Assessing Geriatric conditions as novel risk factors for dropout among those seeking treatment for Substance Use Disorders (SUDs) in mid-to-late life: The role of incarceration history
Lisa Barry, PhD, MPH
The U.S. prison population is rapidly aging with growing numbers of persons in mid-to-late-life annually being released from jail and prison (i.e., reentry). Many of these individuals will have a history or new onset of substance use disorders (SUDs) requiring treatment. Yet, SUD treatment dropout rates are high and associated with negative outcomes that pose enormous costs to individuals, families, and society. Thus, there is immediate need to reduce SUD treatment dropout in this rapidly growing population. A precision-gerontology approach, which strives to improve health outcomes by targeting factors largely specific to older persons but that still show considerable heterogeneity, offers a novel means of distinguishing who may be at greater risk of SUD treatment dropout. We will apply a precision-gerontology approach to Identify geriatric conditions (mobility disability, strength deficits, frailty) in persons seeking SUD treatment after mid-to-late life reentry as a novel means of distinguishing who may be at greater risk of SUD treatment dropout. We will also meet with stakeholders (e.g., SUD clinic directors) to identify attitudes towards, facilitators of, and barriers to integrating a precision-gerontology approach to SUD treatment as a means of optimizing services outcomes.
The Health Effects of Exposure to the Criminal Legal System Among Non-Incarcerated Older Adults
Louisa Holaday, MD
The broad reach of mass incarceration means that even people not currently incarcerated may feel its effects, including through a personal history of incarceration or an incarcerated family member. These spillover effects of mass incarceration deserve particular study in older adults, who may take on child care responsibilities for their incarcerated children, or depend on family members for financial stability. This study will use a large, nationally representative dataset to examine how exposure to the criminal legal system - including through a personal or family history of incarceration - is associated with wellbeing among older adults, using a validated tool associated with life expectancy.
How Did COVID-19 Change Racial and Ethnic Inequities in Mortality? The Case of Currently and Formerly Incarcerated Populations
Monik Jiménez, Sc.D
Compared to the general population, the incarcerated are at a higher risk of COVID-19 mortality and total mortality compared to the general population. However, examining COVID-19 mortality alone underestimates the true extent of pandemic-related mortality among populations exposed to incarceration, particularly among middle-aged and older adults with the highest prevalence of chronic conditions. In addition, little is known about how the pandemic has shaped inequities in mortality among incarcerated people by intersectional identities of age and race and ethnicity. This innovative project will address these gaps by estimating pandemic-related mortality by incarceration status, age, race, ethnicity, and structural factors (carceral and racism), using innovative epidemiologic surveillance methods. Importantly, the project is grounded within a Public Health Critical Race Praxis framework to guide the conceptualization and interpretation of intersectional age and racialized data.