Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose In this NIDA-funded study, 100 women with recent histories of substance abuse and criminal justice supervision were interviewed. The purpose of the study was to examine health conditions of these mothers and their families. This is a growing population with complex service needs. From 1986-2000, arrests of women for felony drug charges grew by 98%. The majority are mothers on probation or parole (Kubiak, Siefert, & Boyd, 2004).

Methods A structured, 1 ½ -hour interview was completed with 100 women. All lived with at least one child between the ages of 2-12, were age 18+, spoke English, and had criminal justice and substance abuse involvement. Subjects were referred by a statewide nonprofit agency providing case management and service referral under contract to Illinois courts. Data gathered included self- reports of health of household members, demographics, employment, income, and criminal justice system involvement. Level of substance abuse was measured by the Addiction Severity Index (McLellan, 1985).

Results Sixty-eight mothers reported that they or other family members suffered from health conditions. Thirty-seven reported co-occurring health conditions; twenty-nine reported residing with at least one minor with health conditions, and 34 reported residing with another adult with health conditions. The most frequently reported health conditions were asthma (n= 38), high blood pressure (n = 18), diabetes (n = 17), and depression (n = 10). Twenty-three women reported giving birth to premature children. Mean age was 35.7. Most were African-American, single, with an average 11.2 years of schooling. Most reported 6+ arrests, most often for drug possession. Most identified heroin as their drug of choice. Eighty-seven were in substance abuse treatment. Median income was $5,000 - $9,999. Eighty were unemployed. Most received public assistance. Households had 2-13 members (mean = 4.7), with 1-7 minors (mean = 2.5). Forty-six mothers reported biological children not residing with them; twenty-six reported current involvement with child protective services, and five reported that their most recent arrest was on charges of child maltreatment.

Implications Most participants manage their own or a household member's chronic health condition that may affect their capacity to hold jobs, fulfill household responsibilities, and otherwise diminish their quality of life. Household members must depend upon each other for both instrumental and emotional support even though each's capacity may be limited by his or her own needs. The limited financial resources of these families suggest that available medical care may be confined to hard-to-access publicly funded services. Work with these families should include support and assistance in accessing appropriate health care services. Policies should be developed to reduce barriers to health care for all family members.