Incarceration of Family during Childhood Linked with Diabetes in Men

TUSCALOOSA, Ala. — Men who experienced a family member’s incarceration are 64% more likely to have diabetes in later adulthood compared to those who did not, report researchers from The University of Alabama and the University of Toronto in a recent study in SAGE-Open Medicine.

The study – by Dr. Bradley White, UA associate professor of psychology and Dr. Esme Fuller-Thomson, professor of social work at Toronto  – mirrors previous research by the authors, published in 2016, which found the incarceration of a family member during childhood was also associated with a much higher risk of heart attacks in men, but not women.

Their recent study looked at a large representative sample of adults older than the age of 40 across five U.S. states. Of the men exposed to this childhood trauma, 7.9% had diabetes. Of the men who had not experienced the incarceration of a family member as a child, only 4.8% had the disease. The difference was much less for women, 5.4% verse 4.5%.

“Previous studies have found that the incarceration of a parent plays havoc with the stability of housing, employment and parental marital relationships. It has also been associated with psychosocial maladjustment and mental disorders in children and often leads to considerable social and familial stigma,” White said. “Less attention has been paid to the long-term physical health outcomes of the children as they grow up.”

Family member incarceration during childhood is an under-investigated, yet increasingly common, childhood experience in the United States. One in every 17 respondents aged 40-64 had experienced a family member incarcerated compared to one in every 63 respondents aged 80 and older. The vast majority of U.S. prison inmates are men, most of whom are fathers to children under 18.

While White and Fuller-Thomson’s study was not designed to draw conclusions about the different results found between men and women, the researchers developed several hypotheses they would like to explore.

“Prior evidence suggests men may be more vulnerable biologically to early adversities than women and experience stress-related testosterone suppression, which is linked to insulin resistance,” White said. “In addition, incarceration also frequently interferes with fathers’ contact with children, which may particularly impact their sons’ abilities to cope with stress. Boys and men are also less likely than girls and women to seek psychosocial support in response to adverse events.”

Since other adverse childhood traumas also found to contribute to the development of health problems in later life are also more prevalent in households where a family member is incarcerated, six other forms of childhood traumas were adjusted for in the analysis, in addition to most of the known risk factors for diabetes, such as obesity and smoking. The six forms of trauma include sexual, physical and verbal abuse along with parental addictions, parental mental illness and parental domestic violence.

“The results of our two studies suggests that the dramatic increase in incarceration rates may have detrimental long-term health effects for boys with a family member in prison, and these effects may persist into later life,” said Fuller-Thomson, director of the U of T’s Institute for Life Course and Aging.

“Our results support the consideration of alternatives to current incarceration policies and practice,” said co-author Keri J. West, a social work doctoral candidate at U of T. “These alternatives include investment in diversion strategies to redirect individuals to community-based rehabilitative programs, facilitating family contact by placing incarcerated individuals in facilities close to their communities, and eliminating visitation policies that create excessive burden for family members, such as restrictive visitation hours and prohibitive fees for phone calls.”

Along with her position in the U of T Factor-Inwentash Faculty of Social Work, Fuller-Thomson holds a cross appointment to the U of T department of family and community medicine and the faculty of Nursing. At UA, White is a core faculty member at Center for Youth Development and Intervention.