Abstract

Background

Studies have shown that adults with a history of incarceration have elevated cardiovascular (CVD) risk. Research on racial/ethnic group differences in the association between incarceration and CVD risk factors of hypertension and hyperglycemia is limited.

Objective

To assess racial/ethnic group differences in the association between incarceration and hypertension and hyperglycemia.

Design

We performed a secondary data analysis using the National Longitudinal Survey of Adolescent to Adult Health (Add Health). Using modified Poisson regression, we estimated the associations between lifetime history of incarceration reported during early adulthood with hypertension and hyperglycemia outcomes measured in mid-adulthood, including incident diagnosis. We evaluated whether associations varied by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Asian).

Participants

The analytic sample included 4,015 Add Health respondents who self-identified as non-Hispanic White, Non-Hispanic Black, Hispanic, and Asian, and provided incarceration history and outcome data.

Main Measures

Outcome measures included (1) hypertension (2) systolic blood pressure  ≥ 130 mmHg, and (3) hyperglycemia.

Key Results

In non-Hispanic Black and non-Hispanic White participants, there was not evidence of an association between incarceration and measured health outcomes. Among Hispanic participants, incarceration was associated with hyperglycemia (Adjusted Risk Ratio (ARR): 2.1, 95% Confidence Interval (CI): 1.1–3.7), but not with hypertension risk. Incarceration was associated with elevated systolic blood pressure (ARR: 3.1, CI: 1.2–8.5) and hypertension (ARR: 1.7, CI: 1.0–2.8, p = 0.03) among Asian participants, but not with hyperglycemia risk. Incarceration was associated with incident hypertension (ARR 2.5, CI 1.2–5.3) among Asian subgroups.

Conclusions

Our findings add to a growing body of evidence suggesting that incarceration may be linked to chronic disease outcomes. Race/ethnic-specific results, while limited by small sample size, highlight the need for long-term studies on incarceration’s influence among distinct US groups.

 

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Topic

Clinical Practice, Health Equity, JGIM, Social Determinants of Health, Vulnerable Populations

Author Descriptions

Rachel S. Engelberg MD, MSc, Joy D. Scheidell PhD, MPH, Nadia Islam PhD, Lorna Thorpe PhD, MPH & Maria R. Khan PhD, MPH, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA

Rachel S. Engelberg MD, MSc, Division of General Internal Medicine, NYU Grossman School of Medicine, New York, NY, USA

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