Examining Health Disparities: The Health and Healthcare of Incarcerated Adults

Project: Research project

Description

DESCRIPTION (provided by applicant): Incarceration is an often ignored and poorly understood factor in health disparities research (Moore and Elkavich 2008). Incarcerated persons are excluded from national health surveys (Ahalt et al. 2011) and correctional facilities often have an inadequate surveillance system for providing valid and reliable data on the health status of inmates (Greifinger 2006). The NCCHC report on the health status of inmates concludes that there is a tremendous and largely unexploited opportunity to benefit public health by illuminating health disparities among inmates and improving correctional health care practices. The overall goal of the current research and training fellowship application is to prepare the applicant to become an independent, interdisciplinary researcher who can contribute to the reduction of inmate health disparities. The specific training goals of this fellowship are: 1) expand the applicants' knowledge of public health approaches to health disparities including the social determinants of health, the healthcare of inmates, and the social epidemiology of drug use, mental health, and violence; 2) increase the applicants' research design and quantitative analysis skills necessary to study health disparities among inmates; and 3) examine the complex way that demographic characteristics, mental health, risk behaviors, and prison treatment and healthcare intersect with incarceration to influence health. To achieve the first aim, the applicant will take several courses in epidemiology to build on her sociology and demography training including social epidemiology, epidemiology of mental health, epidemiology of violence and injury, and analytic epidemiology. The second aim will be accomplished via continuous engagement in activities that focus on the responsible conduct of research and the completion of statistical courses covering several topics directly related to the research aims and the use of large national datasets including missing data for large data sets, propensity score matching, resampling techniques, sampling theory, confounding and mediation, database management, and sampling weight computation. Completion of a doctoral dissertation focusing on inmate health disparities will fulfill the third aim. The proposed dissertation will use multiple preexisting, national probability samples (i.e., SISCF, SICFC, NHANES, and Add Health) as well as multiple statistical and methodological approaches (i.e., logistic regression, moderation, mediation, quasi-experimental design, and multilevel modeling) to identify demographic patterns of health disparities for chronic health and infectious diseases for incarcerated adults, determine the effect of the prison environment on health, and examine disparities in in the utilization of treatment (i.e., substance use, mental health) and healthcare services by adult inmates as well as the inmate- and prison-level factors that may account for these variations. Findings will be useful in the development of policy aimed at decreasing health disparities related to alcohol and drug addiction, mental health, and trauma for inmates during incarceration and community reentry. Additionally, findings from this study can be used by prison staff to target specific groups for inclusion in treatment and healthcare services as well a develop knowledge that can contribute to personalized or customized interventions for inmates. Specifically, the findings can inform age-appropriate and culturally-relevant, gender-informed treatment interventions. The applicant is firmly committed to a research career that will contribute to the understanding and reduction of health disparities for inmates and the communities to which they return.
StatusFinished
Effective start/end date6/1/145/31/17

Funding

  • National Institutes of Health: $33,978.00
  • National Institutes of Health: $31,378.00
  • National Institutes of Health: $9,935.00

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Delivery of Health Care
Health
Epidemiology
Prisons
Mental Health
Research
Demography
Violence
Health Status
Research Design
Public Health
Social Determinants of Health
Sampling Studies
Propensity Score
Sociology
Nutrition Surveys
Policy Making
Wounds and Injuries
Mental Health Services
Risk-Taking