SSM - Mental Health 1 (2021) 100002

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SSM - Mental Health
journal homepage: www.journals.elsevier.com/ssm-mental-health

Family member incarceration and mental health: Results from a nationally
representative survey
Kristin Turney
University of California, Irvine, USA

A R T I C L E I N F O

A B S T R A C T

Keywords:
Criminal justice system
Incarceration
Inequality
Mental health
Population health

Research increasingly documents the repercussions of family member incarceration for health, but little is known
about the relative health consequences of different types of family member incarceration (including parent,
sibling, child, and romantic partner/co-parent incarceration) or demographic variation in the health consequences of family member incarceration. I used data from the Family History of Incarceration Survey (FamHIS), a
nationally representative cross-sectional survey of U.S. adults (N ¼ 2808), to estimate the association between
family member incarceration history and mental health, net of covariates. Adjusted logistic regression models
suggest three conclusions. First, immediate family member incarceration is positively associated with fair or poor
mental health. Second, parent and sibling incarceration—but not child or romantic partner/co-parent incarceration—is positively associated with fair or poor mental health, but the different types of family member incarceration are not statistically different from one another. Third, the association between family member
incarceration and fair or poor mental health is similar across race/ethnicity, gender, socioeconomic status, and
incarceration history. These findings highlight that any family member incarceration—and not necessarily the
type of family member incarceration—has repercussions for mental health, and that these associations are not
contingent on demographic characteristics. Given the concentration of family member incarceration among
people of color and the poor, this adverse experience may exacerbate population health inequalities.

1. Introduction
The rapid expansion of the U.S. criminal legal system over the past
half century means that a substantial number of individuals have experienced incarceration and its attendant health consequences (Alexander,
2020; Massoglia & Pridemore, 2015; Pettit & Western, 2004). However,
the currently and formerly incarcerated are not isolated individuals and
are instead connected to families as parents, romantic partners and
co-parents, siblings, and children (Wildeman et al., 2019). Recent
research documents that 45% of U.S. adults have ever experienced the
incarceration of an immediate family member including a parent,
romantic partner, sibling, or child (Enns et al., 2019). Family member
incarceration history is concentrated among vulnerable populations
including people of color, those with low socioeconomic status, and those
with their own incarceration history (Enns et al., 2019; Lee et al., 2015).
The stress process perspective, which highlights how the concentration of stressors among the most vulnerable can exacerbate population health disparities, suggests that incarceration is a stressor with
deleterious consequences for mental health (Patterson et al., 2021;
Pearlin, 1989; Pearlin et al., 1981). This perspective also highlights

how these deleterious mental health consequences can extend beyond
the individual directly experiencing the stressor (Pearlin et al., 1997;
Turney, 2014). That is, the stressor of incarceration proliferates to have
reverberating mental health consequences for those connected to the
incarcerated, via pathways such as destabilized family economic
wellbeing or impaired relationships between family members (Turney,
2014). An interdisciplinary body of research consistently documents
the negative consequences of parental incarceration for indicators of
children's and adolescents' mental health including depression, anxiety,
and substance use (Johnson & Easterling, 2012; Lee et al., 2013;
Murray et al., 2012; Poehlmann-Tynan & Turney, 2021; Roettger et al.,
2011; Turney, 2017; Turney & Goodsell, 2018; Wildeman, 2010;
Wildeman et al., 2018; Wildeman & Turney, 2014). A smaller body of
research documents the mental health consequences of romantic
partner and co-parent incarceration (Bruns & Lee, 2020; Wildeman
et al., 2012), sibling incarceration (Tadros et al., 2020), and child
incarceration (Goldman, 2019; Green et al., 2006; Sirois, 2020), or
considers family member incarceration broadly (Brown et al., 2016;
Fleming & Nurius, 2020; Gottlieb, 2016; Lee et al., 2014; Patterson
et al., 2021).

E-mail address: kristin.turney@uci.edu.
https://doi.org/10.1016/j.ssmmh.2021.100002
Received 16 February 2021; Received in revised form 11 May 2021; Accepted 13 May 2021
Available online 27 May 2021
2666-5603/© 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

K. Turney

SSM - Mental Health 1 (2021) 100002

scales such as the Kessler Psychological Distress Scale (Ahmad et al.,
2014; Mawani & Gilmour, 2010).

There are two opportunities to extend research on the relationship
between family member incarceration history and mental health. First,
though all types of family member incarceration history may be differentially associated with mental health, data limitations have precluded a
simultaneous examination of the relative consequences of different types
of family member incarceration, including parent, sibling, child, and
romantic partner/co-parent incarceration. The lack of research on the
repercussions of sibling incarceration, in particular, is a substantial
oversight given that this is the most common type of family member
incarceration (Enns et al., 2019). Second, despite good reason to expect
that family member incarceration is differentially consequential across
population subgroups, little research considers heterogeneity in the association between family member incarceration and mental health by
demographic characteristics (e.g., race/ethnicity, gender).
In this paper, I use data from the Family History of Incarceration Survey
(FamHIS), a recent nationally representative sample of all adults in the
United States, to estimate the association between family member incarceration history and mental health. First, I examine the association between any family member incarceration history and mental health,
adjusting for characteristics associated with family member incarceration
(Enns et al., 2019; Johnson & Easterling, 2012). Second, I provide the first
comprehensive accounting of how types of family member incarceration—including parent, sibling, child, and romantic partner/co-parent
incarceration—is independently associated with mental health. Third, I
estimate the association between family member incarceration and
mental health separately across population subgroups including race/ethnicity, gender, educational attainment, household income, and incarceration history. Taken together, considering both heterogeneity in the
type of family member incarceration and heterogeneity in the consequences of family member incarceration is important for understanding
the scope of incarceration's consequences for mental health.

2.2.2. Family member incarceration
The independent variables included several indicators of family
member incarceration. Respondents were asked the following: “Many
people have been held in jail or prison for a night or more at some point
in their lives. Please think about your immediate family, including parents; brothers; sisters; children; and your current spouse, current
romantic partner, or anyone else you have had a child with. Please
include step, foster, and adoptive family members. Confidentially and for
statistical purposes only, have any members of your immediate family,
not including yourself, ever been held in jail or prison for one night or
longer?” Respondents answering affirmatively to this question were
asked to identify their relationship(s) to the incarcerated individual(s).
The first measure, any family member incarceration, was a binary variable indicating the respondent reported family member incarceration
and identified the family member who had been incarcerated (Enns et al.,
2019). This conservative measure, by requiring respondents to identify
the family member who had been incarcerated, may underestimate the
frequency of family member incarceration. Additionally, four binary
variables indicated parent incarceration, sibling incarceration, child
incarceration, and romantic partner/co-parent incarceration. These were
not mutually exclusive, as respondents could report more than one type
of family member incarceration.
2.2.3. Covariates
The multivariate analyses adjusted for demographic characteristics
including race/ethnicity (white, Black, Hispanic, Native American, other
race), gender, age (18–29 years, 30–39 years, 40–49 years, 50–59 years,
60–69 years, 70 years and older), and marital status (married, cohabiting, widowed, divorced or separated, never married). They also adjusted
for socioeconomic characteristics including education (less than high
school, high school or GED, some college, college) and household income
($0 to $24,999, $25,000 to $49,999, $50,000 to $74,999, $75,000 to
$100,000, $100,000 or higher). A binary variable indicated the respondent was ever incarcerated.

2. Methods
2.1. Data source
I used data from the Family History of Incarceration Survey (FamHIS),
a nationally representative cross-sectional survey of adults in the United
States, to estimate the association between family member incarceration
and mental health. This survey, collected in 2018 via NORC at the University of Chicago, was designed to estimate the prevalence of family
member incarceration (Enns et al., 2019). The initial sample includes
4041 individuals, all of whom completed a screening questionnaire. Of
this initial sample, survey researchers enrolled 2815 individuals to
complete the full questionnaire (including 1806 with immediate family
member incarceration and 1009 without immediate family member
incarceration). Details of the sampling design have been described elsewhere (Enns et al., 2019).
The analytic sample comprised 2808 of the 2815 individuals who
completed the full questionnaire (with 7 excluded due to missing data on
the dependent variable). Missing data was uncommon, with <1%
missing data on family member incarceration and 1% missing data on
incarceration history. I imputed missing data, using the multivariate
normal method, producing 20 data sets and pooling results across data
sets (Allison, 2001). Results were robust to listwise deletion.

2.3. Statistical analyses
The analyses proceeded in three stages, all of which used logistic
regression models. Results that instead used partial proportional odds
regression models, estimating an ordinal outcome variable (1 ¼ poor to 5
¼ excellent), came to similar conclusions. Importantly, these observational data cannot be used to ascertain causal relationships between
family member incarceration and mental health, a point I return to
below.
In the first analytic stage, I used logistic regression to estimate fair or
poor mental health as a function of any family member incarceration. I
first estimated the unadjusted association to examine bivariate differences in mental health between those who do and do not experience
family member incarceration. I then adjusted for individual-level characteristics associated with both family member incarceration and mental
health. In the second analytic stage, I used logistic regression to estimate
the relationship between type of family member incarceration—including parent, sibling, child, and romantic partner/co-parent—and mental
health. I included all types of family member incarceration in the model,
again estimating both unadjusted and adjusted models. In the third analytic stage, I used logistic regression to examine the association between
family member incarceration and mental health across race/ethnic
(white, Black, and Hispanic), gender (female and male), education (less
than high school and high school or higher), income ($0 to $24,999 and
$25,000 or greater), and incarceration history (ever incarcerated and
never incarcerated) subgroups. I tested for statistically significant differences across groups (Paternoster et al., 1998). All analyses were
weighted to adjust for the complex sampling design. These weights,

2.2. Measures
2.2.1. Fair or poor mental health
The dependent variable, fair or poor mental health, was a binary
measure that captures the respondents’ response to the following question (1 ¼ fair or poor, 0 ¼ excellent, very good, or good): “In general, how
would you rate your mental health, including your mood and your ability
to think?” This measure of self-reported mental health, though not a
diagnostic indicator, is widely used in population-based surveys and is
associated with mental disorders and commonly used mental health
2

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SSM - Mental Health 1 (2021) 100002

created by NORC, ensure the results are representative of the U.S. population of adults (Enns et al., 2019).

Table 1
Frequencies of variables included in analyses.
%

2.4. Sample

Fair or poor mental health
Any immediate family member incarceration
Parent incarceration
Sibling incarceration
Child incarceration
Coparent incarceration
Race/ethnicity
White
Black
Hispanic
Native American
Other race
Female
Age
18 to 29
30 to 39
40 to 49
50 to 59
60 to 69
70 and older
Educational attainment
Less than high school
High school or GED
Some college
College
Income
$0 to $24,999
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 or higher
Marital status
Married
Cohabiting
Widowed
Divorced or separated
Never married
Ever incarcerated

Table 1 presents descriptive statistics of the analytic sample. About
one-seventh (13.6%) of respondents reported fair or poor mental health.
Nearly half (45.1%) of respondents reported family member incarceration history. Sibling incarceration was most common, reported by more
than one-fourth of respondents (27.7%), followed by parent incarceration (18.5%), romantic partner/co-parent incarceration (13.6%), and
child incarceration (12.2%).
The demographic characteristics were similar to demographic characteristics of U.S. adults (Enns et al., 2019). The majority of respondents
identified as white (62.8%), followed by Hispanic (16.2%), Black
(12.0%), other race (8.2%), and Native American (0.8%). Slightly more
than half of the sample was female (51.8%). The majority had a high
school diploma or higher (with 28.8% having a high school diploma or
GED, 27.8% having some college, and 32.8% having a college degree).
Nearly one-quarter (23.5%) reported a household income of less than
$25,000. Nearly one-fifth (18.9%) reported an incarceration history.
3. Results
3.1. Any family member incarceration
Table 2 presents estimates of the association between family member
incarceration history and mental health. Model 1, the unadjusted model,
shows that family member incarceration was positively associated with
fair or poor mental health (b ¼ 0.479, OR ¼ 1.61, p < .01). In Model 2,
which adjusted for characteristics associated with family member
incarceration and mental health, the association was reduced by about
one-third, but remained statistically significant. Family member incarceration was positively associated with mental health (b ¼ 0.327, OR ¼
1.39, p < .05).
The covariates were consistent with expectations from previous
research. Compared to white people, Hispanic people (b ¼ 0.479, OR ¼
0.62, p < .05) were less likely to report fair or poor mental health.
Compared to those ages 18 to 29, adults ages 70 and older (b ¼ 1.042,
OR ¼ 0.35, p < .01) were less likely to report fair or poor mental health.
Income was negatively associated with fair or poor mental health;
compared to those with household incomes of less than $25,000, those
with household incomes of $25,000 to $49,999 (b ¼ 0.703, OR ¼ 0.50,
p < .001), $50,000 to $74,999 (b ¼ 0.728, OR ¼ 0.48, p < .01), $75,000
to $100,000 (b ¼ 0.699, OR ¼ 0.50, p < .01), and $100,000 or higher
(b ¼ 0.888, OR ¼ 0.41, p < .01) were less likely to report fair or poor
mental health. An incarceration history was not independently associated with fair or poor mental health (b ¼ 0.313, OR ¼ 1.37, n.s.), though
auxiliary analyses that excluded family member incarceration showed a
positive association between incarceration history and fair or poor
mental health (b ¼ 0.389, OR ¼ 1.48, p < .05).

N

13.6%
45.1%
18.5%
27.7%
12.2%
13.6%
62.8%
12.0%
16.2%
0.8%
8.2%
51.8%
20.8%
17.8%
16.5%
17.1%
15.9%
12.0%
10.6%
28.8%
27.8%
32.8%
23.5%
26.4%
17.0%
13.3%
19.8%
46.9%
7.6%
5.4%
15.0%
25.0%
18.9%
2808

Notes: All analyses weighted to adjust for sampling design.

mental health. Tests for differences across coefficients shows that the
magnitude of these four incarceration coefficients were not statistically
different from one another. For example, the parent incarceration coefficient was similar in magnitude to the sibling incarceration coefficient
(p ¼ .226), child incarceration coefficient (p ¼ .817), and co-parent
incarceration coefficient (p ¼ .262).
I considered more fine-grained types of family member incarceration,
separating parent incarceration into father and mother incarceration,
sibling incarceration into brother and sister incarceration, child incarceration into son and daughter incarceration, and romantic partner/coparent incarceration into current partner and former partner incarceration (Appendix Table A). These results, adjusted for covariates, showed
that son's incarceration was positively associated with fair or poor mental
health (b ¼ 0.601, OR ¼ 1.82, p < .01) while daughter's incarceration was
negatively associated with fair or poor mental health (b ¼ 0.275, OR ¼
0.76, n.s.). These coefficients are statistically different from one another
(p ¼ .022). The coefficient for son's incarceration is also significantly
larger than the coefficient for mother's incarceration (p ¼ .030) and
brother's incarceration (p ¼ .014). Taken together, this suggests that
considering a broad measure of child incarceration obscures variation
based on the child's gender.

3.2. Specific types of family member incarceration
Table 3 presents estimates of the association between specific types of
family member incarceration history and fair or poor mental health.
Model 1, the unadjusted model, showed that parent incarceration (b ¼
0.618, OR ¼ 1.86, p < .001)—but not sibling incarceration (b ¼ 0.106,
OR ¼ 1.11, n.s.), child incarceration (b ¼ 0.175, OR ¼ 1.19, n.s.), or
romantic partner/co-parent incarceration (b ¼ 0.190, OR ¼ 1.21, n.s.)—
were positively associated with fair or poor mental health. In Model 2,
the adjusted model, parent incarceration (b ¼ 0.338, OR ¼ 1.40, p < .05)
and child incarceration (b ¼ 0.399, OR ¼ 1.49, p < .05) were positively
associated with fair or poor mental health. Sibling incarceration (b ¼
0.044, OR ¼ 1.04, n.s.) and co-parent incarceration (b ¼ 0.058, OR ¼
1.06, n.s.) were not statistically significantly associated with fair or poor

3.3. Heterogeneity in association between family member incarceration
and mental health
Table 4 presents estimates of the association between family member
incarceration history and fair or poor mental health across demographic
3

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SSM - Mental Health 1 (2021) 100002

Table 2
Logistic regression models estimating fair or poor mental health as a function of immediate family member incarceration.
Model 1

Model 2

unadjusted
b
Family member incarceration
0.479
Race/ethnicity (reference ¼ White)
Black
Hispanic
Native American
Other race
Female
Age (reference ¼ 18 to 29)
30 to 39
40 to 49
50 to 59
60 to 69
70 and older
Educational attainment (reference ¼ less than high school)
High school or GED
Some college
College
Income (reference ¼ $0 to $24,999)
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 or higher
Marital status (reference ¼ married)
Cohabiting
Widowed
Divorced or separated
Never married
Ever incarcerated
F test
Constant
N

adjusted
(S.E.)

OR

(0.145)

1.61

b
**

10.84
2.087
2808

***

(S.E.)

OR

0.327

(0.159)

1.39

0.217
0.479
0.026
0.353
0.047

(0.226)
(0.216)
(0.606)
(0.268)
(0.154)

0.80
0.62
0.97
1.42
0.95

0.008
0.094
0.434
0.349
1.042

(0.240)
(0.254)
(0.262)
(0.274)
(0.360)

0.99
1.10
0.65
0.71
0.35

0.143
0.189
0.107

(0.267)
(0.252)
(0.287)

0.87
1.21
0.90

0.703
0.728
0.699
0.888

(0.192)
(0.235)
(0.265)
(0.267)

0.50
0.48
0.50
0.41

0.375
0.572
0.258
0.381
0.313

(0.261)
(0.351)
(0.216)
(0.205)
(0.176)

1.45
1.77
1.29
1.46
1.37

4.28
1.463
2808

*

*

**

***
**
**
**

***

Notes: All analyses weighted to adjust for sampling design. *p < .05, **p < .01, ***p < .001.

significant, corroborating the findings that the relationship between
family member incarceration and mental health is consistent across demographic subgroups.
In additional supplemental analyses (Appendix Table B), I considered
heterogeneity in the association between the specific types of family
member incarceration (parent, sibling, child, and co-parent incarceration) and mental health. Similar to the findings for the relationship between any immediate family member incarceration and mental health,
these results show the relationships between specific types of family
member incarceration and mental health were similar across demographic subgroups.

subgroups. First, the positive association between family member
incarceration and fair or poor mental health was concentrated among
white people (b ¼ 0.427, OR ¼ 1.53, p < .05), but tests for equality of
coefficients across groups show this coefficient was not statistically
different than the coefficients for Black people (z ¼ 0.64) or Hispanic
people (z ¼ 1.29). Second, the positive association between family
member incarceration and fair or poor mental health was about twice as
large among women (b ¼ 0.426, OR ¼ 1.53, p < .05) than men (b ¼
0.212, OR ¼ 1.24, n.s.), but the differences across groups were not statistically significant (z ¼ 0.67). Third, the magnitude of the association
was larger among those with lower socioeconomic status. The association
was almost three times as large among those with less than a high school
education (b ¼ 0.872, OR ¼ 2.39, n.s.) compared to those with a high
school education or greater (b ¼ 0.335, OR ¼ 1.40, n.s.). Similarly, the
magnitude of the association was more than two times as large among
those with household incomes between $0 and $24,999 (b ¼ 0.469, OR
¼ 1.60, n.s.) compared to others (b ¼ 0.207, OR ¼ 1.23, n.s.). The differences across groups were not statistically significant (z ¼ 0.61 for
educational attainment, z ¼ 0.75 for household income). Finally, the
association was concentrated among those without a history of incarceration (b ¼ 0.378, OR ¼ 1.46, p < .05) compared to those with a history
of incarceration (b ¼ 0.017, OR ¼ 0.98, n.s.), though the differences
across groups were not statistically significant (z ¼ 0.96). Taken
together, these results suggest the relationship between family member
incarceration and mental health is similar across demographic
subgroups.
In supplemental analyses, I instead estimated the association between
family member incarceration and mental health for the entire sample,
including interaction terms between family member incarceration and
the various demographic groups (for example, family member incarceration * gender). None of the interaction terms were statistically

4. Discussion
Grounded in the stress process perspective, which highlights how
stressors can proliferate to impair the health of those connected to individuals exposed to the stressor, I examine the relationship between
family member incarceration history and mental health (Pearlin, 1989). I
use nationally representative data from the Family History of Incarceration Survey (FamHIS), a recent cross-sectional survey designed to understand the prevalence and correlates of family member incarceration
(Enns et al., 2019). The results extend our knowledge of this association
by considering heterogeneity in type of family member incarceration and
by considering heterogeneity in this association by demographic groups.
First, the results document a positive relationship between family
member incarceration history and fair or poor mental health. This is
consistent with expectations from the stress process perspective.
Stressors are concentrated among the most vulnerable, proliferate from
the individual exposed to the stressor to those vicariously exposed to the
stressor, and can have repercussions for mental health (Patterson et al.,
2021; Pearlin, 1989; Pearlin et al., 1981, 1997; Turney, 2014). Indeed,
4

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SSM - Mental Health 1 (2021) 100002

Table 3
Logistic regression models estimating fair or poor mental health as a function of immediate family member incarceration, heterogeneity by type of family member
incarceration.
Model 1

Model 2

unadjusted

Parent incarceration
Sibling incarceration
Child incarceration
Coparent incarceration
Race/ethnicity (reference ¼ White)
Black
Hispanic
Native American
Other race
Female
Age (reference ¼ 18 to 29)
30 to 39
40 to 49
50 to 59
60 to 69
70 and older
Educational attainment (reference ¼
High school or GED
Some college
College
Income (reference ¼ $0 to $24,999)
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 or higher
Marital status (reference ¼ married)
Cohabiting
Widowed
Divorced or separated
Never married
Ever incarcerated
F test
Constant
N

adjusted

b

(S.E.)

OR

b

0.618
0.106
0.175
0.190

(0.147)
(0.142)
(0.180)
(0.164)

1.86
1.11
1.19
1.21

***

(S.E.)

OR

0.338
0.044
0.399
0.058

(0.172)
(0.151)
(0.197)
(0.176)

1.40
1.04
1.49
1.06

0.252
0.493
0.060
0.411
0.034

(0.232)
(0.218)
(0.616)
(0.263)
(0.158)

0.78
0.61
0.94
1.51
0.97

0.044
0.145
0.344
0.333
1.036

(0.242)
(0.262)
(0.279)
(0.293)
(0.364)

1.04
1.16
0.71
0.72
0.35

0.194
0.127
0.178

(0.269)
(0.255)
(0.295)

0.82
1.14
0.84

0.678
0.666
0.677
0.862

(0.192)
(0.236)
(0.266)
(0.268)

0.51
0.51
0.51
0.42

0.377
0.568
0.242
0.431
0.261

(0.259)
(0.347)
(0.218)
(0.207)
(0.177)

1.46
1.76
1.27
1.54
1.30

*
*

*

**

less than high school)

6.17
3.703
2808

***

3.96
3.457
2808

***
**
*
**

*

***

Notes: All analyses weighted to adjust for sampling design. *p < .05, **p < .01, ***p < .001.

family member incarceration is a stressor that is unequally distributed
across the population (Enns et al., 2019; Lee et al., 2015). This stressor
reverberates across the entire family unit, destabilizing family economic
wellbeing and impairing relationships between family members, both of
which can impair mental health (Turney, 2014). The findings about the
positive relationship between family member incarceration and fair or
poor mental health are consistent with a growing body of literature
documenting the deleterious health consequences of family member
incarceration (Brown et al., 2016; Fleming & Nurius, 2020; Gottlieb,
2016; Patterson et al., 2021).
Second, the results show that the relationship between parent and
child incarceration and mental health is larger than the relationship
between other types of family member incarceration (including sibling
and romantic partner/co-parent incarceration) and mental health. The
positive association between parent incarceration and fair or poor mental
health is consistent with a growing interdisciplinary literature that documents deleterious consequences of parental incarceration from childhood through adulthood (Johnson & Easterling, 2012; Lee et al., 2013;
Murray et al., 2012; Poehlmann-Tynan & Turney, 2021; Roettger et al.,
2011; Turney, 2017; Turney & Goodsell, 2018; Wildeman, 2010;
Wildeman et al., 2018; Wildeman & Turney, 2014). The positive association between child incarceration and fair or poor mental health is also
consistent with a smaller body of research documenting this type of
intergenerational health consequences (Goldman, 2019; Green et al.,
2006; Sirois, 2020). These analyses extend this research by considering
the consequences of parent and child incarceration independent of other
types of family member incarceration, particularly important given the

Table 4
Logistic regression models estimating fair or poor mental health as a function of
immediate family member incarceration, heterogeneity by demographic groups.
b

(S.E.)

OR

Race/ethnicity
White (n ¼ 1760)
Black (n ¼ 397)
Hispanic (n ¼ 410)

0.427
0.054
0.728

(0.200)
(0.433)
(0.425)

1.53
0.95
2.07

*

Gender
Women (n ¼ 1468)
Men (n ¼ 1340)

0.426
0.212

(0.217)
(0.235)

1.53
1.24

*

Educational attainment
Less than high school (n ¼ 188)
High school or higher (n ¼ 2620)

0.872
0.335

(0.859)
(0.165)

2.39
1.40

Household income
$0 to $24,999 (n ¼ 658)
$25,000 or greater (n ¼ 2150)

0.469
0.207

(0.289)
(0.198)

1.60
1.23

Incarceration history
Ever incarcerated (n ¼ 642)
Never incarcerated (n ¼ 2166)

0.017
0.378

(0.370)
(0.177)

0.98
1.46

*

*

Notes: Each row represents a separate logistic regression model, with the coefficient, standard error, and odds ratio for family member incarceration shown.
Models include all control variables from Model 2 of Table 3. All analyses
weighted to adjust for sampling design.

5

K. Turney

SSM - Mental Health 1 (2021) 100002

is self-reported (Ahmad et al., 2014; Mawani & Gilmour, 2010). Future
research should collect data that includes clinical diagnoses of conditions
reported by psychiatrists. Second, details about the nature of family
member incarceration remain unresolved. The measure of family member incarceration captures periods of confinement that last days, weeks,
months, or years. It captures both jail and prison incarceration. It captures incarceration that occurred recently and incarceration that
occurred years ago. It captures one-time confinements and repeated
confinements. It captures incarceration of family members both residing
and not residing in respondents’ households. These details may have
differential consequences for mental health, and should be considered in
future research (Porter & DeMarco, 2019; Sugie & Turney, 2017; Turney,
2021; Yi et al., 2017). Third, the analyses use observational data, limiting
the ability to draw causal conclusions. The analyses adjust for an array of
control variables but additional variables such as neighborhood conditions and criminal activity remain unmeasured. Future research should
collect time-varying measures of family member incarceration and health
to facilitate a fixed effects approach that accounts for time-stable characteristics of individuals.

concentration of incarceration in families (Enns et al., 2019; Wildeman &
Wakefield, 2014). Parental incarceration may be an acute stressor, one
that removes a parent from the household, changes household relationships and dynamics, and impairs the economic functioning of households, all of which may impair mental health (Turney & Goodsell, 2018).
Child incarceration may also alter household relationships and dynamics
(Goldman, 2019). However, the coefficients of the different types of
family member incarceration are not statistically different from one
another, suggesting that any family member incarceration is consequential for mental health (Brown et al., 2016; Fleming & Nurius, 2020;
Gottlieb, 2016; Lee et al., 2014; Patterson et al., 2021).
The analyses show that other two types of immediate family member
incarceration considered—sibling and romantic partner/co-parent
incarceration—are not independently associated with mental health,
but caution should be used when interpreting these findings. For one, the
temporality of family member incarceration is not available in these data,
and it is likely that many of these incarceration experiences occurred
years prior to survey administration. It is possible, therefore, that these
types of family member incarceration have short-term mental health
consequences not captured in the data whereas parental incarceration or
child incarceration have lasting mental health consequences (Foster &
Hagan, 2013; Lee et al., 2013; Turney, 2021). Additionally, supplemental
analyses show that even the broad categories of family member incarceration used in these analyses obscure important variation. That is, son's
incarceration (but not daughter's incarceration) is independently positively associated with fair or poor mental health (and these coefficients
are statistically different from one another). Future research, ideally
qualitative research to understand the processes through which the
stressor of family member incarceration ripples through families, is
needed to further unpack these findings.
Third, the magnitude of the association between family member
incarceration and mental health is concentrated among white people,
women, those with low socioeconomic status, and those without an
incarceration history, but tests for equality of coefficients across subgroups show that none of these group differences are statistically significant. The concentration of negative associations among women is
consistent with scholarship highlighting how women, though incarcerated themselves less than men, nevertheless bear health challenges
stemming from the criminal legal system (Goldman, 2019; Lee &
Wildeman, 2013; Western, 2018). The concentration of negative associations among those without a high school diploma and those with
annual household incomes of less than $25,000, taken together with the
unequal distribution of incarceration among the economically disadvantaged, suggests that these groups will disproportionately experience
the population health consequences of family member incarceration
(Enns et al., 2019). These results should be interpreted cautiously, too, as
the small sample sizes across some subgroups (e.g., Black people, Hispanic people) may explain null findings and the lack of statistically significant differences across groups.

4.2. Conclusions
Incarceration has emerged as an important social determinant of
health (Massoglia & Pridemore, 2015), with a burgeoning literature
documenting how incarceration impairs not only the health of the
incarcerated but also the health of those connected to the incarcerated
(Brown et al., 2016; Bruns & Lee, 2020; Fleming & Nurius, 2020; Goldman, 2019; Gottlieb, 2016; Green et al., 2006; Johnson & Easterling,
2012; Lee et al., 2013, 2014; Murray et al., 2012; Poehlmann-Tynan &
Turney, 2021; Roettger et al., 2011; Sirois, 2020; Tadros et al., 2020;
Turney, 2017; Turney & Goodsell, 2018; Wildeman, 2010; Wildeman
et al., 2012, 2018; Wildeman & Turney, 2014). This paper extends prior
research on the relationship between family member incarceration history and mental health by simultaneously examining the relative consequences of different types of family member incarceration (including
parent, sibling, child, and romantic partner/co-parent incarceration) and
by considering differential associations across demographic characteristics. These findings highlight that any family member incarceration—and
not necessarily the type of family member incarceration—has repercussions for mental health, and that these associations are not
contingent on demographic characteristics considered, including race/ethnicity, gender, socioeconomic status, and incarceration history. Given
the concentration of family member incarceration among people of color
and the poor, this adverse experience may exacerbate existing inequalities in population health.
Funding
Turney's work on this project was supported by the William T. Grant
Foundation.

4.1. Limitations
Declaration of competing interest
This analysis has several limitations. First, though the measure of
mental health is broad and appropriate for capturing population health, it

The author has no competing interests to declare.

Appendix Table A. logistic regression models estimating fair or poor mental health as a function of immediate family member
incarceration, heterogeneity by type of family member incarceration
Model 1

Model 2

unadjusted

adjusted

b
Father incarceration

0.409

(S.E.)

OR

(0.171)

1.51

*

b

(S.E.)

0.216

(0.180)

OR
1.24
(continued on next column)

6

K. Turney

SSM - Mental Health 1 (2021) 100002

(continued )
Model 1

Model 2

unadjusted

adjusted

b
Mother incarceration
Brother incarceration
Sister incarceration
Son incarceration
Daughter incarceration
Current romantic partner incarceration
Former romantic partner incarceration
F test
Constant
N

0.177
0.013
0.467
0.360
0.339
0.089
0.344
3.93
2.050
2801

(S.E.)

OR

b

(S.E.)

OR

(0.243)
(0.147)
(0.196)
(0.187)
(0.299)
(0.183)
(0.234)

1.19
0.99
1.60
1.43
0.71
1.09
1.41

0.126
0.029
0.383
0.601
0.275
0.023
0.153
3.64
1.402
2801

(0.257)
(0.152)
(0.205)
(0.202)
(0.308)
(0.194)
(0.235)

0.88
0.97
1.47
1.82
0.76
1.02
1.17

*

***

**

***

Notes: Model 2 adjusts for all covariates in Model 2 of Table 3. All analyses weighted to adjust for sampling design. *p < .05, **p < .01, ***p < .001.

Appendix Table B. logistic regression models estimating fair or poor mental health as a function of immediate family member
incarceration, heterogeneity by type of family member incarceration and demographic groups
Parent incarceration

Sibling incarceration

Child incarceration

Coparent incarceration

b

(S.E.)

OR

b

(S.E.)

OR

b

(S.E.)

OR

Race/ethnicity
White (n ¼ 1760)
Black (n ¼ 397)
Hispanic (n ¼ 410)

0.413
0.392
0.564

(0.227)
(0.418)
(0.450)

1.51
0.68
1.76

0.306
0.170
0.827

(0.183)
(0.406)
(0.449)

1.36
1.19
0.44

0.573
0.024
0.381

(0.248)
(0.532)
(0.667)

1.77
0.98
1.46

Gender
Women (n ¼ 1468)
Men (n ¼ 1340)

0.482
0.180

(0.245)
(0.247)

1.62
1.20

0.023
0.043

(0.216)
(0.220)

1.02
1.04

0.386
0.474

(0.286)
(0.285)

Educational attainment
Less than high school (n ¼ 188)
High school or higher (n ¼ 2620)

0.766
0.369

(0.639)
(0.176)

2.15
1.45

0.153
0.031

(0.537)
(0.156)

1.17
1.03

0.855
0.349

Household income
$0 to $24,999 (n ¼ 658)
$25,000 or greater (n ¼ 2150)

0.666
0.122

(0.276)
(0.215)

1.95
1.13

0.096
0.092

(0.261)
(0.192)

0.91
1.10

Incarceration history
Ever incarcerated (n ¼ 642)
Never incarcerated (n ¼ 2166)

0.145
0.446

(0.314)
(0.211)

1.16
1.56

0.070
0.013

(0.260)
(0.188)

1.07
1.01

*

*

*

*

b

(S.E.)

OR

0.190
0.208
1.527

(0.235)
(0.485)
(0.483)

0.83
1.23
4.60

1.47
1.61

0.030
0.134

(0.221)
(0.298)

1.03
1.14

(0.683)
(0.220)

2.35
1.42

0.274
0.044

(0.788)
(0.183)

1.32
1.04

0.412
0.329

(0.333)
(0.272)

1.51
1.39

0.263
0.091

(0.296)
(0.227)

1.30
0.91

0.485
0.303

(0.325)
(0.254)

1.62
1.35

0.367
0.154

(0.292)
(0.234)

1.44
0.86

*

**

Notes: Each row represents a separate logistic regression model. Models include all control variables from Model 2 of Table 3. All analyses weighted to adjust for
sampling design. *p < .05, **p < .01, ***p < .001.

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