Parents in Jail

Parents

in Jail

Kathi

J.

Kemper, MD, MPH, and Frederick P. Rivara, MD, MPH

ABSTRACT. Objective. To determine the number of

children in the United States with parents incarcerated in

jail and to describe the characteristics of these parents

and their criminal histories.

Setting. Inmates of local jails accounting for 36.5% of

the incarcerated population of the US in 1989.

Participants. Personal interviews with 5675 inmates

randomly selected from 393 553 inmates of 3312 local jails

in 1989.

Results. 44 263 (36%) inmates had children younger

than the age of 15. Fathers outnumbered mothers 10-fold;

the majority were in their 20s or 30s, unmarried, and

poorly educated. The vast majority of parents had a

record of prior offenses, and substance abuse accounted

for one third of the incarcerations. Substance abuse was

reported by 84% of inmates and 95% had sought prior

treatment for alcohol, drug, or other mental health prob-lems.

Conclusions. Nearly 1 of 50 children in the US has a

parent in jail. Parental imprisonment is not rare, is often

chronic, and is strongly associated with other

psychoso-cial and health problems in the family. Screening for

parental imprisonment potentially should be included as

part of a comprehensive biopsychosocial assessment.

Pediatrics 199392:261-264; jail, crime, parents,

psycho-social problems.

As we have devoted increasing attention to

psy-chosocial screening over the past few years,1 we have

become more aware of the number of children whose

parents are or were in prison. For example, during a

recent 4-week period of attending in the newborn

nursery 5 of 101 newborns had parents who were

incarcerated during the pregnancy and/or at the

time of delivery. In reviewing the clinic record of a

13-year old boy with a positive tuberculin skin test,

we learned that his mother was incarcerated at the

time of his birth, and his father had been incarcerated

numerous times during childhood and had died of

an unspecified pulmonary disease when the child

was 2 years old.

Despite the biological, behavioral, and

develop-mental risks to a child with a parent in prison, we

were unable to find any references to the problems of

parents in prison in the pediatric literature. The crim-inal justice and social service literature discusses

parenting programs in prisons25 and the behavioral

impact of parental imprisonment on childrenP

Health problems of prisoners which may impact

From the Department of Pediatrics, University of Washington, and Harbor-view Medical Center, Seattle.

Received for publication Jan 20, 1993; accepted Mar 26, 1993.

Reprint requests to (F.P.R) Harborview Injury Prevention and Research

Center, 325 Ninth Ave. Seattle, WA 98104.

PEDIATRICS (ISSN 0031 4005). Copyright 0 1993 by the American

Aced-emy of Pediatrics.

their offspring include infectious diseases such as

tuberculosis,1 sexually transmitted disease,126

pneumococcal disease,17 varicella,18 and genetic and

behavioral problems such as alcoholism and drug addiction.

We wished to understand whether our experience

with children whose parents were in prison was

unique and to document better the extent of this

problem. We performed this study to determine the

number of children nationally whose parents were in

jail, the demographic characteristics of these parents, the reasons for and chronicity of their arrests, and the role of alcohol and drugs in their lives and sentences.

METHODS

Data for the study were obtained as part of the 1989 Annual Survey of Jails conducted for the Bureau of Justice Statistics, US Department of Justice, by the Bureau of the Census.’9 This

stan-dardized interview survey, conducted every 5 to 6 years since

1972, provides nationally representative data on persons held

prior to trial and on those convicted offenders serving sentences in

local jails (facilities which hold inmates beyond 48 hours and

administered by local officials) or awaiting transfer to state

pris-ons. The survey did not include inmates in state or federal prisons

and penitentiaries. Persons in jail represented 36.5% of the adult

incarcerated population in 1989. Personal interviews with jail

in-mates were conducted by trained interviewers during July,

Au-gust, and September, 1989. All questions were part of the stan-dardized survey and were identical with those asked in the four

prior surveys. Reliability of the questions has been established by

comparing responses to available records and by the consistency

of the surveys over the past two decades. Informed consent was obtained from all subjects.

The sample of inmates was selected from the 393 553 inmates in

the 3312 jails in the United States in June 1989. A total of 6258

inmates were actually selected for interview from a sample of 424

jails by means of a stratified two-stage process. In the first stage,

six strata were formed on the basis of the size of the male and

female inmate populations in each jail. A total of 424 jails were

then systematically sampled from these six strata. In the second

stage of sampling, separate systematic samples of male and female inmates were chosen from each jail. The total number of inmates

selected to be interviewed was 6258, of whom 112 were later found

to be ineligible and 471 refused or were not available, leaving 5675

inmates with completed interviews.

Weighted data were used in the analysis. The weighting

pro-cedure employed a basic weight for each inmate, a factor for subsampling, an inmate noninterview adjustment, a census ratio adjustment, and a ratio adjustment based on the 1989 annual

survey of jails.

The number of children and adults in the United States in 1989

was obtained from Bureau of the Census estimates.

RESULTS

Overall, an estimated 144 263 or 36% of inmates of

local jails had children younger than 15 years of age. These inmates had a total of 326 903 children,

repro-senting 0.6% of the population of children younger

than 15 and nearly 1% of children 0 through 4 years

262 PARENTS IN JAIL

TABLE 1. Number of Children Wi th Parents in Locaijail in 1989

Child’s Age Parent

Father Mother

Total % of US

1989 Population 0-4 5-9 10-14 Total 157179 11167

85 998 10 496

54959 7104

298 136 28 767

168346 96 494 62063 326 903 0.9 0.5 0.4 0.6

fathers as mothers who were imprisoned. Thus, the

overall percentages are heavily weighted toward

characteristics of the fathers.

The demographic characteristics of parents in jail

are displayed in Table 2. The majority of both fathers

and mothers were in their 20s and 30s. Fewer than

1% were younger than 18 years old, and only about I in 10 were 40 years of age or older. Relatively few of the parents in prison were married. Only 18% of

mothers and 29% of fathers were married at the time

of the survey. The education levels of fathers and

mothers were similar, with only about half having

graduated from high school or going on to higher

education. Overall income levels were low, with

more than half of the parents in prison having an

annual income of less than $10 000 in the year prior

to imprisonment.

The age at first arrest tended to be younger for

fathers than for mothers (39% vs 24% were younger

than 18 years of age) (Table 3). The vast majority

(87%) of parents had a record of prior arrests, and

more than 10% of parents had more than 10 arrests

prior to this incarceration (Table 3). The most

com-mon offense leading to this incarceration was related

to property crimes such as burglary, auto theft,

lar-ceny, fraud, or embezzlement. However, the second,

fourth, and fifth most common offenses for

incarcer-ation were all related to alcohol and/or drug use.

Altogether, offenses directly related to substance

abuse accounted for 33.9% of incarcerations. The

mean sentence length was substantially longer for

fathers (4.8 years) than for mothers (2.0 years).

TABLE 2. Demographic Characteristics of Parents in Jail*

Characteristic Parent Total

Father Mother

Age, y

15-17 0.5 0.3 0.4

18-24 23.9 25.8 24.1

25-29 25.3 34.0 26.2

30-39 39.1 35.4 38.8

40+ 112 4.6 10.5

Married 28.7 18 27.6

Education, y

<9 9.2 7.4 9.1

9-11 37.6 38.1 37.7

12+ 53.2 54.5 53.2

Reported income ($) in year prior to incarceration

<5 000 32.9 48.2 34.4

5000-9 999 24.1 25.4 24.2

10000-14 999 16.3 11.9 15.9

15000-24999 15.7 8.1 15.0

25000+ 11.0 6.4 10.5

*Values represent percentages.

TABLE 3. Incarceration Characteristics*

Characteristic Parent Total

Father Mother

Age (y) at first arrest

6-17 39.1 24.2 37.7

18-24 41.7 45.0 42.0

25+ 19.0 31.8 20.3

Prior arrests (% with) 87.9 79.7 87.1

>10 prior arrests 11.3 12.2 11.4

Top 10 offenses for this incarceration

Property crimes 21.9 25.4 22.3

Drug dealing 13 19.2 13.6

Assault 12.9 10.4 12.6

Drug use 10.8 12.9 11.0

DWI/drunkenness 10.7 4.8 9.3

Robbery 6.6 6.9 6.6

Traffic offenses 4.2 1.5 3.9

Rape, sexual assault 3.5 0.2 3.2

Family-related offenses 3.1 0.2 2.8

Child abuse 1.2 0.5 1.1

Mean sentence length, y 4.8 2.0 4.5

*Except for mean length of sentence, values represent

percent-ages.

Drug and alcohol use were extremely common

among parents in jail (Table 4). Such use was

re-ported by 84% of the sample. The most commonly

used ifiegal drug was cocaine, which was reported

by 45% of fathers and 64% of mothers. The next most

common substance was heroin, which was used by

58% of mothers and 38% of fathers in the month prior

to arrest (Table 4). Nearly all parents had reportedly

sought treatment for alcohol, drug, or other mental

health problems prior to their arrest (95% overall).

More than two thirds of parents had sought

treat-ment for alcohol-related problems and 22% had sought drug treatment. Relatively few parents were

TABLE 4. Drug and Alcohol Use and Treatment Among Par-ents in Jail*

Parent Total

Father Mother

Drug use in month prior to arrest

Cocaine 45.3 63.8 47.7

Heroin 39.0 58.4 42.2

Amphetamines 24.5 27.6 24.8

T & B 18.5 15.8 18.3

Methadone 1.4 19.8 12.7

Phencyclidine 11.3 15.3 11.7

Lysergic acid diethyl- 5.3 3.5 5.1

amide

Any 84.9 72.9 83.7

In treatment prior to arrest

Alcohol 68.1 64.4 67.9

Drug 22.3 20.0 21.9

Psychiatric 0.7 0.4 0.6

Any 95.1 94.6 9.5

Sentenced to treatment

Alcohol 2.6 1.4 2.5

Drug 2.0 4.4 2.2

Psychiatric 0.7 0.4 0.6

Sex Offender 0.4 0.0 0.3

Any treatment 4.9 5.4 5.0

*Values represent percentages.

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actually sentenced to alcohol (2.5%), drug (2.2%), or psychiatric treatment (0.6%).

DISCUSSION

These findings indicate that a substantial number

of children have a parent who has recently been

ar-rested andis in jail. The majority of the jailed parents

are unmarried, are poor, have low educational

achievement, and have a long history of substance

abuse. Their children are already at substantial risk

of adverse health, academic, and social outcomes

given the background of their parents. While the

ma-jority reported having sought prior treatment for

their substance abuse, the problem went largely

un-addressed by the criminal justice system.

The criminal activity of these parents does not

ap-pear to be a one-time problem. The majority of

par-ents who have been in jail have been incarcerated

before; one in eight have more than 10 prior arrests.

Crime usually peaks between the ages of 15 and 20; the fact that three fourths of parents in this study

were 25 and older indicates that the majority are

“career criminals.”20 Individuals who are career

criminals with multiple offenses tend to be violent

with their cohabitees, unemployed, and substance

abusers.2#{176}The children of such parents are thus

likely to be exposed to domestic violence, poverty,

and substance abuse.

What are the implications for child health

provid-ers and child advocates? First, the frequency of the

problem indicates it should be included as part of a

more general, psychosocial screening of high-risk

families. Since jail inmates represent only 36.5% of

the incarcerated population, the number of children with incarcerated parents may be nearly threefold

greater than our estimate or I in 50 children younger

than the age of 15. This would make it one of the

more common psychosocial and health problems

fac-ing children. In certain populations it will be even

greater. While individuals in jail tend to be younger

(33% <24 years) and more likely to be female (10%)

than those in prison (27% and 6% respectively),

prison inmates are more likely to be career criminals

and have committed more serious crimes. Second,

the presence of a parent in jail should alert the

pro-vider to the possibility of several risk factors in the

child’s environment, particularly substance abuse

and domestic violence. There are potential medical

consequences to the child as well, including exposure

to tuberculosis, hepatitis, human immunodeficiency virus, or other infections acquired by the parent

while incarcerated. The frequency of the arrests and

the likelihood of persistence indicates that this is not likely to be a single event in the life of the child, but

rather an ongoing factor in the child’s life and

envi-ronment.

The impact on the child is not only short-term. One

of the strongest risk factors for juvenile delinquency

is a parental history of criminality. In a longitudinal

study in St Louis, arrested parents tended to have

arrested children, and the juvenile records of the

par-ents and children were similar.21 Fathngton7 in a

study of working class boys in London, found four

factors to be important independent predictors of

criminality: poverty family criminality, poor

parent-ing, and school failure. Family criminality was an

important predictor of criminal behavior and social

failure in males up to the age of 32 years.

Given the implications for the child, how can we

intervene to minimize the negative impact? The

iden-tification of parental substance abuse and the

provi-sion of effective treatment programs should be a high

priority. Substance abuse increases the risk of

vio-lence, including spouse abuse and child abuse?- It

appears to be also associated with chronic

offend-ing.2#{176}Efforts to improve parenting skills might suc-ceed in lowering the risk of child abuse and

subse-quent criminal activity by the children.24 These

might be accompanied by programs to improve

in-terpersonal cognitive problem-solving skills among

children together with modeling of norms and

re-wards for normal interaction.25 Early entrance into

programs such as Head Start may lead to an increase

in school success and minimize the risk of school

failure; such programs have been associated with a

lower risk of delinquency during adolescence.26’7

Provision of tuberculosis screening and hepatitis

vac-cine can minimize their risks of these diseases. Unfortunately, parental imprisonment is not rare,

is often chronic, and may be associated with other

psychosocial and health problems in the family.

Pe-diatric health care providers may wish to include

questions about parental imprisonment as part of a

comprehensive biopsychosocial assessment,

refer-ring parents and children to effective intervention

programs for substance abuse, parenting education,

school readiness, and communication skills/conflict resolution.

ACKNOWLEDGMENTS

This work was funded by grant R49/CCR002570 from the

Cen-ters for Disease Control.

Thanks to Robert Soderberg for computer programming and to Tom Koepsell, MD, MPH, for advice on analysis.

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ABSTRACT

Henry FJ, Briend A, Fauveau V, Huttly 5, Yunus M, Chakraborty

J.

The Risk

Approach to Intervention in Severe Malnutrition in Rural Bangladesh. Am

J

Epidemiol. 1992;136:460-463.

In this study from the International Center for Diarrheal Disease Research, the

authors: a) identify in rank order consumption of formula, the number of siblings

in the household less than 5 years of age, maternal education, and maternal

preg-nancy as specific risk factors for marasmus in children 6 to 59 months age; and b)

conclude that targeting intervention at households in which these risk factors are

present would not be an efficient strategy for combating marasmus in Bangladesh.

Complete information on 37 demographic, socioeconomic, morbidity, dietary, and

environmental factors was obtained on 142 marasmus and case-control pairs in

Matlab, Bangladesh. Marasmus cases were defined by a mid-upper arm circum-ference of less than 110 mm. Controls were identified by matching sex and age with

mid-upper arm circumference of greater than 120 mm. Stepwise conditional logistic

regression to estimate odds ratios and 95 percent confidence intervals, and

likeli-hood ratio testing to determine significance levels were used to identify the

asso-ciated risk factors noted above. The sensitivity and specificity of specific variables

for prediction of marasmus were 56% and 63% for the number of siblings, 76% and

35% for absence of maternal education, and 17% and 98% for formula consumption.

The importance of these findings is to shed light on the utility of the risk

approach as a strategy for resource allocation to combat marasmus in Bangladesh.

Given the sensitivity and specificity analyses, children at high risk of marasmus could not be identified efficiently using the 4 associated risk factors.

Submitted by the AAP Committee on International Child Health

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1993;92;261

Pediatrics

Kathi J. Kemper and Frederick P. Rivara

Parents in Jail

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Pediatrics

Kathi J. Kemper and Frederick P. Rivara

Parents in Jail

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