Physical and Mental Health Among Incarcerated Parents: Testing a Life Course Adversity Model

 Introduction: Health and functioning disparities increasingly argue for attention to developmental pathways through which life stress accumulates, progressively building risk. Exploring pathways through which early adversities exert their long reaching impact on highly vulnerable and fragile population of parents is critical, especially in interrupting transgenerational transmission of risk. Incarcerated parents are a priority population of interest in this regard. Using stress proliferation and life course frameworks, we tested cumulative adversity pathways in childhood through adulthood:  hypothesizing direct and indirect effects from family of origin adversity through childhood and then adult adversities relative to adult physical and psychosocial health outcomes.

 Methods  Data were drawn from a racially diverse multi-site parent management training program designed specifically for incarcerated mothers and fathers who were nearing release and recontact with their children (N=357).  Family of origin adversity included maternal/paternal criminal history, incarceration, substance abuse; childhood adversity included child welfare involvement and juvenile justice involvement; and adult adversity included poverty and adult victimization. Outcomes included physical health (injury, major illness, chronic condition) and psychosocial health (depression and anxiety).

 Results: Multiple statistics (SEM using maximum likelihood) indicated satisfactory fit of the model to the data (Chi-square = 80.52, df = 45, p = .0009; CFI= .95, TLI= .91, RMSEA=.04), with pathways demonstrating proliferation of adversities across three life periods, predictive of all health outcomes. Exposure to adversities in families of origin evinced significant direct effects to both juvenile justice and child welfare involvement as well as to adult victimization.  In turn, childhood adversities provided both direct and mediated pathways for family of origin effects on adult adversity, with pathways leading to worse physical health, depression and anxiety.

 Conclusion: Our findings demonstrate stress effects on adult health stemming from each assessed life period, and with particularly powerful effects rooted in early childhood ecologies of intense parental adversities. Timely preventive interventions that interrupt the intergenerational cascade of family adversities into further adversities in childhood to later life periods could reverse, or at least attenuate their damaging impact on physical and mental health in adulthood. In the long term, these interventions could potentially diminish adversity’s reach from one generation to another.