Substance Use Among Rural Youth with Incarcerated Parents: Evidence from a State-Wide Sample of Adolescents

Background and Purpose

On any given day, more than two million people are incarcerated in U.S. prisons and jails, over half of whom are parents. Owing largely to systemic factors, incarceration rates are highest in rural communities, making youth in rural regions disproportionately more likely to experience parental incarceration (PI). Despite substance use being a pressing public health issue - and key driver of incarceration - in rural communities, limited research has examined PI as a social determinant of health which may heighten risk for rural adolescents’ substance use. The current study asks two main questions: first, how is PI associated with past-year substance use among rural adolescents and, second, how does co-residence with incarcerated parents present differential risk for substance use among rural youth who experience PI.

Methods

Data come from the 2019 Minnesota Student Survey, an anonymous and voluntary survey of 8th-, 9th-, and 11th-grade public school students. The analytic sample includes 18,820 adolescents who resided in rural Minnesota (M age = 14.9 years; 50.5% female; 82.3% White). Youth self-reported experiences of PI (current, former, never), whether they lived with the parent at the time they went to jail or prison, and past-year alcohol, marijuana, cocaine, heroin, and methamphetamine use (1 = yes; 0 = no). Descriptive statistics and adjusted logistic regression models assessed odds of substance use dependent upon parental incarceration exposure.

Results

Over 22% of rural adolescents (n = 4,222) experienced PI (19.8% former, 2.7% current), over half of whom (52.88%) lived with their parents at the time they went to jail or prison. Youth with currently incarcerated parents reported significantly greater past-year alcohol (43.7%), marijuana (35.7%), cocaine (5.0%), heroin (4.6%), and methamphetamine (5.5%) use than peers who never experienced PI (23.5%, 7.5%, 0.7%, 0.3%, 0.5%, respectively; p < 0.001). In adjusted logistic regression models that control for sociodemographics and exposure to household substance use, current PI was associated with greater past-year alcohol (aOR = 2.25), marijuana (aOR = 3.97), cocaine (aOR = 3.63), heroin (aOR = 4.94), and methamphetamine (aOR = 5.40) use compared to peers who never experienced PI (p < 0.001). These trends hold when comparing youth with formerly incarcerated parents to those who never experienced PI, with odds ratios ranging from 2.07 to 3.87 across all outcomes (p < 0.01). Associations between incarcerated parent/child co-residence and substance use were largely non-significant in this sample of rural adolescents.

Conclusions and Implications

Given demonstrated health inequities for rural youth and evidence of PI’s additive risk for substance use, the findings cast concern over the well-being of rural youth disproportionately exposed to PI. The elevated risk for substance use and its adverse sequelae call for expanded prevention and intervention social work strategies that support the health of rural youth and families alongside targeted decarceration efforts in rural communities that reduce the number of families put in the compromising situation of PI.