Incarceration as a key variable in racial disparities of asthma prevalence

Section of General Medicine, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
BMC Public Health (Impact Factor: 2.26). 05/2010; 10(1):290. DOI: 10.1186/1471-2458-10-290
Source: PubMed


Despite the disproportionate incarceration of minorities in the United States, little data exist investigating how being incarcerated contributes to persistent racial/ethnic disparities in chronic conditions. We hypothesized that incarceration augments disparities in chronic disease.
Using data from the New York City Health and Nutrition Examination Study, a community-based survey of 1999 adults, we first estimated the association between having a history of incarceration and the prevalence of asthma, diabetes, hypertension using propensity score matching methods. Propensity scores predictive of incarceration were generated using participant demographics, socioeconomic status, smoking, excessive alcohol and illicit drug use, and intimate partner violence. Among those conditions associated with incarceration, we then performed mediation analysis to explore whether incarceration mediates racial/ethnic disparities within the disease.
Individuals with a history of incarceration were more likely to have asthma compared to those without (13% vs. 6%, p < 0.05) and not more likely to have diabetes or hypertension, after matching on propensity scores. Statistical mediation analysis revealed that increased rates of incarceration among Blacks partially contribute to the racial disparity in asthma prevalence.
Having been incarcerated may augment racial disparities in asthma among NYC residents. Eliminating health disparities should include a better understanding of the role of incarceration and criminal justice policies in contributing to these disparities.

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Available from: Jeremy Craig Green, Oct 07, 2014
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    • "Full list of author information is available at the end of the article outcomes, high-cost health services use, and low use of regular medical services. A history of incarceration has been associated with a higher prevalence of infectious disease including HIV and STIs; mental illness; and substance abuse and dependency (Davis & Pacchiana, 2004; Fazel et al. 2006; Fisher et al. 2006; Wilper et al. 2009); a higher prevalence of chronic diseases (Binswanger et al. 2009; Davis & Pacchiana, 2004; Hawkins et al. 2010; Wang & Green, 2010), and a higher risk of death (Binswanger et al. 2007). The poor health status of reentry populations also led to use of high-cost health services (Leukefeld et al. 2006). "

    Full-text · Article · Jan 2014
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    • "Studies on the health effects of incarceration report that incarceration exposure increases the likelihood of severe health limitations (Schnittker & John, 2007) and is associated with disparities in access to care (Kulkarni et al., 2010) and disparities in health conditions (Wang & Green, 2010). In contrast, repeated exposure to systems that treat mental health or substance use disorders can be the result of real or perceived greater need for such services (Druss et al., 2007; Fleury et al., 2012; Lindamer et al., 2012) that thus confounds relationships with subsequent health outcomes or it can represent a model of continuing care that can reduce risk and thereby yield better health outcomes (Chi et al., 2011; Grella et al., 2010; Parthasarathy et al., 2012). "
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