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

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 County, 1922-1997

James Thomas, PhD

University of North Carolina


Social forces post depression
Social Forces: Post Depression County, 1922-1997

James Thomas, PhD

University of North Carolina


Get big or get out
“Get big or get out” County, 1922-1997

James Thomas, PhD

University of North Carolina


Unbalanced effects
Unbalanced effects County, 1922-1997

James Thomas, PhD

University of North Carolina


Klan march wilson county 1993
Klan march, Wilson County,1993 County, 1922-1997

James Thomas, PhD

University of North Carolina


Creation of the rural ghetto
Creation of the rural ghetto County, 1922-1997

James Thomas, PhD

University of North Carolina


Black white income dualism
Black-white income dualism County, 1922-1997

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” County, 1922-1997

James Thomas, PhD

University of North Carolina


Loss of social capital
Loss of social capital County, 1922-1997

James Thomas, PhD

University of North Carolina


I 95 and syphilis 1989
I-95 and syphilis, 1989 County, 1922-1997

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, County, 1922-1997 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 County, 1922-1997

James Thomas, PhD

University of North Carolina


Rates of incarceration and gonorrhea for north carolina counties 1999
Rates of Incarceration and Gonorrhea County, 1922-1997for North Carolina Counties, 1999

James Thomas, PhD

University of North Carolina


Incarceration and health outcomes
Incarceration and health outcomes County, 1922-1997

James Thomas, PhD

University of North Carolina

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


Incarceration and health outcomes County, 1922-1997

James Thomas, PhD

University of North Carolina


Incarceration and health outcomes County, 1922-1997

James Thomas, PhD

University of North Carolina


Incarceration and health outcomes County, 1922-1997

James Thomas, PhD

University of North Carolina


Incarceration and health outcomes County, 1922-1997

James Thomas, PhD

University of North Carolina


Census tract level associations
Census-tract-level associations County, 1922-1997

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 County, 1922-1997

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 County, 1922-1997 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 County, 1922-1997

Incarceration

Illicit Drug Use

STDs

James Thomas, PhD

University of North Carolina


Direct effects of incarceration
Direct effects of incarceration County, 1922-1997

__

D

D

a

E

b

__

E

c

d

James Thomas, PhD

University of North Carolina


Sexual behavior
Sexual behavior County, 1922-1997

  • 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 County, 1922-1997

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 County, 1922-1997

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 County, 1922-1997

__

D

D

E

a

b

__

c

E

d

James Thomas, PhD

University of North Carolina


Indirect effects of incarceration1
Indirect effects of incarceration County, 1922-1997

  • Absence from relationships

  • Sex ratio

  • Social control, collective efficacy

James Thomas, PhD

University of North Carolina


Uneven rates of incarceration
Uneven rates of incarceration County, 1922-1997

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 County, 1922-1997

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 County, 1922-1997

James Thomas, PhD

University of North Carolina

Wenink E, Thomas JC (under review)


Indirect effects of incarceration2
Indirect effects of incarceration County, 1922-1997

  • Absence from relationships

  • Sex ratio

  • Social control, collective efficacy

James Thomas, PhD

University of North Carolina


Scarcity of black males

U.S. Whites County, 1922-1997

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 County, 1922-1997

  • Absence from relationships

  • Sex ratio

  • Social control, collective efficacy

James Thomas, PhD

University of North Carolina


Social control
Social control County, 1922-1997

James Thomas, PhD

University of North Carolina

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


Homicides and social control
Homicides and social control County, 1922-1997

James Thomas, PhD

University of North Carolina

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


Social control and stds
Social control and STDs County, 1922-1997

James Thomas, PhD; University of North Carolina

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


Homicide and stds
Homicide and STDs County, 1922-1997

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 County, 1922-1997

James Thomas, PhD

University of North Carolina

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


Where next
Where next? County, 1922-1997

  • Ethnography

  • Multi-level quantitative analysis

  • Agency interactions

James Thomas, PhD

University of North Carolina


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