Research Project
10488980
The United States continues to have the highest incarceration rate in the world. Chronic stress induced by incarceration is associated with risk factors for cardiovascular disease (CVD) and exacerbation of existing health disorders. Additionally, justice-involved persons smoke tobacco and use alcohol at higher rates than the general population; interventions to address either behavior during incarceration have demonstrated limited efficacy. Incarceration-associated impacts, moreover, are heterogeneous; Black men are incarcerated at far greater rates than their White or Latino counterparts, leading to greater stressors among them and their communities. Consequently, we are seeing a syndemic of incarceration, tobacco and alcohol use, and cardiovascular disease (CVD) in Black men and their communities that urgently requires a public health response. However, greater understanding of how these factors act together to impact CVD in communities of justice-involved persons is needed, which can in turn inform estimates of how policy reform may positively impact this syndemic. The impact of such reforms is difficult to assess using purely empirical methods. Agent-based models, a dynamic systems modeling technique, provides flexibility in modeling individual persons and members of their community networks as agents, and the social network structures that connect them as ties. The co-evolution of agents and networks provides practical insight on the impacts of health policy implementations. In this project, an agent-based network model, parameterized with incarceration and recidivism patterns as measured from cohort data for Black men in Chicago, will be developed. Risk factors for tobacco smoking, alcohol use, and chronic stress will be estimated using existing clinical laboratory data from project mentors. Social network parameters on incarcerated Black men will be obtained from an ongoing NIDA study (PI Schneider, Co-I Khanna). A synthetic population, generated in a virtual computational laboratory, will be simulated using powerful computing supercomputing resources at Brown University to investigate the following aims: (1) Quantify the impact of incarceration on smoking, alcohol use and cardiovascular disease among Black men and persons in their social networks; (2) Predict how various decarceration policies are likely to impact this syndemic. Scientific and policy insights generated from this study will provide the PL data and opportunity to develop open source modeling tools for an R01 application that considers interventions in communities of justice-involved persons and develop interventions tailored to improve health outcomes among them.
