Lifetime sentence: Incarcerated parents impact youth behavior

Strikingly, incarceration of a mother during childhood, as opposed to a father, doubled the likelihood of young adults using the emergency department instead of a primary care setting for medical care.

Young adults whose mothers had been incarcerated also were twice as likely to have sex in exchange for money, while those with histories of father incarceration were 2.5 times more likely to use intravenous drugs.

"The United States has the highest incarceration rates in the world. With the climbing number of parents, especially mothers, who are incarcerated, our study calls attention to the invisible victims -- their children," says lead author Nia Heard-Garris, MD, MSc, a pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago and Instructor of Pediatrics at Northwestern University Feinberg School of Medicine. "We shed light on how much the incarceration of a mother versus father influences the health behaviors of children into adulthood."

Dr. Heard-Garris and colleagues analyzed national survey data from over 13,000 young adults (ages 24-32), finding that 10 percent have had a parent incarcerated during their childhood. Participants were on average 10 years old the first time their parent was incarcerated.

Additionally, young Black adults had a much higher prevalence of parental incarceration. While Black participants represented less than 15 percent of the young adults surveyed, they accounted for roughly 34 percent of those with history of an incarcerated mother and 23 percent with history of an incarcerated father.

"The systemic differences in the arrest, prosecution, conviction, and sentencing of people of color impact the future health of their children," says Dr. Heard-Garris.

Previous research shows that individuals with a history of parental incarceration have higher rates of asthma, HIV/AIDS, learning delays, depression, anxiety and post-traumatic stress disorder.

"It's possible that because these young adults are more likely to forgo medical care and engage in unhealthy behaviors, they are at higher risk to develop these physical and mental health conditions," says Dr. Heard-Garris. "By pinpointing the specific health-harming behaviors that these young adults demonstrate, this study may be a stepping stone towards seeking more precise ways to mitigate the health risks these young adults face. Hopefully, future studies will teach us how to prevent, screen for, and target negative health behaviors prior to adulthood."

The authors also stress that more research is needed to identify specific barriers to healthcare, targeting this population's under-utilization of care.

"We need to consider how to help youth of incarcerated parents receive timely healthcare," says senior author Matthew Davis, MD, MAPP, Senior Vice-President and Chief of Community Health Transformation at Lurie Children's and Professor of Pediatrics, Medicine, Medical Social Sciences and Preventive Medicine at Northwestern University Feinberg School of Medicine. "We must intervene if we are going to change the health trajectories for these kids."

Dr. Davis also is Division Head of Academic General Pediatrics and Primary Care at Lurie Children's; Director of Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center; and Associate Chief Research Officer at Stanley Manne Children's Research Institute at Lurie Children's.