Physical and Mental Health Concerns for Young Women with Arrest Histories: Results from the National Survey on Drug Use and Health

Background and Purpose: Criminal justice epidemiology focuses on the intersections of public health and criminal justice. One particular public health concern is the significantly higher rates of physical and mental health needs of women, versus men, in jail. However many of these studies have been conducted regionally, with little attention to variation due to age. Given recent attention to ‘transitional youth’ and that 20% of women in jail are 25 or younger, it is important to determine if they differ from their non-criminally involved counterparts. Younger women entering the adult criminal justice system offer an important opportunity for prevention and intervention efforts that improve health and decrease recidivism. As such, this study has two research questions: (1) For women ages 18-25, what physical health factors are associated with a history of arrest?; (2) What mental health factors are associated with a history of arrest?

Methods: Secondary data analysis was conducted with the 2011 National Survey on Drug Use and Health. This annual survey utilizes multistage area probability sampling to obtain a representative sample of households in the U.S.  The subpopulation of 18-25 year old women in this sample was 9899 women. History of arrest, the independent variable, was dichotomously coded and race, income, and education were control variables. Dependent variables included the presence or absence of specific physical (asthma, diabetes, hepatitis, high blood pressure and sexually transmitted disease) and mental health (anxiety, depression, serious mental illness, substance use, co-occurring disorder, suicide ideation, and suicide attempt) factors.  All health indicators were measured for occurring during the past year. STATA (version 12) subpopulation functions for complex surveys, binary logistic regression models and adjusted Wald tests were performed for each health outcome. 

Results: Approximately 12% of women had an arrest history and were significantly more likely to have a lower income and education level than women without arrest. Compared to women without, women with an arrest had a higher risk of hepatitis [OR=5.99, 95% CI (1.68, 21.35), p=.007] and sexually transmitted diseases [OR=2.29, 95% CI (1.60, 3.27), p<.001). Furthermore, women with arrest histories had a significantly higher risk for all mental health conditions: most strikingly, serious mental illness [OR=2.12, 95% CI (1.68, 2.68), p<.001], co-occurring disorders [OR=3.43, 95% CI (2.63, 4.25), p<.001], and suicide attempt [OR=2.57, 95% CI (1.58, 4.18), p<.001). 

Conclusions and Implications: Although it cannot be determined if the health issues occurred before or after the arrest, young women with an arrest history display a greater risk for public health concerns, including hepatitis, STDs, anxiety, depression, and serious mental illness. Similarly, the high rate of suicide attempts in the past year for women with arrest histories is a pressing public health concern especially given that suicide is the primary cause of death for jail inmates. Thus, social work involvement is needed that focuses on interventions that prevent arrest and re-arrest, promote healthy re-entry and improve physical and mental health for young women.  Future research can inform such efforts and the expansion of criminal justice epidemiology with social work.