The community health effects of incarceration
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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)

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The community health effects of incarceration

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The community health effects of incarceration

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

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

South African diamond mines

James Thomas, PhD

University of North Carolina


Reported syphilis in north carolina and wilson aka step county 1922 1997

Reported syphilis in North Carolina and Wilson (aka Step) County, 1922-1997

James Thomas, PhD

University of North Carolina


Std rates in the us 2000

STD Rates in the US, 2000

James Thomas, PhD

University of North Carolina


Social forces post depression

Social Forces: Post Depression

James Thomas, PhD

University of North Carolina


Get big or get out

“Get big or get out”

James Thomas, PhD

University of North Carolina


Unbalanced effects

Unbalanced effects

James Thomas, PhD

University of North Carolina


Klan march wilson county 1993

Klan march, Wilson County,1993

James Thomas, PhD

University of North Carolina


Creation of the rural ghetto

Creation of the rural ghetto

James Thomas, PhD

University of North Carolina


Black white income dualism

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

“The Great Migration”

James Thomas, PhD

University of North Carolina


Loss of social capital

Loss of social capital

James Thomas, PhD

University of North Carolina


I 95 and syphilis 1989

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 Arrest Rates by County Type, North Carolina, 1985-94

Cook RL, Royce RA, Thomas JC, Hanusa BH. Am J Public Health 1999; 89:369-73

James Thomas, PhD

University of North Carolina

FIGURE 2

Cook et. al


The incarceration boom

The incarceration boom

James Thomas, PhD

University of North Carolina


Rates of incarceration and gonorrhea for north carolina counties 1999

Rates of Incarceration and Gonorrhea for North Carolina Counties, 1999

James Thomas, PhD

University of North Carolina


Incarceration and health outcomes

Incarceration and health outcomes

James Thomas, PhD

University of North Carolina

Thomas JC, Torrone E , Am J Public Health 2006;96:1762-5.


The community health effects of incarceration

Incarceration and health outcomes

James Thomas, PhD

University of North Carolina


The community health effects of incarceration

Incarceration and health outcomes

James Thomas, PhD

University of North Carolina


The community health effects of incarceration

Incarceration and health outcomes

James Thomas, PhD

University of North Carolina


The community health effects of incarceration

Incarceration and health outcomes

James Thomas, PhD

University of North Carolina


Census tract level associations

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 associations1

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

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

Dual outcomes of another cause

Incarceration

Illicit Drug Use

STDs

James Thomas, PhD

University of North Carolina


Direct effects of incarceration

Direct effects of incarceration

__

D

D

a

E

b

__

E

c

d

James Thomas, PhD

University of North Carolina


Sexual behavior

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

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

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

Indirect effects of incarceration

__

D

D

E

a

b

__

c

E

d

James Thomas, PhD

University of North Carolina


Indirect effects of incarceration1

Indirect effects of incarceration

  • Absence from relationships

  • Sex ratio

  • Social control, collective efficacy

James Thomas, PhD

University of North Carolina


Uneven rates of incarceration

Uneven rates of incarceration

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

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

Intergenerational effects

James Thomas, PhD

University of North Carolina

Wenink E, Thomas JC (under review)


Indirect effects of incarceration2

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

U.S. Blacks

NC Blacks

aged 15-44 years

Wilson County

Blacks, 15-44 years

Scarcity of black males

0.95

0.88

0.90

0.80

0.5

1.0

Equity

James Thomas, PhD

University of North Carolina

Thomas JC, Thomas K. Soc Sci & Med 1999;49:1075-84.


Indirect effects of incarceration3

Indirect effects of incarceration

  • Absence from relationships

  • Sex ratio

  • Social control, collective efficacy

James Thomas, PhD

University of North Carolina


Social control

Social control

James Thomas, PhD

University of North Carolina

Thomas JC, Torrone E, Browning C (under review)


Homicides and social control

Homicides and social control

James Thomas, PhD

University of North Carolina

Thomas JC, Torrone E, Browning C (under review)


Social control and stds

Social control and STDs

James Thomas, PhD; University of North Carolina

Thomas JC, Torrone E, Browning C (under review)


Homicide and stds

Homicide and STDs

James Thomas, PhD; University of North Carolina

Thomas JC, Torrone E, Browning C (under review)


Neighborhood characteristics and stds in chicago

Neighborhood characteristics and STDs in Chicago

James Thomas, PhD

University of North Carolina

Thomas JC, Torrone E, Browning C (under review)


Where next

Where next?

  • Ethnography

  • Multi-level quantitative analysis

  • Agency interactions

James Thomas, PhD

University of North Carolina


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