A study, sponsored by the Centers for Disease Control and Prevention and released in December 2008, concludes that “Incarceration may not only affect those individuals incarcerated, but also those family members and friends left behind in the community.”

In a unique approach to the study of the disparity of physical illness between blacks and whites, Daniel J. Kruger PhD and E. Hill DeLoney, MA attempted to establish a correlation between the higher incidence of physical illness in the black community and the higher rate of incarceration within the same group.

In their own words, “We hypothesized that the incarceration of individuals close to survey respondents would correspond with greater adversity in physical and mental health outcomes. Differential incarceration rates for Blacks and Whites may be a contributing factor to health disparities.”

The study consisted of a telephone survey in Genesee County, Michigan. The urban hub of Genesee County is the city of Flint. For years General Motors (GM) had been the major employer in Flint, Michigan. Over the last decade the auto industry has been in serious decline and the main auto producer, GM, has closed many of its plants and laid off hundreds of workers. This economic decline led to an increase in crime and a climbing incarceration rate. The city’s parole rate for 2003 was 37 percent higher than the statewide average and figures for 2006 showed that Genesee County incarcerated its citizens at a rate significantly higher than the national average.

Research was conducted by use of phone surveys. Health questions were constructed through the collaborative efforts of seven groups including the University of Michigan’s School of Public Health, the Genesee County Health Department, the Greater Flint Health Coalition, University of Michigan--Flint, Faith Access to Community Economic Development, Genesee County Community Action Resource Department and the Flint Odyssey House--Health Awareness Center. Survey questions were created by the above groups and approved by the Institutional Review Board--Health Sciences at the University of Michigan and also the Institutional Review Board at the Michigan Public Health Institute.

The sample survey consisted of adults over the age of 18 selected at random and in proportion to Census Tracts for the city of Flint. Respondents were categorized by race, marital status, gender and education level. Results of the study are based only on the responses of those who identified themselves as black or white because of insufficient input (6%) of other racial groups.

Itemized behavior within the survey included eating, drinking, smoking and exercise habits. Questions also included in the survey categorized chronic mood and perceived stress levels of those surveyed.

Survey questions then compared the perceived closeness of those surveyed to an incarcerated person who may have held some significance in their lives. The reasoning was that incarceration leads to a decline in the presence of a potential “financial provider, nurturer, physical caregiver, disciplinarian, general companion, and contributor to the routine needs of family life.”

Specific questions were, “Within the last 5 years, have you had a relative or friend in prison?” and “How close is this person to you?” The answer to this second question was rated by the respondent on a scale of 1-to-4 of not close at all to very close.

Total sample size was 1,748 respondents. Of those, 1,288 fell into the category of White (67%) or Black (26%). Women constituted 71% of the sample and men, 29%. Age of respondents ranged from 18 to 93. Education levels broke down as follows: less than high school - 10%, high school - 31%, technical school - 2%, college (no degree) -27%, Associates degree - 10%, Bachelor’s degree - 13%, Master’s degree or higher - 8%

Of those surveyed, Blacks (49%) were more likely than Whites (20%) to have a relative or friend in prison within the last five years. A comparison of responses showed that Blacks also tended to be closer to the incarcerated individual than Whites.

Controlling for the range of health behavior patterns mentioned earlier and accounting for known health predictors, those who admitted to having close relationships with incarcerated individuals reported poorer mental, physical and emotional health. They also reported a higher average number of days per month “where poor physical, mental and emotion health interfered with their usual activities.”

Noting that the United States incarcerates “more than 1 in every 100 adults” and that there are about three times as many Blacks and Latinos behind bars as there are in college these statistics could correlate to a significant loss of worker productivity within the non-incarcerated population.

Researchers admitted to several limitations with their research methods. They recognized that their survey included only those individuals who could be reached by land-line telephones and with the increased use of cell phones an important population demographic may have been missed. Surveyors also concluded that, when compared to the data provided by the U.S. Census, their sample population under-represents those who are less educated.

However, the study supports the supposition that incarceration can have direct and adverse physical and emotional effects on those close to a person in prison. Also, “Institutions of incarceration may serve as a vector for infectious dis-eases.”

Based on the uniqueness of their study and the data collected to support their hypothesis researchers recommend more rigorous testing of their hypothesis that incarceration can directly and adversely affect the health of the general population. The report, The Association of Incarceration with Community Health and Racial Health Disparities, is available on PLN’s website.

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