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Study Finds Incarceration of Loved Ones Correlates to Early Vascular Aging in African American Women
By Rama Esrawee
African Americans have been subjected to racialized mass incarceration from the post-slavery era to modern-day police brutality. The impact of this phenomenon goes far beyond simply throwing someone behind bars: it can have severe effects on familial structure and personal health.
Incarceration disproportionately impacts African American men compared to other groups, yet little research has investigated the impact of the carceral system on African American women, who often assume those men’s familial responsibilities. A new study investigates the possibility that the impact may not only be a matter of familial roles or stress but can also produce measurable physiological results.
Nicole Fields, PhD, an epidemiologist and assistant professor at Northwestern University, and colleagues investigated early vascular aging among African American women with incarcerated loved ones in the Journal of Epidemiology and Community Health. While their study found that nearly half of African American women aged 30 to 46 in Atlanta had an incarcerated loved one, this finding reflects a broader national trend, where roughly half of the African American women in the U.S. have a loved one who has been jailed. The study reveals that the incarceration of loved ones is associated with elevated blood pressure and arterial stiffness, suggesting a connection to increased early vascular aging based on the physiological effects of chronic stress related to incarceration.
“Nearly half of black women said that they knew someone that was incarcerated. It’s not just an isolated event,” says Fields. “It affects a lot of families. Black women experience what we call double jeopardy; they don’t just experience racism, but they experience sexism too. They’re at this intersection of those marginalizations. A lot of these social constructs, a lot of these social exposures, tend to impact black women’s health in a negative way, unfortunately.”
Fields experiences this double jeopardy herself as a black woman with an incarcerated loved one; her lived experiences inspired her desire to explore the broader impact of incarceration on African American health.
Fields and her team brought her vision to life by recruiting 403 African American women from the Atlanta Metropolitan Area through residential lists and voter registration records. Fields surveyed these women and assessed indicators of vascular health like blood pressure, stiffness in the arteries, and pulse strength.
Participants were asked whether they had a relative or friend in prison within the last five years. Those who answered “yes” were then prompted to describe their relationship with the incarcerated individual. The participants were also asked about whether they found the incarceration distressing or not, which was categorized as either “not upsetting” or “upsetting”. Fields also questioned external factors that may influence the impact of incarceration such as the education and income of the participants.
The researchers compared these external factors between women who had a loved one incarcerated and those who did not. This analysis included a statistical test to assess whether incarceration status is associated with other conditions. The study also used another test to compare blood pressure readings between African American women with and without incarcerated loved ones.
The survey revealed that 45 percent of the African American women in the sample had a family member or friend incarcerated within the past five years. Women with a loved one in prison were less likely to have a college degree as high school graduates were 13.4 percent more likely to have someone incarcerated. They were also less likely to earn an income of $75,000 or more, as participants earning below this amount were 12.6 percent more likely to have an incarcerated loved one.
The investigation revealed that all participants with incarcerated loved ones had higher blood pressure, measuring 3.3 mm Hg higher than those without. The researchers also identified a correlation between incarceration and signs of early vascular aging with a 2.29 percent increase in the stiffness in the arteries of women with an incarcerated loved one. Even among women with high levels of education and income who had an incarcerated loved one, high blood pressure and arterial stiffness persisted, suggesting that the stress and impact of incarceration can influence cardiovascular health regardless of socioeconomic status.
These effects expand beyond a physiological impact. The study also found that these women had depressive symptoms and chronic stress burdens, putting African American women at a greater risk for mental health problems. Depression scores were about 67 percent higher for all participants with an incarcerated loved one compared to those without. Chronic stress burden scores were also 8 percent higher for these women than women without an incarcerated loved one.
“I think the study highlights something important by showing how this stress is linked to measurable cardiovascular effects,” says Kylie Smith, PhD, the director of the Center for Healthcare History and Policy at Emory University. “It’s frustrating, though, that we need scientific proof for something that seems so obvious—that the incarceration of loved ones is stressful and damaging to health.”
These results suggest a correlation between the stress of having an incarcerated loved one and long-term cardiovascular risks. The combination of elevated blood pressure, increased arterial stiffness, and higher stress burden emphasizes the need for targeted interventions to support the health of these women.
“This is an opportunity where we can actually have an impact on the upstream factors and improve these indices of vascular aging before they develop into overt disease,” says Zac Martin, PhD, a postdoctoral fellow in epidemiology and integrative physiologist at Emory University who collaborated on this research.
Fields urges health policymakers to expand access to preventative care and mental health services specifically for African American women with incarcerated loved ones. Her findings indicate that these women experience increased early vascular aging and depressive symptoms, suggesting they are currently overlooked in the American healthcare and justice systems. They should be classified as an “at-risk population” and prioritized for health services, including screenings to monitor signs of early vascular aging for timely intervention. Being considered “at-risk” would prompt policymakers to create initiatives that allocate funding to reduce the risk of early vascular aging in this group, improving their access to preventative care.
The results of this research are further evidence of how systemic issues, such as racial disparities in the criminal justice system, can lead to substantial health consequences. These findings reveal the broader impact of a racialized U.S. criminal justice system, calling for policy changes that address the indirect health consequences of the carceral system on African American families. Fields hopes to further her research by exploring how these stressors affect the long-term well-being of African American women with incarcerated loved ones in a longitudinal study.