Abstract
While there is a growing literature on the relationship between incarceration and health, few studies have expanded the investigation of criminal justice system involvement and health to include the more common intervention of arrest. This study uses a quasi-experimental design to evaluate the long-term effect of arrest in young adulthood on health behaviors in midlife for African Americans. We use propensity score matching methods and gender-specific multivariate regression analyses to equate those who did and did not incur an arrest in young adulthood from a subsample (n = 683) of the Woodlawn cohort, an African American community cohort followed from childhood into midlife. The results suggest that, for men, having been arrested in young adulthood has a direct effect on smoking, daily drinking, and risky sexual behaviors into midlife while young adult arrest does not seem to impact midlife health risk behaviors for women. This study adds health risk behaviors to the growing list of detrimental outcomes, such as crime, drug use, education, and mental health that are related to criminal justice contact for African American men, in particular.
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Notes
Incarceration stints for the longest time served in young adulthood ranged from 1 to 7300 days for men. The mean, standard deviation, and median self-reported time served are 822, 1319, and 180 days, respectively. The corresponding time served for women ranged from 1 to 1460 days, with a mean, standard deviation, and median self-reported time served of 370, 437, and 180 days.
Arrest that results in an incarceration represents a different experience than arrest alone. Those who are incarcerated are removed from the community and therefore have different experiences stemming from their criminal justice contact as well as different opportunities for engaging in coping and health behaviors.
For findings on the impact of arrest on drug use (and drug disorders) in midlife, we refer the reader to prior research among this sample (Doherty et al., 2016).
Defining obesity as a BMI ≥ 30 is based on the CDC’s classification of obesity. This cutoff has been largely based on White populations rendering it potentially less valid for non-whites. Although this is the best indicator available in the data, utilizing this cutoff might overestimate obesity in African Americans (Cornier et al., 2011).
The majority of ever smokers did not quit by midlife (60% of the men and 56% of the women) and those who did quit tended to be less serious smokers quitting in early adulthood (e.g., 61% of the male and 70% of the female prior smokers quit 10 years ago or longer) and not reporting heavy smoking (e.g., 56% of the male and 54% of the female prior smokers smoked 3 cigarettes or fewer a day when they did smoke).
While daily alcohol use could be one drink per day, among the 20.1% of men and 10.8% of women who drank daily, only 4 men and 4 women “typically” had only one drink. The average number of drinks per day is 6.3 and 6.9 for men and women, respectively.
A variety score gives equal weight to each offense that taps into the seriousness of offenders, as more serious offenders tend to commit more crime types. This safeguards against the concern with frequency scales where less serious but more frequent offenses dominate the distribution. Variety scores have been found to be reliable measures of offending (see Sweeten, 2012). This measure is significantly correlated with the total number of arrests in young adulthood for men (r = 0.369, p < 0.001) and women (r = 0.167, p < 0.05).
This measure includes cohabitation as “not married.” The number of years married is drawn from retrospective questions tapping into changes in marital status, which does not include cohabitation.
Several key young adult measures related to cumulative disadvantage, such as access to health care, mental health, friend support, and discrimination, were not included. In designing our models, we were careful to include adequate controls while safeguarding against over-fitting our models. We prioritized controlling for young adult health behavior and self-reported offending, which left little room for the inclusion of all key measures. However, these omissions are offset by the fact that several of the measures in the propensity models are highly correlated with these omitted young adult covariates. Moreover, we conducted sensitivity analyses that included several combinations of these young adult covariates, and the results are robust (results available upon request).
Due to rounding, standardized differences for mother’s education for men in Table 2 is −0.20; however, the actual standardized difference is −0.1979.
Prior research shows that being arrested in young adulthood is strongly related to being arrested in midlife among the Woodlawn cohort (Doherty et al., 2016). To control for this continuity in criminal justice contact into midlife, we ran additional models for each health risk behavior outcome that included the number of arrests between ages 33 and 42. All results and conclusions are consistent with those reported here (results available upon request).
The subsample sizes would have become increasingly small (for men, 34 had one arrest and 79 had multiple, for women 41 had one arrest and 41 had multiple).
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Funding
The Woodlawn study has been supported by the National Institutes of Health over many years and the Harry Frank Guggenheim Foundation. The current work is supported by the National Institutes of Health R01DA042748.
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All procedures performed in this study were approved by the institutional review boards (IRBs) of the University of Missouri-St. Louis, Johns Hopkins University, and the University of Maryland and were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Appendix
Appendix
Childhood and Adolescent Matching Covariates
Measure | Description | |
|---|---|---|
Demographics | Poverty | A binary variable of whether the family’s income in 1967 fell below the poverty line for the household sizea |
Mother’s education | The number of years of school the mother had completed at the time of the interview in 1966–1967 (range 0–18) | |
Family | Family size | The number of children < 19 years old in the household during childhood (range 1–15) |
Female-headed household | A dichotomous variable of whether a child was living in a “mother alone” household or not in first grade | |
Residential mobility | The number of times a child had moved in the six years between his or her birth and the time of the interview in 1966–1967 (range 0–9) | |
Family discipline | A composite score of mother report at the 1966–67 interview (range 1–9): how often was the child spanked (range: never to almost every day), and how often the child got punished (range: hardly ever to always) (r = 0.27, p < 0.001) | |
Family affection | A summed score (range 1–7) (r = 0.19, p < 0.001) of two questions: how often did the mother play with/read to the child; how often did the child get taken out (range: never to every week) | |
Mother’s anxiety | Based on mother reports of frequency of feeling nervous, tense, or edgy on a scale of 0 to 3, ranging from hardly ever to very often | |
Early social adaptation | Aggression | First grade teacher observation rating of aggressive behavior, ranging from 0 to 3, adapting to severely maladapting |
Shyness | First grade teacher observation rating of shy behavior, ranging from 0 to 3, adapting to severely maladapting | |
Inattention | First grade teacher observation rating of ability to focus, ranging from 0 to 3, adapting to severely maladapting | |
Underachievement | First grade teacher observation rating of achievement, ranging from 0 to 3, adapting to severely maladapting | |
Immaturity | First grade teacher observation rating of maturity, ranging from 0 to 3, adapting to severely maladapting | |
Reading grades | First grade teacher rating of reading skills (range: unsatisfactory to excellent) | |
Math grades | First grade teacher rating of math skills (range: unsatisfactory to excellent) | |
Classroom conduct scores | First grade teacher rating of each child’s general classroom conduct (range: unsatisfactory to excellent) | |
Adolescent risk behaviors | Adolescent status offending | A mean scale of 6 status offenses (e.g., run away from home) drawn from the adolescent and young adulthood assessments (range: never, once, more than once) |
Adolescent violent offending | A mean scale of 14 violent offenses (e.g., get into a serious fight) drawn from the adolescent and young adulthood assessments (range: never, once, more than once) | |
Adolescent non-violent offending | A mean scale of 9 non-violent offenses (e.g., damage school property) drawn from the adolescent and young adulthood assessments (range: never, once, more than once) | |
Early onset of smoking | A binary variable of smoking a full cigarette before age 15 | |
Early onset of alcohol | A binary variable of drinking more than a sip of beer, wine, or hard liquor before age 15 | |
Early onset of marijuana | A binary variable of initiating marijuana use before age 15 | |
High school dropout | A binary variable indicating whether someone dropped out of school prior to graduation versus being a high school graduate or receiving a GED | |
Teen parent | A binary variable indicating whether someone became a parent before age 20 as opposed to never a parent or a parent after age 20 | |
Adolescent health | Adolescent self-rated health | Self-rating of how healthy the respondent had been since first grade (range: not at all healthy (1) to very, very healthy (6)) |
Adolescent anxious mood | A mean scale of how true 7 statements are over the past several weeks (e.g., I feel nervous, new situations make me tense), ranging from 1 to 6, not at all to very, very much, when at least 4 of the 7 items are valid |
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Doherty, E.E., Green, K.M. & Ensminger, M.E. Long-term Consequences of Criminal Justice System Intervention: The Impact of Young Adult Arrest on Midlife Health Behaviors. Prev Sci 23, 167–180 (2022). https://doi.org/10.1007/s11121-021-01236-5
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DOI: https://doi.org/10.1007/s11121-021-01236-5