people with a history of incarceration were more likely to be black, low income, recently homeless and less than a high school education compared to the people who have never been incarcerated. The people who have been incarcerated were also more likely to have used drugs recently and have unhealthy alcohol use. People who were previously incarcerated were less adherent to the antiretroviral therapy than people who have not been incarcerated. Incarcerated and non-incarcerated were equally likely to have received care and engage with their care.
After adjusting their VACS score and taking out recent drug use, they found that drug use had the biggest mediating effect and does play a role in the poor HIV outcomes for previously incarcerated people. Individuals with a history of incarceration were more likely to be engaging in drug use and this accounted for 22% of the association between incarceration and the VACS score. Overall, people who were incarcerated were more likely to have worse HIV outcomes and it is important to bring awareness to the negative health effects that people with HIV who have been or are currently incarcerated can suffer from.
The situation of HIIV does not only effect incarcerated people but the general public as well. This virus is spread through blood or saliva which shows how easy it is to obtain. HIV can be easily transmitted through intercourse and you will show no signs of having it until you take a test or your body shuts down. A study between sexual partners and incarceration history was done to prove association. The study was done by analyzing data from men with valid HIV test results and who completed responses about sexual partners. After the study it was evident that incarceration does introduce sexual partners of past incarceration people to being at a high risk of catching HIV.

Incarceration and aging

Besides affecting people with chronic illnesses and children, incarceration can also affect the health of older adults. The article examined if having a history of incarceration was associated with worse mental and physical health in older adults. The researchers also wanted to see if racism and sexism had an effect on these outcomes. The number of women in the prison system grew by 700% in the span of 30 years so that may be having a drastic effect on their health. Women are more likely to have multiple health conditions. People of color are more likely to be incarcerated than white people and get harsher sentences for the same crime. Black women have the highest incarceration rates among women and are at a higher risk of getting a disease.
To get information on the effects the researcher used the Health and Retirement Survey which is a representative survey of people who are over 50 in the United States and had a sample of 11,883 people. To measure the mental health effects, they asked about depressive symptoms and to measure the physical health effects they examined the physical limitations of the subjects. They wanted to measure three different independent variables and asked questions revolving around their incarceration history, their gender and sex and their race and ethnicity. They used General linear models to assess the effect of the three independent variables and how they interact. Most of the sample was female, White and the average age was 65.
The results showed that incarcerated individuals had more physical limitations and depressive symptoms with men and women who were older than 52. They also found that women who were previously incarcerated had higher rates of health problems specifically women of color who had the highest rates of negative physical and mental health symptoms compared to any other group. This article brings attention to the negative health outcomes that people who have been incarcerated can face especially women of color.
Aging if different for women. Support for women experiencing menopause in incarceration is outlined in the 2009 Kyiv Declaration on Women’s Health in Prison.

Mental health

Mental health disorders have been found to be significantly more prevalent in prison populations than in the general population. New mental health conditions often develop while a person is in prison and pre-existing conditions can worsen. A person suffering from depression will get worse and often suicidal if not getting the correct treatment in or out of prisons. Incarceration is shown to be a chronic stressor due to sleep loss and family separation etc. This traumatic stimulation can cause PTSD within some incarcerated people.
Incarcerated men are three times more likely to die by suicide than non-incarcerated men and incarcerated women are nine times more likely to die by suicide than non-incarcerated women. While in prison, women are more likely to attempt suicide although men are more likely to commit. Women incarcerated also report having done repeated self injury which leads to suicidal behavior. Inmates with mental health issues tend to be among those who are involved in these harming behaviors. The incarceration of juveniles often results in adverse mental health consequences, especially in adult facilities. Such incarceration is also related to worse health across the life course.