Northwestern receives $20 million to study the health consequences of incarceration

• Link to: Northwestern Now Story

EVANSTON, Ill. --- Northwestern University has been awarded $20 million over five years from the National Institutes of Health to study how incarceration affects health, age-related conditions and risk factors for Alzheimer’s disease and related dementias (ADRD).

Black and Hispanic adults disproportionately suffer from disparities in socioeconomic status and chronic age-related health conditions, such as hypertension and diabetes. These same variables predict risk for ADRD. Mass incarceration also disproportionately affects Black and Hispanic people. The study is investigating a seemingly simple question: How does incarceration affect health, age-related conditions and risk factors for ADRD? 

A unique approach
Led by Feinberg School of Medicine’s Linda Teplin, principal investigator of the Northwestern Juvenile Project (NJP), the study is the first of its kind.   

Although incarceration is a known predictor of poor health, prior studies examined incarceration only as a “yes/no” variable, equating one-night jail stays for drunk driving with 30-year prison sentences.

“Like any other risk factor for health, incarceration must be investigated as a dose, including frequency and duration of stay, type of facility, age(s) and recency,” Teplin said. “For example, where someone is incarcerated matters. Jails, designed for short-term stays, have different health services available than prisons, which house only people convicted of a felony and serving sentences longer than one year.”

A critical public health challenge
Treating Alzheimer’s is extremely costly and adds to the already significant financial and mental health burden of individuals who already experience health inequities.

Building upon the data collected in the longitudinal study, the Northwestern Juvenile Project, the researchers will examine the age-related health conditions of a large and diverse 1,829-member cohort. Data collection began in the 1990s, when the participants were at a median age of 15. Originally designed to track the health and outcomes of juvenile justice youth, the Northwestern Juvenile Project provides extensive data collected from nearly 18,000 interviews with individuals who were interviewed up to 18 times. Most important, they have already collected extensive data on the “dose” of incarceration: the frequency and duration of stay, type of facility, age(s) and recency of incarceration.

“The research led by Linda Teplin and her colleagues at Feinberg is a stellar example of the University prioritizing work that seeks to find solutions to improve society,” said Northwestern President Michael Schill. “This $20 million grant to the Northwestern Juvenile Project will explore potential impacts of incarceration on health outcomes and, hopefully, help prevent disease.”

Gathering midlife data
The study participants, now median age of 43, will be interviewed and tested for physical and mental health and psychological well-being including cognitive assessments and blood tests to check for biomarkers that indicate a risk for age-related conditions.

Unlike prior studies, the researchers will use a dose-response model framework to examine how incarceration affects health and risk factors for Alzheimer’s.

“To predict risk of ADRD, we need to study people before they develop the disease. Mass incarceration, which disproportionately affects Black and Hispanic people, may play a key role in health inequities in overall health, age-related conditions and the development of ADRD,” Teplin said. “Only by identifying risk factors contributing to these disparities can we address them.”

The Northwestern Juvenile Project research on age-related conditions kicked off Aug.15.