Research Reports - Association between traumatic brain injury and incarceration

CMAJ Open. 2016 Dec 6;4(4):E746-E753. doi: 10.9778/cmajo.20160072.

McIsaac KE(1), Moser A(1), Moineddin R(1), Keown LA(1), Wilton G(1), Stewart
LA(1), Colantonio A(1), Nathens AB(1), Matheson FI(1).

BACKGROUND: There is recent evidence to suggest that sustaining a traumatic brain
injury (TBI) increases risk of criminal justice system involvement, including
incarceration. The objective of this study was to explore the association between
TBI and risk of incarceration among men and women in Ontario.
METHODS: We identified a cohort of 1.418 million young adults (aged 18-28 yr) on
July 1, 1997, living in Ontario, Canada, from administrative health records; they
were followed to Dec. 31, 2011. History of TBI was obtained from emergency and
hospital records, and incarceration history was obtained from the Correctional
Service of Canada records. We estimated the hazard of incarceration using Cox
proportional hazard models, adjusting for relevant sociodemographic
characteristics and medical history.
RESULTS: There were 3531 incarcerations over 18 297 508 person-years of
follow-up. The incidence of incarceration was higher among participants with
prior TBI compared with those without a prior TBI. In fully adjusted models, men
and women who had sustained a TBI were about 2.5 times more likely to be
incarcerated than men and women who had not sustained a TBI.
INTERPRETATION: Traumatic brain injury was associated with an increased risk of
incarceration among men and women in Ontario. Our research highlights the
importance of designing primary, secondary and tertiary prevention strategies to
mitigate risk of TBI and incarceration in the population. 

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