Video Abstract
On any day, the United States incarcerates more than 2 million individuals, half of whom are parents.1 One out of 14 children has ever experienced parental incarceration (PI), rates disproportionately higher for youth of color and those experiencing poverty.2 Of note – 1 study found rural children were twice as likely as urban peers to experience PI (10.7% versus 6.3%, respectively).2 PI situates children at 5 times greater risk for additional adverse childhood experiences (ACEs) and contributes to poor health,3,4 though most research has overlooked geographic differences and regional disparities. Meanwhile, rural incarceration rates continue to climb despite stabilizing or decreasing trends nationally and in urban areas.5 Whereas initial evidence suggests that rural PI negatively influences youth health,6 more evidence is needed to understand the reach and impact of PI across regions – gaps that this study seeks to fill.
Methods
Data come from the voluntary and anonymous 2019 Minnesota Student Survey of eighth, ninth, and eleventh graders across 81% of Minnesota public schools (yielding responses from 54% to 68% of students). The sample includes 113 050 students between 12- and 19-years-old (M = 14.8), half of whom were female (51.5%). Regions were categorized using the National Center for Education Statistics classifications of cities, suburbs, townships, and rural locales.7 Youth self-reported experiences of parental incarceration, race and ethnicity, and exposure to ACEs (Table 1). The study was reviewed and deemed exempt by the University of Minnesota institutional review board. Of the students with PI responses, data on race or ACEs were missing in less than 1.5% of cases (with city students having more missing data). χ2 and t tests assessed differences between PI, region, race, and ACEs.
Measure Descriptions and Experiences of ACEs Across Regions by Parental Incarceration Status
. | Parental Incarceration . | ||||||||
---|---|---|---|---|---|---|---|---|---|
. | Have any of your parents or guardians ever been in jail or prison? . | ||||||||
. | City youtha . | Suburban youtha . | Township youtha . | Rural youtha . | . | ||||
. | No . | Yes . | No . | Yes . | No . | Yes . | No . | Yes . | . |
. | 11 694 (84.4) . | 2163 (15.6) . | 44 342 (85.9) . | 7303 (14.1) . | 22 982 (80.0) . | 5746 (20.0) . | 14 598 (77.6) . | 4222 (22.4) . | Sig. . |
Physical abuse | |||||||||
Has a parent or other adult in your home ever hit, beat, kicked, or physically hurt you in any way? | 1128 (9.8) | 536 (25.5) | 4789 (11.0) | 1917 (27.0) | 2097 (9.2) | 1427 (25.3) | 1288 (8.9) | 992 (24.0) | e |
Sexual abuse | |||||||||
Has anyone (relative or family member or otherwise) ever pressured, tricked, or forced you to do something sexual or done something sexual to you against your wishes? | 440 (3.8) | 303 (14.4) | 1930 (4.4) | 967 (13.5) | 1082 (4.7) | 860 (15.2) | 666 (4.6) | 600 (14.4) | d |
Psychological abuse | |||||||||
Does a parent or other adult in your home regularly swear at you, insult you, or put you down? | 1196 (10.34) | 574 (27.1) | 5393 (12.3) | 2203 (30.7) | 2839 (12.5) | 1738 (30.7) | 1790 (12.4) | 1245 (30.0) | a, b |
Domestic violence | |||||||||
Have your parents or other adults in your home ever slapped, hit, kicked, punched, or beat each other up? | 478 (4.2) | 508 (24.3) | 1895 (4.3) | 1676 (23.6) | 957 (4.2) | 1328 (23.6) | 636 (4.4) | 989 (23.9) | |
Household substance use | |||||||||
Do you live with anyone who drinks too much alcohol? OR Do you live with anyone who uses illegal drugs or abuses prescription drugs? | 1015 (8.7%) | 696 (32.5%) | 4120 (9.3%) | 2422 (33.4%) | 2418 (10.5%) | 1908 (33.3%) | 1450 (9.9%) | 1341 (31.9%) | |
Household mental illness | |||||||||
Do you live with anyone who is depressed or has any other mental health issues? | 2616 (22.6) | 919 (43.5) | 10212 (23.3) | 3109 (43.4) | 5126 (22.5) | 2510 (44.3) | 3069 (21.2) | 1814 (43.5) | |
Food insecurity | |||||||||
During the past month, have you skipped meals because your family did not have enough money to buy food? | 632 (3.1) | 288 (13.4) | 1175 (2.7) | 811 (11.2) | 715 (3.1) | 636 (11.1) | 397 (2.7) | 445 (10.6) | a, b, c |
Housing instability | |||||||||
During the past year, have you stayed in a shelter, somewhere not intended as a place to live, or someone else’s home because you had no other place to stay? | 413 (3.6) | 335 (15.9) | 1423 (3.3) | 848 (11.9) | 768 (3.4) | 686 (12.2) | 511 (3.6) | 508 (12.3) | a, b, c |
Cumulative ACEs | |||||||||
Sum of each individual ACE indicator above, range from 0–8; (M / SD) | 0.66 (1.06) | 1.94 (1.86) | 0.70 (1.08) | 1.92 (1.77) | 0.70 (1.09) | 1.94 (1.78) | 0.67 (1.08) | 1.89 (1.76) |
. | Parental Incarceration . | ||||||||
---|---|---|---|---|---|---|---|---|---|
. | Have any of your parents or guardians ever been in jail or prison? . | ||||||||
. | City youtha . | Suburban youtha . | Township youtha . | Rural youtha . | . | ||||
. | No . | Yes . | No . | Yes . | No . | Yes . | No . | Yes . | . |
. | 11 694 (84.4) . | 2163 (15.6) . | 44 342 (85.9) . | 7303 (14.1) . | 22 982 (80.0) . | 5746 (20.0) . | 14 598 (77.6) . | 4222 (22.4) . | Sig. . |
Physical abuse | |||||||||
Has a parent or other adult in your home ever hit, beat, kicked, or physically hurt you in any way? | 1128 (9.8) | 536 (25.5) | 4789 (11.0) | 1917 (27.0) | 2097 (9.2) | 1427 (25.3) | 1288 (8.9) | 992 (24.0) | e |
Sexual abuse | |||||||||
Has anyone (relative or family member or otherwise) ever pressured, tricked, or forced you to do something sexual or done something sexual to you against your wishes? | 440 (3.8) | 303 (14.4) | 1930 (4.4) | 967 (13.5) | 1082 (4.7) | 860 (15.2) | 666 (4.6) | 600 (14.4) | d |
Psychological abuse | |||||||||
Does a parent or other adult in your home regularly swear at you, insult you, or put you down? | 1196 (10.34) | 574 (27.1) | 5393 (12.3) | 2203 (30.7) | 2839 (12.5) | 1738 (30.7) | 1790 (12.4) | 1245 (30.0) | a, b |
Domestic violence | |||||||||
Have your parents or other adults in your home ever slapped, hit, kicked, punched, or beat each other up? | 478 (4.2) | 508 (24.3) | 1895 (4.3) | 1676 (23.6) | 957 (4.2) | 1328 (23.6) | 636 (4.4) | 989 (23.9) | |
Household substance use | |||||||||
Do you live with anyone who drinks too much alcohol? OR Do you live with anyone who uses illegal drugs or abuses prescription drugs? | 1015 (8.7%) | 696 (32.5%) | 4120 (9.3%) | 2422 (33.4%) | 2418 (10.5%) | 1908 (33.3%) | 1450 (9.9%) | 1341 (31.9%) | |
Household mental illness | |||||||||
Do you live with anyone who is depressed or has any other mental health issues? | 2616 (22.6) | 919 (43.5) | 10212 (23.3) | 3109 (43.4) | 5126 (22.5) | 2510 (44.3) | 3069 (21.2) | 1814 (43.5) | |
Food insecurity | |||||||||
During the past month, have you skipped meals because your family did not have enough money to buy food? | 632 (3.1) | 288 (13.4) | 1175 (2.7) | 811 (11.2) | 715 (3.1) | 636 (11.1) | 397 (2.7) | 445 (10.6) | a, b, c |
Housing instability | |||||||||
During the past year, have you stayed in a shelter, somewhere not intended as a place to live, or someone else’s home because you had no other place to stay? | 413 (3.6) | 335 (15.9) | 1423 (3.3) | 848 (11.9) | 768 (3.4) | 686 (12.2) | 511 (3.6) | 508 (12.3) | a, b, c |
Cumulative ACEs | |||||||||
Sum of each individual ACE indicator above, range from 0–8; (M / SD) | 0.66 (1.06) | 1.94 (1.86) | 0.70 (1.08) | 1.92 (1.77) | 0.70 (1.09) | 1.94 (1.78) | 0.67 (1.08) | 1.89 (1.76) |
Data are presented at n (%) unless otherwise noted. To test for differences in ACE exposure among youth with incarcerated parents across regions, the following notations are used to indicate significance levels of P < .05: a, city PI versus suburb PI; b, city PI versus township PI; c, city PI versus rural PI; d, suburb PI versus township PI; e, suburb PI versus rural PI; f, town PI versus rural PI.
Within regions, youth with incarcerated parents were significantly more likely than their counterparts without incarcerated parents to experience each individual ACE indicator and total cumulative ACEs (P < .001).
Results
Approximately 17% of youth ever experienced PI, though there were significant regional disparities as those outside of metropolitan areas were more likely to report PI (Table 1). Pointedly, 22% of rural and 20% of township youth experienced PI compared with 16% of city and 14% of suburban youth. Across locales, white youth were significantly underrepresented among those experiencing PI, whereas youth of color were overrepresented in the full sample and city, suburban, township, and rural subsamples (Fig 1). Of note, over half of Native youth and more than one-third of Black, Hispanic, and multiracial youth who lived in rural communities experienced PI. Within each region, youth experiencing PI reported significantly more individual and cumulative ACEs than their non-PI peers; though, across regions, there were some significant differences in PI youths’ exposure to individual ACEs (Table 1).
Percentages of youth who have experienced parental incarceration by region and race.
Percentages of youth who have experienced parental incarceration by region and race.
Discussion
This study yielded rates of rural PI that were significantly higher than urban areas and double what was previously understood.3 Underlying these inequities are criminal legal policies and practices that pathologize communities of color (leading to racial disparities in surveillance, arrest, conviction, and incarceration) and regional differences in legal resources and services across urban-rural lines.8,9 For instance, findings regarding rural Native youth underscore the disproportionate policing of Indigenous communities and align with calls for increased economic and health supports to combat unmet needs.10 Co-occurring household challenges can be common for youth experiencing PI, regardless of region, with cumulative ACE exposure being 2 to 3 times greater than non-PI peers (with other studies reporting rates nearly 5 times).3 These findings point to social and structural factors that contribute to disparities and health inequities. As such, health-related services for families navigating the carceral system, especially those in rural settings given heightened PI prevalence, must be funded and expanded (including collaborative care, community health workers, and telemedicine). Pairing these resources with prevention and intervention services, such as economic, housing, and youth development programs, will invest in communities, reduce risk for PI, and support youth well-being across regions.
Study limitations include selection bias, inability to validate psychometric properties of responses, and unaccounted for nuances behind PI and ACEs (eg, stigma, recency, frequency, duration). Future work should replicate these findings with other state or nationally representative data to better understand rural PI and include a more robust set of health-related outcomes.
In all, this study highlights the regional distribution of PI among youth, shedding light on disparities of PI in rural communities. By examining regional differences in PI, tailored strategies can be developed that address health inequities and work toward decarceration across communities.
Dr Muentner conceptualized and designed the study, conducted analyses, drafted the initial manuscript, and reviewed and revised the piece; Dr Heard-Garris reviewed and revised the manuscript and critically assessed the piece for important intellectual content; Dr Shlafer conceptualized and designed the study, supervised data analyses, revised the manuscript, and critically reviewed the piece for important intellectual content; and all authors approve the final manuscript as submitted and agree to be accountable for all aspects of the work.
FUNDING: No external funding.
CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no conflicts of interest relevant to this article to disclose.
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