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A Syndemic Model of Women Incarcerated in Community Jails
Author(s) -
Kelly Patricia J.,
Cheng AnLin,
SpencerCarver Elaine,
Ramaswamy Megha
Publication year - 2013
Publication title -
public health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 55
eISSN - 1525-1446
pISSN - 0737-1209
DOI - 10.1111/phn.12056
Subject(s) - syndemic , mental health , sexual abuse , psychological intervention , domestic violence , psychiatry , clinical psychology , public health , population , substance abuse , confirmatory factor analysis , medicine , psychology , sexual violence , poison control , suicide prevention , environmental health , structural equation modeling , nursing , statistics , mathematics
Objective The purpose of this study was to test whether variations in substance abuse, mental health diagnoses, individual experiences of violence, community experiences of violence, and incarceration history may be reduced to a single underlying syndemic factor for a sample of women incarcerated in three M idwestern U.S. jails. Design and Sample Secondary data analysis of a cross‐sectional study of a medical utilization survey; initial confirmatory factor analysis tested fit of model; modification indexes provided confirmatory fit. 290 women incarcerated in three urban M idwestern U.S. jails. Measures Demographics and variables associated with women's criminal justice experience and sexual health risk were assessed. The analysis included women's mental health, drug dependence, childhood sexual and physical abuse, and partner violence. Results The final model had four variables with significant pathways: childhood sexual abuse, childhood physical abuse, domestic violence, and mental health diagnoses. The fit of this model was very good (χ 2 (1) = 0.6; CFI = 1.00; standardized RMR = 0.0147), strongly suggesting the intertwined nature of the variables. Conclusion Clarification of the specific components in a syndemic model for this population will allow for the implementation of interventions with the appropriate inclusion of content. In interventions and clinical practice, public health nurses should consider these interrelationships.