Incarceration Exposure and Maternal Food Insecurity During Pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2004–2015



This study examines the relationship between exposure to incarceration and food insecurity among mothers during pregnancy.


Using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2004 to 2015, logistic regression models were used to assess the association between incarceration of a woman or her partner in the year before birth and the likelihood of experiencing food insecurity.


Net of control variables, exposure to incarceration either personally or vicariously through a partner is associated with a 165% increase in the odds of food insecurity (OR 2.65, CI 2.29, 3.08). Attenuation analyses indicate this association partly operates through financial hardship, maternal unemployment, and receiving WIC benefits.

Conclusions for Practice

Given the adverse consequences of food insecurity for maternal health and early childhood development, public health and criminal justice practitioners should develop targeted interventions to alleviate the negative repercussions associated with exposure to incarceration among pregnant women.

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  1. 1.

    Among the states in the analytic sample, food insecurity rates were highest in Tennessee and lowest in Minnesota. Across years, food insecurity rates were highest in 2007–2009 and lowest in 2014–2015.

  2. 2.

    We also assessed whether the association between incarceration exposure and food insecurity differed across key subgroups by testing interactions of incarceration with maternal race, maternal age, and maternal education. Across each model, we found no statistically significant difference in the relationship between incarceration and food insecurity across any subgroups. These models are available upon request.


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The authors wish to acknowledge the CDC PRAMS Working Group: Tammie Yelldell, MPH (AL), Kathy Perham-Hester, MS, MPH (AK), Letitia de Graft-Johnson, DrPH, MHSA (AR), Ashley Juhl, MSPH (CO), Jennifer Morin, MPH (CT), George Yocher, MS (DE), Tara Hylton, MPH (FL), Florence A. Kanu, PhD, MPH (GA), Matt Shim, PhD, MPH (HI), Julie Doetsch, MA (IL), Jennifer Pham (IA), Tracey D. Jewell, MPH (KY), Rosaria Trichilo, MPH (LA), Tom Patenaude, MPH (ME), Laurie Kettinger, MS (MD), Hafsatou Diop, MD, MPH (MA), Peterson Haak (MI), Mira Grice Sheff, PhD, MS (MN), Brenda Hughes, MPPA (MS), Venkata Garikapaty, PhD (MO), Emily Healy, MS (MT), Jessica Seberger (NE), David J. Laflamme, PhD, MPH (NH), Sharon Smith Cooley, MPH (NJ), Sarah Schrock, MPH (NM), Anne Radigan (NY), Pricila Mullachery, MPH (New York City), Kathleen Jones-Vessey, MS (NC), Grace Njau, MPH (ND), Ayesha Lampkins, MPH, CHES (OK), Cate Wilcox, MPH (OR), Sara Thuma, MPH (PA), Karine Tolentino Monteiro, MPH (RI), Kristin Simpson, MSW, MPA (SC), Ransom Wyse, MPH, CPH (TN), Tanya Guthrie, PhD (TX), Nicole Stone, MPH (UT), Peggy Brozicevic (VT), Kenesha Smith, MSPH (VA), Linda Lohdefinck (WA), Melissa Baker, MA (WV), Fiona Weeks, MSPH (WI), Lorie Chesnut, PhD (WY), CDC PRAMS Team, Women’s Health and Fertility Branch, Division of Reproductive Health.

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Correspondence to Alexander Testa.

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See Table 4.

Table 4 State and years included in sample

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Testa, A., Jackson, D.B. Incarceration Exposure and Maternal Food Insecurity During Pregnancy: Findings from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2004–2015. Matern Child Health J 24, 54–61 (2020) doi:10.1007/s10995-019-02822-4

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  • Food Insecurity
  • Incarceration
  • Pregnancy
  • Maternal health