Abstract Body: Background: Few studies have prospectively examined associations of parental incarceration during childhood with offspring cardiovascular health (CVH). We assessed: (1) associations between parental incarceration and subclinical cardiovascular disease (subCVD) in young adulthood, and (2) whether associations were mediated by CVH.
Methods: Data are from the FF-CHAYA Study, an ancillary study of the Future of Families and Child Wellbeing Study. Incarceration of mothers and fathers as well as the number of times the father was incarcerated (never, once, ≥2 times) was collected via interviews at birth and ages 1, 5, and 9y. Carotid intima-media thickness (IMT) was measured at age 22 using B-mode ultrasound and analyzed as a continuous or dichotomous (high IMT ≥75^th percentile) outcome. In linear and logistic regression models, covariates included age, sex, race, mother’s poverty level, young adult’s arrest history, and CVH (Life’s Essential 8 score at age 22). Attenuation by adjustment and formal mediation analyses were performed to understand how much of the association between parental incarceration and subCVD was explained by CVH.
Results: Among 1,372 participants, 54% identified as female, 51% as Black, 27% as Hispanic, 17% as non-Hispanic White, and 4% as Other or Mixed; 278 (20.3%) experienced incarceration of a parent prior to age 9y. Most parental incarceration was paternal (n=222; 79.9%); 106 (47.7%) reported their father was incarcerated once and 116 (52.3%) reported their father was incarcerated ≥2 times. Parental incarceration was associated with higher mean-mean (Model 2: b= 0.86; 95% CI: 0.05, 1.67) and mean-max cIMT (b=0.94; 95% CI: 0.06, 1.82) but was attenuated and nonsignificant after adjustment for CVH (Model 3). There was significant mediation by CVH (22.3% and 25.7% for mean-mean and mean-max cIMT, respectively, P < 0.05). Paternal incarceration ≥2 or more times (versus never) was associated with high mean-mean (OR=1.66; 95% CI: 1.01, 2.73) and mean-max (OR=2.05; 95% CI: 1.25, 3.36) IMT.
Conclusions: In these young adults, the association between parental incarceration and subCVD was partially mediated by CVH, suggesting that promotion of CVH earlier in life may lessen future CVD risk, although other pathways may also be important. Further, a greater number of paternal incarcerations was associated with developing high IMT suggesting that targeted interventions may help mitigate future CVD risk among this vulnerable population.