The community health effects of incarceration James C. Thomas, MPH, PhD University of North Carolina Associate Professor of Epidemiology Director, Program.

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Presentation transcript:

The community health effects of incarceration James C. Thomas, MPH, PhD University of North Carolina Associate Professor of Epidemiology Director, Program in Public Health Ethics

Research funding National Institute of Allergy and Infectious Disease (NIAID) National Institute of Mental Health (NIMH) Agency for Healthcare Research and Quality (AHRQ) Soros Foundation University of North Carolina Program on Ethnicity, Culture, and Health Outcomes (ECHO)

South African diamond mines James Thomas, PhD University of North Carolina

Reported syphilis in North Carolina and Wilson (aka Step) County, James Thomas, PhD University of North Carolina

STD Rates in the US, 2000 James Thomas, PhD University of North Carolina

Social Forces: Post Depression James Thomas, PhD University of North Carolina

“Get big or get out” James Thomas, PhD University of North Carolina

Unbalanced effects James Thomas, PhD University of North Carolina

Klan march, Wilson County,1993 James Thomas, PhD University of North Carolina

Creation of the rural ghetto James Thomas, PhD University of North Carolina

Black-white income dualism 0 LowHigh North Carolina* (5.8) Wilson County (13.5) *SE=4.27 James Thomas, PhD University of North Carolina Thomas JC, Thomas K. Soc Sci & Med 1999;49:

“The Great Migration” James Thomas, PhD University of North Carolina

Loss of social capital James Thomas, PhD University of North Carolina

I-95 and syphilis, 1989 James Thomas, PhD University of North Carolina Cook RL, Royce RA, Thomas JC, Hanusa BH. Am J Public Health 1999; 89:369-73

FIGURE 2 Cook et. al Drug Arrest Rates by County Type, North Carolina, James Thomas, PhD University of North Carolina Cook RL, Royce RA, Thomas JC, Hanusa BH. Am J Public Health 1999; 89:369-73

The incarceration boom James Thomas, PhD University of North Carolina

Rates of Incarceration and Gonorrhea for North Carolina Counties, 1999 James Thomas, PhD University of North Carolina

Thomas JC, Torrone E, Am J Public Health 2006;96: Incarceration and health outcomes James Thomas, PhD University of North Carolina

Incarceration and health outcomes James Thomas, PhD University of North Carolina

Incarceration and health outcomes James Thomas, PhD University of North Carolina

Incarceration and health outcomes James Thomas, PhD University of North Carolina

Incarceration and health outcomes James Thomas, PhD University of North Carolina

Census-tract-level associations Thomas JC, Levandowski B, Torrone E, Isler MR. J Urban Health (in press) James Thomas, PhD University of North Carolina

Census tract-level associations James Thomas, PhD University of North Carolina Thomas JC, Levandowski B, Torrone E, Isler MR. J Urban Health (in press)

Potential Relations Between Incarceration and STD Rates Dual outcomes of another cause Direct effects (on prisoners) Indirect effects (on communities) James Thomas, PhD University of North Carolina

Dual outcomes of another cause Illicit Drug Use Incarceration STDs James Thomas, PhD University of North Carolina

Direct effects of incarceration D D E E __ a b cd James Thomas, PhD University of North Carolina

Sexual behavior Two out of three men had more than one partner in the previous three months Concurrency facilitates epidemic transmission James Thomas, PhD University of North Carolina

Sex while in prison You know what, I'm going to tell you what shocked me to see some of the guys I knew here from years, knowing them years, and they're on state [in state prison] now and they're messing with, you know, gays. And I'm looking at them like, you know, ain’t no way and sleep with that man and then you going to come out here and you got kids and you got your wife or your girlfriend comes to see you and you're doing it. Can't, you can't do that. But that's, you know, it’s goin’ all come to the light someday. Ex-offender, Durham County James Thomas, PhD University of North Carolina Thomas JC, Levandowski B, Torrone E, Isler MR. J Urban Health (in press)

Sex upon release from prison They trying to get serious, but I tell them all before I do anything, before I touch them in any kind of way. When I first talk to them, I just got out of prison and I ain't looking for no girlfriend, ain't looking for no wife, ain't looking for no baby momma. I would like, you can keep all your drama, I would like, cause if we do anything, as two consenting adults and if you agree to this, you agree to it, so don't look for me to hold your hand the next morning and tell you I love you and nothing like that. And you got one or two that just won't listen. Ex-offender, Durham County James Thomas, PhD University of North Carolina Thomas JC, Levandowski B, Torrone E, Isler MR. J Urban Health (in press)

Indirect effects of incarceration D D E E __ ab c d James Thomas, PhD University of North Carolina

Absence from relationships Sex ratio Social control, collective efficacy Indirect effects of incarceration James Thomas, PhD University of North Carolina

Sentenced State and Federal Prisoners per 100,000 U.S. Residents by Gender and Race, 1997 Uneven rates of incarceration James Thomas, PhD University of North Carolina

Prisoners with children Mumola, C. Special Report: Incarcerated Parents and Their Children. In: US Department of Justice, Bureau of Justice Statistics. Washington, DC, James Thomas, PhD University of North Carolina

Intergenerational effects Wenink E, Thomas JC (under review) James Thomas, PhD University of North Carolina

Absence from relationships Sex ratio Social control, collective efficacy Indirect effects of incarceration James Thomas, PhD University of North Carolina

Scarcity of black males U.S. Whites U.S. Blacks NC Blacks aged years Wilson County Blacks, years Equity James Thomas, PhD University of North Carolina Thomas JC, Thomas K. Soc Sci & Med 1999;49:

Indirect effects of incarceration Absence from relationships Sex ratio Social control, collective efficacy James Thomas, PhD University of North Carolina

Social control James Thomas, PhD University of North Carolina Thomas JC, Torrone E, Browning C (under review)

Homicides and social control James Thomas, PhD University of North Carolina Thomas JC, Torrone E, Browning C (under review)

Social control and STDs James Thomas, PhD; University of North CarolinaThomas JC, Torrone E, Browning C (under review)

Homicide and STDs James Thomas, PhD; University of North CarolinaThomas JC, Torrone E, Browning C (under review)

Neighborhood characteristics and STDs in Chicago James Thomas, PhD University of North Carolina Thomas JC, Torrone E, Browning C (under review)

Where next? Ethnography Multi-level quantitative analysis Agency interactions James Thomas, PhD University of North Carolina