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.
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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 Rate (Cases per 100,000 person-years) Reported syphilis in North Carolina and Wilson (aka Step) County, 1922-1997 1600.0 1400.0 Step County North Carolina 1200.0 1000.0 800.0 600.0 400.0 200.0 0.0 1920 1930 1940 1950 1960 Year James Thomas, PhD University of North Carolina 1970 1980 1990 2000 STD Rates in the US, 2000 1200 800 White Hispanic Black 400 0 Chlamydia James Thomas, PhD University of North Carolina Gonorrhea 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 Wilson County (13.5) North Carolina* (5.8) 0 Low High *SE=4.27 Thomas JC, Thomas K. Soc Sci & Med 1999;49:1075-84. James Thomas, PhD University of North Carolina “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 Cook RL, Royce RA, Thomas JC, Hanusa BH. Am J Public Health 1999; 89:369-73 James Thomas, PhD University of North Carolina Drug Arrest Rates by County Type, North Carolina, 1985-94 Drug Arrate Rate (per 100,000 persons) 900 800 counties with large cities 700 600 I-95 counties 500 400 300 200 1985 non I-95 counties 1986 1987 1988 1989 1990 1991 1992 1993 1994 YEAR James Thomas, PhD FIGURE 2 University Cook et. al 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 400 Gonorrhea Rate/100,000 pop 350 300 250 200 150 100 50 0 0 50 100 150 200 250 300 Incarceration Rate/100,000 pop Source: Sampson LA, Thomas JC - UNC Chapel James Thomas, PhD University of North Carolina Incarceration and health outcomes James Thomas, PhD University of North Carolina Thomas JC, Torrone E , Am J Public Health 2006;96:1762-5. 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 James Thomas, PhD University of North Carolina Thomas JC, Levandowski B, Torrone E, Isler MR. J Urban Health (in press) 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 Incarceration Illicit Drug Use STDs James Thomas, PhD University of North Carolina Direct effects of incarceration __ E D D a b c d __ E 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 __ E __ E James Thomas, PhD University of North Carolina D D a b c d Indirect effects of incarceration Absence from relationships Sex ratio Social control, collective efficacy James Thomas, PhD University of North Carolina Uneven rates of incarceration 3500 3000 2500 2000 White Black 1500 1000 500 0 Females Males Sentenced State and Federal Prisoners per 100,000 U.S. Residents by Gender and Race, 1997 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, 2000. James Thomas, PhD University of North Carolina Intergenerational effects James Thomas, PhD University of North Carolina Wenink E, Thomas JC (under review) Indirect effects of incarceration Absence from relationships Sex ratio Social control, collective efficacy James Thomas, PhD University of North Carolina Scarcity of black males U.S. Whites 0.95 U.S. Blacks 0.88 NC Blacks aged 15-44 years 0.90 Wilson County Blacks, 15-44 years 0.80 0.5 James Thomas, PhD University of North Carolina Thomas JC, Thomas K. Soc Sci & Med 1999;49:1075-84. 1.0 Equity 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 Carolina Thomas JC, Torrone E, Browning C (under review) Homicide and STDs James Thomas, PhD; University of North Carolina Thomas 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