When an individual is incarcerated, family and loved ones suffer concrete consequences, says a study led by Daniel J. Kruger, PhD (www-personal.umich.edu/~kruger/), University of Michigan research professor for the School of Public Health. Physical and emotional health plummet, and in demographics with high rates of incarceration, this means poorer work performance and other disadvantages, affecting the whole community.
The first known study to examine the health of the loved ones of inmates, results indicated that people with a family member or friend in prison suffered worse physical and mental health than people who do not have a loved one in prison. The closer the study participant was to the inmate, the worse his or her mental and physical health.
This issue is particularly distressing to the African American community, which suffers a higher incarceration rate than the white community, Kruger says.
“The African American community is very concerned about the impact that high incarceration rates are having on their community,” he says. Nearly half of blacks surveyed reported knowing someone who was incarcerated within the last five years, compared with only 20 percent of whites. This may be one factor that accounts for health disparities between blacks and whites, Kruger adds. “African Americans are more likely to feel close to a person who is incarcerated than whites. It is a double whammy, because they are more likely to know someone incarcerated, and then more strongly affected by it.”
As a result, African Americans are also more likely to suffer declines in physical and emotional health, affecting their productivity at work and the quality of their day-to-day activities.
He hopes that awareness of the issue will help citizens of the community protect their health.
“We collect data and use the results to help spread the word. We included a couple of simple questions about incarceration into our health survey and we found a representative community,” Kruger explains. “We did random digital dialing, we did not even focus on high-risk areas.”
Previous research examining incarceration and health had ignored prison’s effects on the related community, he notes. “Other studies look at those already in the system; no one else looked at the general population. We looked at people who had friends and relatives incarcerated in the last five years and those who didn’t,” Kruger explains. “We also looked at smoking, drinking, exercise, nutrition; we controlled for factors that could provide an alternative explanation.”
While critics may argue that those with loved ones in prison may be predisposed to risk factors, Kruger maintains, “We controlled for these factors, and looked at the unique relationship of health with incarcerations.”
Most shocking, he says, was how far-reaching the effects of incarceration are on the community. “The magnitude was surprising. The extent of the results that incarceration was associated with every physical and mental health outcome that we measured was pretty striking,” Kruger says. “We found that people who had a close friend or relative that was incarcerated had 40 percent more days when poor physical health interfered with their daily activities, including work.”
Mental health caused even more disruption in routine, results show. Emotional distress interfered with daily activities, including work, on 54 percent more days, Kruger adds.
Clearly, the effects of high incarceration rates on physical and emotional health of the community bear economic consequences, he notes.
Stress, a known obstacle to good physical and mental health, is most likely to blame, but Kruger adds that a more elaborate study would need to be conducted to pinpoint details regarding just which factors are responsible.
“Stress is definitely involved,” he contends. “People who knew someone who is incarcerated had higher levels of stress.”
When someone is incarcerated, Kruger explains, his or her family may have lost a key figure in the household. That person may have provided economic, emotional or practical support.
“We would have to investigate what aspect of having someone incarcerated is driving this?” he says. “We didn’t go through other possible components that could be a factor, like day care provided or economic support. This person could have been making some sort of contribution, financial or social support, and now is no longer around. That support leaves.”
Some of the stress that loved ones experience is due to worry about what could happen to the inmate while in prison. That distress, Kruger says, is influenced by the movies and the media, which highlights prison violence.
“When you speak to inmates, you find out that incarceration is actually more boring than people think—there is violence, but not every day,” he says.
Overall, the effects of the high incarceration rate in the African American community are striking. When inmates enter prison, their family and friends suffer emotional and physical stress, affecting their work performance, leading to economic consequences. When inmates leave prison, they find it difficult to find a job because they have a record—“Stress doesn’t end after a prison term,” Kruger contends—leaving the community in a constant state of economic turmoil. How can this study and others that examine the effects of incarceration on the population help?
“We need to raise awareness that this is an issue. People might understand this when it happens, but [the incarceration of a loved one] is not really known as a risk factor,” Kruger explains. “There is no literature, no recommendations to be made on a medical visit, or in other types of health delivery or mental health delivery services. There could be a more direct way to help.”
The majority of inmates, Kruger adds, are non-violent drug users. The solution, he says, may lie in rehabilitation, not incarceration. “The majority of people who are incarcerated are not inherently evil sociopaths; there is potential for rehabilitation,” he explains. “We need to say, ‘How much of a threat does someone pose to society?’ The majority of inmates are non-violent drug offenders; they are just users, and they need treatment and rehab. We need to get the health sector involved.”
“We need better triage so people are not locked up and the key thrown away. We need some institutional process like there is northern Europe where there is more recovery and job training,” he argues.
Prison has now become big business. “The prison industrial complex is growing,” Kruger warns. “There are private prisons now; it is a for-profit business in some states.”
Future work will focus on continuing to use community survey data to benefit the community; Kruger and his team is preparing data collection for next survey.