Prison hard on more than the incarcerated

More people live behind bars in the United States than in any other country, but the American prison system punishes more than just inmates — it also takes a toll on the health of friends and loved ones left behind.

In the first known study of its kind, U-M researchers found that people with a family member or friend in prison or jail suffer worse physical and mental health and more stress and depressive symptoms than those without a loved one behind bars. Moreover, these symptoms worsen the closer the relationship to the person incarcerated.

The study results could help explain health disparities between minorities and whites, says Daniel Kruger, research professor at the School of Public Health and lead researcher on the study.

African Americans are more likely to know someone in prison and to feel closer to the person incarcerated than whites do, Kruger says.

“It’s like a double whammy,” he says.

The research included 1,288 adults from Flint and surrounding areas of Genesee County. In the study, 67 percent of respondents were white and 26 percent were African American.

Forty-nine percent of blacks in the study report having a friend or relative in prison during the past five years, compared to 20 percent of whites.

Those who knew someone in prison had 40 percent more days in which poor physical health interfered with their usual activities, including work, and 54 percent more days where poor mental or emotional health interfered with these activities, according to the study.

Kruger and colleagues considered whether a person smoked tobacco, drank alcohol heavily, was overweight or obese, or had adequate nutrition and physical exercise.

“Our study demonstrates that incarceration is not only enormously expensive economically, it also has public health costs and these should be taken into consideration,” Kruger says. Moving toward a rehabilitation model may benefit both the offending individuals and society, he says.

“The vast majority of people incarcerated are nonviolent drug offenders,” Kruger says. “We should shift oversight of substance use and abuse to the health-care sector.”

One out of every 100 adults in the United States is incarcerated and more than three times as many blacks and Latinos live in jails or prisons than college dorms, Kruger says. This particular study looked only at blacks because there is not a large population of Latinos in Flint and Genesee County.

The paper, “The Association of Incarceration with Community Health and Racial Health Disparities,” is in the April issue of Progress in Community Health Partnerships.

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