Links of Previous Incarceration With Geriatric Syndromes and Chronic Health Conditions Among Older Adults in the United States.

BACKGROUND: This study investigated the association between previous incarceration and various geriatric and chronic health conditions among adults 50 and older in the United States. METHODS: Data came from the National Longitudinal Study of Adolescent to Adult Health-Parent Study (AHPS) collected in 2015-2017, including 2 007 individuals who participated in the parent study (Parent Sample) and 976 individuals who participated in the spouse/partner study (Spouse/Partner Sample). Multiple logistic regression was used to investigate the relationship between previous incarceration and geriatric syndromes (dementia, difficulty walking, difficulty seeing, difficulty with activities of daily living) and chronic health conditions (self-reported poor/fair health, diagnosis of cancer, hypertension, diabetes, heart disease, stroke, chronic lung disease, depression, and alcohol use [4 or more drinks per week]). RESULTS: In adjusted analyses, respondents with previous incarceration in the AHPS had significantly higher odds of reporting difficulty walking, activities of daily living difficulty, cancer diagnosis, depression diagnosis, and chronic lung disease (adjusted odds ratios [aORs] = 2.21-2.95). Respondents in the AHPS spouse/partner study reported higher odds of difficulty seeing, cancer, depression, chronic lung disease, and heavy alcohol use (aORs = 1.02-2.15). CONCLUSIONS: Previous incarceration may have an adverse impact on healthy aging. Findings highlight the importance of addressing the enduring health impacts of incarceration, particularly as individual transition into older adulthood.

Prior Incarceration and Performance on Immediate and Delayed Verbal Recall Tests: Results From National Longitudinal Study of Adolescent to Adult Health-Parent Study.

OBJECTIVES: This study aimed to investigate the cognitive functioning of formerly incarcerated older adults compared to their never-incarcerated counterparts, focusing on immediate and delayed verbal recall. METHODS: Data are from 2,003 respondents who participated in the National Longitudinal Study of Adolescent to Adult Health-Parent Study (AHPS; ages 47-82, mean age 62). AHPS participants were administered word recall memory exercises to the parent respondent from the Rey Auditory-Verbal administered Learning Test, including (a) 90-s (immediate or short-term verbal memory), (b) 60-s recall tests (delayed or long-term verbal memory), and (c) combined word recall on the 90-s and 60-s tests. RESULTS: Adjusting for control variables, respondents who reported prior incarceration had a lower rate of verbal recall on the combined word recall (incidence risk ratio [IRR] = 0.915, 95% confidence interval [CI] = 0.840, 0.997) and immediate word recall (IRR = 0.902, 95% CI = 0.817, 0.996). When restricting the sample to respondents over age 60, prior incarceration was associated with lower combined word recall (IRR = 0.847, 95% CI = 0.752, 0.954), immediate word recall (IRR = 0.857, 95% CI = 0.762, 0.963), and delayed word recall (IRR = 0.834, 95% CI = 0.713, 0.974). DISCUSSION: This study underscores the adverse impact of prior incarceration on cognitive functioning in the older adult population, emphasizing the need for targeted interventions and support for formerly incarcerated older adults. The results reinforce the importance of addressing the long-term consequences of incarceration, especially as individuals enter older adulthood.

"The COVID-19 pandemic and operational challenges, impacts, and lessons learned: a multi-methods study of U.S. prison systems".

BACKGROUND: The purpose of this study was to examine how the COVID-19 pandemic changed U.S. prison operations and influenced the daily work of prison staff. METHODS: In collaboration with the National Institute of Corrections, we administered a survey to 31 state correctional agencies in April 2021 and conducted five focus groups with 62 correctional staff. RESULTS: Using a framework of bounded rationality, we find that daily operations were strained, particularly in the areas of staffing, implementing public health policy efforts, and sustaining correctional programming. While prison systems and staff were under-prepared to respond to the pandemic, they attempted to address complex problems with the limited resources they had. CONCLUSIONS: Results underscore a need in corrections for prioritizing further developments and reviews of collaborative policies and practices for managing crisis situations. Seeking avenues for leveraging technological innovations to improve operations and facilitate enhanced communication are especially warranted. Finally, meaningful reductions in the prison population, changes in physical infrastructure, and expansions of hiring and retention initiatives are critical for positioning prisons to manage future emergencies.

Mental Illness and Racial Disparities in Correctional Staff-Involved Violence: An Analysis of Jails in the United States.

In this study, we draw on theories of opportunity and focal concerns to examine how mental illness and race correspond to correctional staff-involved violence, particularly within the transient and diverse context of jails. Using a sample of 3,936 people incarcerated in jails from the 2011 to 2012 National Inmate Survey (NIS-3), we analyze how an individual's mental health status (number of mental illness diagnoses) and race relates to the risk of staff-inflicted victimization. Using a series of Firth's logistic regression models, we find that Black and Hispanic individuals are much more likely to be victims of correctional staff assault than their White counterparts. Those with one and two or more mental illness diagnoses are also at greater risk for staff-involved violence, respectively. Supplementary models show that those who suffer from serious mental illness are at particularly high risk for staff victimization. In a subsequent moderation analysis, we find that race does not condition the influence of mental health diagnoses on risk for staff-involved violence. Our findings reinforce the need for more research on correctional staff-involved violence and the implications of this research support calls for enhanced training of correctional staff regarding mental illness and racial bias.

Health Information Seeking Behaviors in Prison: Results From the U.S. PIAAC Survey.

Distinct challenges exist in the delivery of medical services in correctional facilities, yet little is known about the sources of health information incarcerated patients rely upon to understand and manage their health. Using a nationally representative sample of U.S. incarcerated adults (N = 1,319) from the Programme for the International Assessment of Adult Competencies, we examine patterns in health information seeking behavior. We find incarcerated persons report television (72.9%) and social contacts (61.8%) as their most common sources of health information and use of magazines and books/brochures is significantly related to better health. We argue that asking incarcerated patients how they get health information and using this knowledge to provide them with health information in formats they will use are important steps toward reducing incarcerated individuals' health disparities.

Visitation and quality of life among older adults in jail.

PURPOSE: The purpose of this paper aims to examine differences in measures of and relationships between visitation and quality of life (QOL) among older and younger jailed adults. The authors also explored the contribution of visitation to QOL among adults in this setting. The authors anticipated fewer visits and lower QOL among older adults. Framed by psychosocial developmental theory, the authors also anticipated a larger effect in the relationship between visitation and QOL among older rather than younger adults and that visitation would contribute most readily to psychological QOL. DESIGN/METHODOLOGY/APPROACH: Cross-sectional data from a large US jail were used (n = 264). The authors described the sample regarding visitation and QOL measures among older (≥45) and younger adults (≤44) and examined differences in measures of and relationships between visitation and QOL using independent sample t-tests and bivariate analyses. The authors explored the contribution of visitation to psychological, social relationships, physical and environmental QOL among jailed adults using hierarchical multiple linear regression. FINDINGS: Older adults had fewer family visits and lower physical QOL than younger adults, disparities were moderate in effect (d range = 0.33-0.35). A significant difference also emerged between groups regarding the visitation and environmental QOL relationship (z = 1.66, p <0.05). Visitation contributed to variation in physical and social relationships QOL among jailed adults (Beta range = 0.19-0.24). ORIGINALITY/VALUE: Limited research exists among jailed older adults and scholars have yet to examine the relationship between visitation and QOL among persons in these settings.

Prisons and COVID-19: A Desperate Call for Gerontological Expertise in Correctional Health Care.

The large and continued growth of the older adult population within U.S. prisons affects not only criminal justice policy and correctional health practice, but also gerontology. Amidst the unfolding COVID-19 crisis, associated knowledge and skills surrounding older adulthood will be critical to assuring the needs of older adults incarcerated in prisons are met during their detention, while undergoing off-site intervention in community settings, and when preparing for release. We outline several key areas for which gerontologists and associated practitioners are especially well suited in the effort to curtail morbidity and mortality driven by the disease caused by the novel coronavirus. Critical gerontological knowledge and skills needed in prison health care include awareness regarding the unusual clinical presentations of COVID-19 among older adults, deconditioning among older adults due to immobility, challenges in prognostication, and advance care planning with older adults. Specific, targeted opportunities for gerontologists are identified to reduce growing risks for older adults incarcerated in prisons.

Revisiting 'awareness contexts' in the 21st century hospital: How fragmented and specialized care shape patients' Awareness of Dying.

In 1965, Glaser and Strauss (1965) offered the concept of "awareness contexts" to explain what patients in hospitals do or don't know about their death trajectories. Awareness ranges from closed (where patients are completely unaware and family and providers protect "the secret") to open (where all parties communicate openly and honestly). While closed awareness was the norm in 1960s, open awareness is now considered standard practice in US, a reflection of mounting evidence that patients, families, and providers benefit from clear and honest communication at end of life (Seale et al., 1997; Wright et al., 2008). Despite the known benefits of open awareness, many terminal patients remain unaware or confused about their prognoses (Chen et al., 2017). This paper asks why, in an era of open awareness, are patients and families uncertain about dying? To answer this question, we focus on an aspect of Glaser and Strauss's theory that remains relatively understudied by researchers, namely the role of institutional and organizational realities in shaping awareness contexts. Based on interviews with 43 family members of deceased patients who died at General Hospital in the Midwestern US, we argue that two related conditions in hospitals-the increased specialization of medical professionals and the fragmentation of patient care-serve as important context for the death awareness of patients and families.

Utilizing a General Strain Framework to Examine Behavioral Responses to Psychological Intimate Partner Violence: Are Responses Gendered?

We know from the violence literature that a distinct sex disparity exists in the perpetration of other-directed violence (ODV). Some scholars suggest that this disparity is explained in part by gendered reactions to stress, strain, or violence victimization, in which males and females engage in different coping mechanisms, with males more likely to engage in ODV than females. Using a college sample, we investigate the behavioral responses of male and female victims of psychological intimate partner abuse. We find that although there is a sex disparity in the use of ODV as a coping mechanism, there is also a distinct gender orientation disparity. Our results indicate that victims who ascribe to a masculine identity are more likely than those of a feminine identity to engage in ODV, regardless of biological sex. These findings shed light on the impact of gender orientation as both a risk and protective factor in the use of ODV.

When women tell: intimate partner violence and the factors related to police notification.

We analyze how victim perceptions of mandatory arrest policies, perpetrator substance use, and presence of children are related to decisions to invoke law enforcement assistance. Logistic regression was used on survey responses from women receiving care in domestic violence shelters. Results suggest that as victim support for mandatory arrest increases, the odds of law enforcement notification of the abuse also increase. Accordingly, mandatory arrest may simply be reducing the probability of reporting intimate partner violence (IPV) among those who do not support the policy, instead of reducing IPV. Results also suggest that perpetrator substance use plays a significant role in law enforcement notification.

Crisis Intervention Team (CIT) programs in rural communities: a focus group study.

The Crisis Intervention Teams model (CIT) was originally developed as an urban model for police officers responding to calls about persons experiencing a mental illness crisis. Literature suggests that there is reason to believe that there may be unique challenges to adapting this model in rural settings. This study attempts to better understand these unique challenges. Thematic analysis of focus group interviews revealed that there were both external and internal barriers to developing CIT in their respective communities. Some of these barriers were a consequence of working in small communities and working within small police departments. Participants actively overcame these barriers through the realization that CIT was needed in their community, through collaborative efforts across disciplines, and through the involvement of mental health advocacy groups. These results indicate that CIT can be successfully implemented in rural communities.