Life Course Patterns and Risky Health Behaviors in Incarcerated Women

Abstract

Purpose/Aim The purpose of this secondary analysis was to examine the life course patterns associated with risky health behaviors in a sample of 15 incarcerated women who participated in the Life Histories of Women in Prison, 1986–1987 study. Research Questions The research questions that guided this study included: What types of life events comprised these women's lives and how did women respond to these events? In what risky behaviors had they engaged? Are there distinguishable combinations of events, their timing, and women's responses to these events that were associated with their risky health behaviors? Significance/Background Incarcerated women have long been recognized as living troubled and chaotic lives. Because they have been identified as a high‐risk population with similarities to women with HIV, understanding the life patterns of incarcerated women might shed light on the factors playing a role in women's involvement in HIV‐related risky behaviors. The Life Course Theory and the concept of cumulative advantage and disadvantage guided the identification of pathways to risk behaviors associated with HIV and other threats to physical and psychosocial well‐being. Methods Qualitative person‐centered analyses of data from questionnaires and life history interviews were conducted to examine the distinctive variations in women's lives and involved the identification of life events and risky health behaviors across the lifespan. Limitations included inability to clarify women's responses and inability to determine causal relationships. Findings All women described life events characteristic of cumulative disadvantage that began in childhood. Women who described serial/overlapping disadvantage tended to become involved in risky health behaviors during pre‐ or early adolescence. Those reporting isolated disadvantage were more likely to delay involvement in risky health behaviors until later in adolescence or adulthood. Discussion The findings indicate the need for early, trauma‐informed interventions that incorporate women's unique experiences with and responses to physical, emotional, and psychological trauma. Such interventions might help to minimize women's involvement in risky health behaviors and improve health outcomes for women with chaotic lives. Replication of this study in other samples of women with chaotic lives will strengthen the evidence to inform the development of effective interventions.