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Exploring Parental Incarceration, US Government Support Programs, and Child Health and Well-Being: A National Cross-Sectional Study - 11/12/23

Doi : 10.1016/j.jpeds.2023.113764 
Destiny G. Tolliver, MD, MHS 1, , Laura C. Hawks, MD, MPH 2, Louisa W. Holaday, MD, MHS 1, 3, Emily A. Wang, MD, MAS 4, 5
1 Yale National Clinician Scholars Program, Yale School of Medicine, New Haven, CT 
2 Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 
3 Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 
4 Yale School of Medicine, New Haven, CT 
5 SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT 

Reprint requests: Destiny G. Tolliver, MD, MHS, Department of Pediatrics, 801 Albany St, Boston, MA 02119.Department of Pediatrics801 Albany StBostonMA02119

Abstract

Objectives

To describe relationships between parental incarceration and child health and flourishing—a measure of curiosity, resilience, and self-regulation—and to identify government programs that moderate this relationship.

Methods

Using the National Survey of Children's Health data from 2016 through 2019 for children 6-17 years old, we estimated associations with logistic regression between parental incarceration and overall health and flourishing, adjusting for child, caregiver, and household factors. We secondarily examined physical health (asthma, headaches), mental health (attention deficit disorder/attention deficit hyperactivity disorder, depression), developmental needs (learning disability, special educational plan use), and educational (missing ≥11 school days, repeated grade) outcomes. We performed interaction analyses to determine whether government program participation (eg, free/reduced lunch, cash assistance) moderated relationships between parental incarceration and child outcomes.

Results

Children with parental incarceration accounted for 9.3% of the sample (weighted n = 4 400 000). Black, American Indian/Alaska Native, and multiracial children disproportionately experienced parental incarceration. Parental incarceration was associated with worse health (aOR, 1.31; 95% CI, 1.11-1.55) and higher odds of not flourishing (aOR, 1.66; 95% CI, 1.46-1.89). Physical health, mental health, developmental issues, and educational needs were also associated with parental incarceration. Participation in free and reduced lunch moderated the relationships between parental incarceration and general health and flourishing, and cash assistance moderated the association between parental incarceration and flourishing. For each, parental incarceration had an attenuated association with health among people who participated in government programs.

Conclusions

Parental incarceration is disproportionately experienced by Black and Indigenous children and associated with worse child health and well-being. Government support program participation may mitigate negative associations between parental incarceration and child outcomes.

Le texte complet de cet article est disponible en PDF.

Keywords : health inequities, public policy, structural racism, mass incarceration

Abbreviations : FPL, NSCH, PRWORA, SNAP, TANF, WIC


Plan


 At the time of this study, D.G.T.’s time was funded by the Yale National Clinician Scholars Program and by Clinical and Translational Science Award number TL1 TR001864 from the National Center for Advancing Translational Science.
 Data from this analysis were presented at the American Academy of Pediatrics National Conference and Exhibition in 2021, and are available as an abstract at “Destiny G. Tolliver, Laura Hawks, Louisa Holaday, Emily Wang; Exploring the Relationship Between Parental Incarceration, Government Programs, and Child Health and Flourishing. Pediatrics February 2022; 149 (1 Meeting Abstracts February 2022): 620.”


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