Same Behaviors, Different Access: How Paternal Incarceration Shapes Adolescents’ Health Care Utilization and Health Behaviors

• In Event: Health Criminology Panel: Social-Ecological Consequences of Criminal Legal System Involvement for Health

Abstract

Parental incarceration is a childhood risk factor associated with a multitude of poor outcomes, including worse health. This study examines how paternal incarceration shapes adolescents’ health care utilization and health behaviors. In this study I employ multiple methodological approaches, including a lesser-used method of adjusting for unobserved heterogeneity that exploits plausibly exogenous variation in the timing of paternal incarceration. In this approach youth who have experienced paternal incarceration are compared to youth who will experience paternal incarceration after the outcomes are measured. Paternal incarceration is associated with a higher probability of having no insurance, forgoing needed medical care, and receiving psychological counseling after reducing unobserved heterogeneity. Initial increases in risky health behavior (alcohol and tobacco use) are not significant when better adjusting for unobserved heterogeneity. Paternal incarceration has profound implications for health care use during the transition to adulthood, but not necessarily for health behaviors, indicating that paternal incarceration should be considered a distinctive risk factor that contributes to health inequity in the United States and the family-level consequences for healthcare access and utilization play a key role in this effect.

Author

• Erin Josephine McCauley, University of California, San Francisco