Health effects of family member incarceration in the United States: A meta-analysis and cost study

Existing primary studies indicate that family member incarceration is associated with increased mental and physical health problems and health risk behaviors. This study presents a meta-analytic summary of the health effects of family member incarceration and provides estimates of cost-to-treat health conditions in the United States. Sources comparing a childhood family member incarceration group with a comparison group on a health outcome were identified through approaches such as a search of electronic databases and reference lists of 19 reviews on family member incarceration. Thirty sources provided effect sizes, and outcomes were meta-analyzed (fixed-effects analysis using Comprehensive Meta-Analysis v.2 software) in the short-term (during childhood) and the long-term (during adulthood). Study quality was assessed using a standardized instrument. Synthesized odds ratios were significantly greater than 1.0 for health risk behaviors and experiences (OR = 2.922), mental health and behavior problems (OR = 2.234), and physical health problems (OR = 1.473). These values all indicate greater odds of health problems among children with family members incarcerated than among others. Increased odds ratios were generally statistically significant in both childhood and in adulthood. Cost-to-treat estimates for health conditions were substantial. Examples include alcohol use, abuse, or dependence with a cost of almost $1.5 billion, and asthma/COPD with a cost of almost $0.5 billion. Total costs were estimated at $22.5 billion for adults and $346 million for children. Limitations of our methods and implications for policy makers are discussed. The substantial health costs underscore the importance of policy makers attending to the effects of family member incarceration. We recommend investment of into supporting children who experience family member incarceration. •Children experiencing a family member’s incarceration may have poor health outcomes during childhood and adulthood.•Poor health outcomes impose treatment costs on children experiencing a family member’s incarceration.•The study estimates treatment costs for poor health outcomes, indirect costs of experiencing a family member’s incarceration.•Annual treatment for poor health outcomes amount to $22.5 billion during adulthood and $346 million during childhood.