Abstract P321: Family Member Incarceration and Subclinical Cardiovascular Disease in Mexican Women

Introduction: Losing a family member to incarceration is a stressful life event associated with emotional and financial burdens potentially influencing cardiovascular health through altered behavioral changes and psychobiological processes. Because of men′s higher likelihood of incarceration, women may disproportionately shoulder this burden. As the prison population increases globally, there is a need to evaluate the impact of incarceration on cardiovascular health in women. Hypothesis: Women who have or have ever had a family member in prison are more likely to have subclinical CVD compared to women without ever having an incarcerated family member. Methods: We examined the association between family member incarceration, carotid artery intima-media thickness (IMT), and subclinical CVD (sCVD) in 1,848 women reporting no CVD from the Mexican Teachers’ Cohort. Between 2013 and 2016, women responded to family incarceration related questions from the Life Stressor Checklist (LSC). We categorized women according to their response on whether they have or have ever had a family member incarcerated. IMT was measured on both carotid arteries through ultrasound by standardized neurologists and log transformed. We defined sCVD as an intima media thickness of ≥0.8mm in either of the carotid arteries or the presence of plaque. We collected data on potential cofounders (age, site, health insurance provider, indigenous background, education, marital status, socio-economic status, and LSC-measured exposure to violence) and potential intermediates (anthropometry, smoking, physical activity, hypertension, diabetes, and self-reported treated depression). We used multivariable linear and logistic regression models to assess the association between family incarceration, IMT, and subclinical CVD. Results: Among 275 (14.9%) women having experienced family incarceration, obesity (40.4% vs. 37.8%), smoking (8.7% vs. 6.5%), hypercholesterolemia (20.4% vs. 17.5%), and depression (7.3% vs. 4.7%) were more common relative to women without family incarceration. We did not observe an association between family incarceration and IMT when comparing exposed to unexposed women (confounder-adjusted mean % difference=0.48; 95%CI -01.15, 2.11). The prevalence of sCVD was 28.4% in women who ever experienced family incarceration and 20.9% in women with no family incarceration. The confounder-adjusted odds ratio for sCVD among women that have ever had an incarcerated family member was 1.40 (95%CI 1.03, 1.91) relative to women with no family incarceration. Conclusion: Having or having had an incarcerated family member was associated with increased sCVD in middle-aged Mexican women. Incarceration of a family member may exert a psychological burden that could disproportionally affect women’s cardiovascular health.