Health care use and health behaviors among young adults with history of parental incarceration

Nia Heard-Garris, Tyler N.A. Winkelman, Hwajung Choi, Alex K. Miller, Kristin Kan, Rebecca Shlafer, Matthew M. Davis

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39 Scopus citations


OBJECTIVES: To determine if longitudinal associations exist between parental incarceration (PI) and health care use or health behaviors among a national sample of young adults. METHODS: 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) (N = 13 084). Multivariable logistic regression models accounted for individual, family, and geographic factors and generated adjusted odds ratios (aORs). RESULTS: 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]). CONCLUSIONS: 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.

Original languageEnglish (US)
Article numbere20174314
Issue number3
StatePublished - Sep 2018

Bibliographical note

Funding Information:
FUNDING: Drs Heard-Garris, Winkelman, and Kan completed some portions of this study during their tenure as Robert Wood Johnson Clinical Scholars at the University of Michigan and acknowledge funding from the Robert Wood Johnson Foundation during that time. Dr Winkelman also acknowledges funding from the US Department of Veterans Affairs. The funders were not involved in the study design, collection, analysis, interpretation of data, writing of the report, or in the decision to submit the manuscript and they accept no responsibility for the content.

Publisher Copyright:
Copyright © 2018 by the American Academy of Pediatrics.


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