Caring For Children of Incarcerated Parents

There’s a growing recognition that childhood parental incarceration is a “silent American epidemic” in pediatrics. There are 4.2 million children in the United States who currently have asthma; there are 4.9 million who have ever had a parent or guardian incarcerated.

That may seem like a social and community issue, but it’s also a health care issue, say experts at Nationwide Children’s Hospital. Children of incarcerated parents have an increased risk of many negative health outcomes – from developmental and language delays to depression and asthma. There are also outcomes that aren’t the traditional concern of pediatrics, like housing instability and food insecurity, but that have an impact on health.

“Pediatricians who really know their patients are realizing this has been a silent epidemic for a long time. They’ve had to deal with it on their own,” says Kelly Kelleher, MD, vice president of health services research at Nationwide Children’s. “We need to give providers better guidance on caring and advocating for these children.”

A recent publication from Nationwide Children’s in Pediatrics in Review is an important step. It’s the first summary document of its kind, laying out the scope of the issue, the different ways that children of incarcerated parents are affected, and suggestions of how health care providers can help both in the office and outside of it.

The authors are Rosemary Martoma, MD, an academic pediatrician at Nationwide Children’s; Alex Kemper, MD, division chief of Primary Care Pediatrics at the hospital; and Dr. Kelleher.

Among the many challenges of working with this population of children is creating a health care environment where they or their family members feel comfortable disclosing that a parent is incarcerated. It’s hard to intervene without knowledge of the child’s circumstances. But talking about the trauma of incarceration may itself be traumatizing.

“Many people fear disclosing a family member’s incarceration because of the associated stigma,” says Dr. Martoma. “Families may be more likely to feel comfortable if pediatricians use a trauma-informed approach and can offer resources.”

Drs. Kelleher and Martoma have written before about the importance of avoiding dehumanizing language when caring for children of incarcerated parents. The new publication outlines how health care providers can help children build resilience, stay connected to an incarcerated parent, and find community resources.

“Pediatricians are uniquely situated to help these children and advocate for them,” says Dr. Kemper. “It’s important that we bring this issue into the public square.”