People who have suffered a traumatic brain injury are
approximately 2.5 times more likely to be incarcerated in a federal
correctional facility in Canada than people who have not, a new study has
found.
“These findings contribute to emerging research suggesting
traumatic brain injury is an important risk factor for involvement with the
criminal justice system,” said lead author Dr. Flora Matheson of the Centre for
Urban Health Solutions of St. Michael’s Hospital and an adjunct scientist at
the Institute for Clinical Evaluative Sciences.
“This may be just the tip of the iceberg as our study
focused only on people with more serious TBI,” she said. “We also did not
include people who may have served time in provincial, rather than federal
jails.” The study was published online in the journal CMAJ Open.
The authors stressed that the overall risk of someone who
has experienced TBI being incarcerated was still low, at less than five in
1,000, compared to less than two in 1,000 for people without a history of TBI.
However, knowing that people who are incarcerated are much more likely to have
experienced brain injury than the general population will help health–care
providers better identify people at risk for incarceration and provide better
care for people within the prison system.
The researchers identified nearly 1.42 million adults ages
18–28 who were eligible for health care in Ontario on July 1, 1997, and
followed them to the end of 2011. The age group was selected because of its high
risk of TBI and involvement in the criminal justice system.
Their health information, including previous TBIs, was
obtained from emergency and hospital records stored at ICES, and linked to
incarceration records held by the Correctional Service of Canada.
Of the 77,519 people with a history of TBI, 402 were
incarcerated during the 14– year period, a rate of 0.5 per cent. This was more
than double the rate of people with no history of TBI (3,331 people out of
1,401,887, or 0.2 per cent).
To examine the impact of the issue more clearly, Dr.
Matheson and her team further broke down the numbers to look at the rate of
incarceration, taking into account the number of new cases and years spent
incarcerated for each group during the study period.
The researchers found incarceration was 2.47 times higher in
men who had sustained a TBI before being incarcerated in a federal correctional
facility compared to men who had not.
For women, incarceration was 2.76 times higher for those who
had suffered a TBI in comparison to women who did not suffer a TBI. However,
the researchers did note that the number of incarcerated women with TBI was
small – 17 of 210 incarcerated women.
Dr. Matheson, a medical sociologist, said that while her
study found an association between TBI and incarceration, rather than evidence
that TBIs caused people to be incarcerated, it highlighted the fact that many
people are being incarcerated with a potentially serious health issue.
Dr. Matheson said this study was one of the largest of its
kind, with 16 per cent more criminal justice events than reported previously,
and was the first Canadian study to explore how TBI is associated with serious
or chronic offending among people in federal custody. Another novel aspect was
that the findings applied similarly to men and women, although she noted the
number of women studied was small.
https://www.mdlinx.com/neurology/top-medical-news/article/2016/12/12/4
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Kathryn E. McIsaac, Andrea Moser, Rahim Moineddin, Leslie
Anne Keown, Geoff Wilton, Lynn A. Stewart, Angela Colantonio, Avery B. Nathens,
Flora I. Matheson. Association between
traumatic brain injury and incarceration: a population-based cohort study. CMAJ Open.
http://cmajopen.ca/content/4/4/E746.full
Background: There is recent evidence to suggest that
sustaining a traumatic brain injury (TBI) increases risk of criminal justice
system involvement, including incarceration. The objective of this study was to
explore the association between TBI and risk of incarceration among men and
women in Ontario.
Methods: We identified a cohort of 1.418 million young
adults (aged 18-28 yr) on July 1, 1997, living in Ontario, Canada, from
administrative health records; they were followed to Dec. 31, 2011. History of
TBI was obtained from emergency and hospital records, and incarceration history
was obtained from the Correctional Service of Canada records. We estimated the
hazard of incarceration using Cox proportional hazard models, adjusting for
relevant sociodemographic characteristics and medical history.
Results: There were 3531 incarcerations over 18 297 508
person-years of follow-up. The incidence of incarceration was higher among
participants with prior TBI compared with those without a prior TBI. In fully
adjusted models, men and women who had sustained a TBI were about 2.5 times
more likely to be incarcerated than men and women who had not sustained a TBI.
Interpretation: Traumatic brain injury was associated with
an increased risk of incarceration among men and women in Ontario. Our research
highlights the importance of designing primary, secondary and tertiary
prevention strategies to mitigate risk of TBI and incarceration in the
population.
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