Substance Use, Disordered Eating, and Weight Gain: Describing the Prevention and Treatment Needs of Incarcerated Women

Weight-related concerns are associated with women's substance use and treatment relapse. The prevalence of overweight, obesity, disordered eating behavior, and substance abuse history was assessed among female inmates incarcerated for 6 to 24 months at an Oregon state prison, using a self-administered survey and physical measurements. 

Average weight gain was 20 pounds, 87% of women were overweight (39%) or obese (48%), and 24% reported using one or more unhealthy strategies to lose weight in the past 6 months. Women who used tobacco and illicit substances before incarceration gained more weight. 

Integrating nutrition and weight gain issues into substance abuse treatment could benefit incarcerated women-both soon after entering prison to prevent weight gain and close to release to prevent relapse into substance use.

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By:  Drach LL1, Maher JE2, Braun MJ3, Murray SL4, Sazie E5.

• 1Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, Portland, OR, USA linda.drach@state.or.us.
• 2Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, Portland, OR, USA.
• 3Oregon Youth Authority, Portland, OR, USA Oregon Department of Corrections (formerly), Portland, OR, USA.
• 4Oregon Public Health Division, Portland, OR, USA.
• 5Oregon Department of Corrections (formerly), Portland, OR, USA. 
• J Correct Health Care. 2016 Apr;22(2):139-45. doi: 10.1177/1078345816634692.

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Formerly Homeless People Had Lower Overall Health Care Expenditures After Moving Into Supportive Housing

The provision of supportive housing is often recognized as important public policy, but it also plays a role in health care reform. Health care costs for the homeless reflect both their medical complexity and psychosocial risk factors. Supportive housing attempts to moderate both by providing stable places to live along with on-site integrated health services. In this pilot study we used a mixture of survey and administrative claims data to evaluate outcomes for formerly homeless people who were living in a supportive housing facility in Oregon between 2010 and 2014. 

Results from the claims analysis showed significantly lower overall health care expenditures for the people after they moved into supportive housing. Expenditure changes were driven primarily by reductions in emergency and inpatient care. Survey data suggest that the savings were not at the expense of quality: Respondents reported improved access to care, stronger primary care connections, and better subjective health outcomes. 

Together, these results indicate a potential association between supportive housing and reduced health care costs that warrants deeper consideration as part of ongoing health care reforms.

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By:  Wright BJ1, Vartanian KB2, Li HF3, Royal N4, Matson JK5.

• 1Bill J. Wright (bill.wright@providence.org) is regional director of the Center for Outcomes Research and Education at Providence Health and Services (CORE), in Portland, Oregon.
• 2Keri B. Vartanian is an associate research scientist at CORE.
• 3Hsin-Fang Li is a research analyst at CORE.
• 4Natalie Royal is a research associate at CORE.
• 5Jennifer K. Matson is a project manager at CORE.
• Health Aff (Millwood). 2016 Jan 1;35(1):20-7. doi: 10.1377/hlthaff.2015.0393. 

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Portland Homeless Counts

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Intergenerational Transmission of Maltreatment: A Multilevel Examination

Despite the commonly held belief that there is a high degree of intergenerational continuity in maltreatment, studies to date suggest a mixed pattern of findings. One reason for the variance in findings may be related to the measurement approach used, which includes a range of self-report and official indicators of maltreatment and both cross-sectional and longitudinal designs. 

This study attempted to shed light on the phenomenon of intergenerational continuity of maltreatment by examining multiple indicators of perpetration of maltreatment in young adults and multiple risk factors across different levels within an individual’s social ecology. The sample included 166 women who had been placed in out-of-home care as adolescents (>85% had a substantiated maltreatment incident) and followed into young adulthood, and included three waves of adolescent data and six waves of young adult data collected across 10 years. 

The participants were originally recruited during adolescence as part of a randomized controlled trial examining the efficacy of the Treatment Foster Care Oregon intervention. Analyses revealed weak to modest associations between the three indicators of perpetration of maltreatment in young adulthood, i.e., official child welfare records, self-reported child welfare system involvement, and self-reported maltreatment (r = .03–.51). Further, different patterns of prediction emerged as a function of the measurement approach. Adolescent delinquency was a significant predictor of subsequent self-reported child welfare contact, and young adult partner risk was a significant predictor of perpetration of maltreatment as indexed by both official child welfare records and self-reported child welfare contact. In addition, women who were originally assigned to the intervention condition reported perpetrating less maltreatment during young adulthood. 

Implications for measurement and interventions related to reducing the risk for intergenerational transmission of risk are discussed.

Full article at: http://goo.gl/JXehc5

By: Leslie D. Leve, Atika Khurana, and Emily B. Reich

University of Oregon

Correspondence concerning this article should be addressed to Leslie Leve, Prevention Science Institute, 6217 University of Oregon, Eugene, OR 97403-6217; direct inquiries regarding clinical aspects of Treatment Foster Care Oregon and its implementation to Patricia Chamberlain, Oregon Social Learning Center, 10 Shelton McMurphey Boulevard, Eugene, OR 97401. Email: ude.nogerou@evel or ; Email: gro.clso@cittap.

 

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