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Food Insecurity, Morbidities, and Substance Use in Adults on Probation in Rhode Island

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Abstract

When individuals are on probation, they face challenges with securing employment and safe housing due to their criminal records, which may make food access problematic. Food insecurity is a construct used as a marker for food access that considers financial constraints and has been associated with poorer health and substance use. There is limited research on the extent of food insecurity and associated morbidities and substance use among adults on probation. We conducted a cross-sectional study in 2016, surveying 304 probationers in Rhode Island to determine whether food insecurity is associated with obesity, high blood pressure, depression, and substance use. Separate logistic regression models were used to determine the associations between food insecurity and obesity, high blood pressure, depression, and substance use. Food insecurity was experienced by 70% of our study population. The estimated prevalence of high blood pressure was significantly higher in our study sample compared to the general US population. Food insecurity was not associated with obesity, high blood pressure, or current drug use in this study sample. Food insecurity was independently associated with more than three times greater odds of being depressed (AOR 3.33, 95%CI 1.89, 5.86) and a nearly twofold greater odds of self-reporting a lower health status (AOR 1.91, 95%CI 1.18, 3.10) after adjusting for gender, race/ethnicity, age, income categories, and being homeless. Probationers were found to have a higher estimated prevalence of high blood pressure and food insecurity compared to the general population, which highlights the health disparities faced by this population. Our findings have important implications for future research and interventions to decrease the health burden not only on the individuals but their families and communities.

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Acknowledgments

The authors would like to thank the study participants. We also thank Marc Moody from the Rhode Island Department of Corrections, Tasia Liu, and the probation officers for their invaluable contributions to the implementation of this study.

Funding

Funding was provided by National Institute on Drug Abuse (NIDA) Grant #R25DA037190, The Lifespan/Brown Criminal Justice Research Program on Substance Use, HIV, and Comorbidities; The Providence/Boston Center for AIDS Research Grant #P30AI042853; and The Boston Obesity Research Center Grant #P30DK046200.

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Authors and Affiliations

  1. Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA

    Kimberly R. Dong, Aviva Must, Alice M. Tang & Thomas J. Stopka

  2. The Miriam Hospital and the Alpert Medical School of Brown University, Box G-A1, Providence, Rhode Island, 02912, USA

    Curt G. Beckwith

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  1. Kimberly R. Dong
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  2. Aviva Must
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Correspondence to Kimberly R. Dong.

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Dong, K.R., Must, A., Tang, A.M. et al. Food Insecurity, Morbidities, and Substance Use in Adults on Probation in Rhode Island. J Urban Health 95, 564–575 (2018). https://doi.org/10.1007/s11524-018-0290-2

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  • DOI: https://doi.org/10.1007/s11524-018-0290-2

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