Advancing Health Disparities Research in Aging: The Aging Research in Criminal Justice & Health (ARCH) Network

项目概要/摘要 尽管20年来参与刑事司法的老年人（被捕者， 法庭，监狱或监狱，缓刑或假释），为此制定基于证据的干预措施所需的知识 早发性疾病、残疾以及行为和社会风险因素发生率高的人口， 开发特别是，研究了解生命历程的经验，健康的社会决定因素， 这一人群晚年健康差异的驱动因素，包括刑事司法参与本身，是有限的。此外，委员会认为， 关于这一人群的许多研究未能研究老年病（例如，功能和认知 损伤、福尔斯、虐待老人、多种药物），这些是了解老年人健康和福祉的关键， 刑事司法参与的每个阶段（从逮捕到监禁后重返社区）。这种缺乏 知识对公共卫生产生了深远的影响，因为超过95%的被监禁患者最终被释放到 他们不成比例地依赖社区安全网医疗保健系统的社区。证据的相对缺乏 在老龄化和健康差距这一领域，研究部分反映了越来越多的老年人在职业上的孤立。 研究老龄化和刑事司法参与的研究人员-其中许多人在职业生涯的早期-来自一系列 学科（如医学，公共卫生，护理，流行病学，社会福利）遍布全国 很少有集中在任何一个机构。因此，重要的跨学科研究合作是有限的和初级的 研究人员往往缺乏在这一领域从事成功研究所需的指导。作为回应，我们建议 发展刑事司法和健康老龄化研究网络，以建立这一新兴领域的研究能力。 领域和催化有影响力的研究需要制定基于证据的干预措施，以满足这一需求 历史上被忽视的老年人。 为了实现这些目标，我们提出了两个具体目标：（1）建立一个多学科的国家研究网络， 制定和完善研究议程，措施，以及推进健康和社会研究所需的方法。 老年人一生中刑事司法参与和健康差异的驱动因素及其后果 （2）支持新老科学家发展和 通过提供研究技术，对涉及刑事司法的老年人的健康进行生命历程研究。 援助计划，为初级调查人员创建国家导师计划，直接资助试点和探索性项目， 研究，并创造正式的网络机会，以发展新的多学科研究合作。的 老年人网络将确保老年医学原则在研究老年人的健康和医疗保健需求方面处于前沿和中心地位。 参与刑事司法的老年人，并将制定一个研究议程，可以告知惩教和社区 在整个生命过程中，可以测试方案和政策干预措施的机会的医疗保健系统， 减少这一人群的健康差距。

Project Summary / Abstract Despite 20 years of unprecedented growth in the number of criminal justice-involved older adults (those under arrest, in court, in prison or jail, on probation or parole), the knowledge needed to develop evidence-based interventions for this population with high rates of early onset disease, disability and behavioral and social risk factors, is deeply under- developed. In particular, research to understand the life course experiences, the social determinants of health, and the drivers of later life health disparities in this population, including criminal justice involvement itself, is limited. Moreover, much of the research about this population has failed to study geriatric conditions (e.g., functional and cognitive impairment, falls, elder abuse, polypharmacy) that are key to understanding the health and wellbeing of older adults at each phase of criminal justice involvement (from arrest through community reintegration after incarceration). This lack of knowledge has profound impacts on public health as over 95% of incarcerated patients are eventually released to the community where they disproportionately rely on community safety net healthcare systems. The relative lack of evidence in this area of aging and health disparities research reflects, in part, professional isolation among the growing number of researchers who study aging and criminal justice involvement – many of them early in their careers – from a range of academic disciplines (e.g. medicine, public health, nursing, epidemiology, social welfare) spread throughout the nation with few centered at any one institution. As a result, vital interdisciplinary research collaborations are limited and junior researchers often lack the mentorship needed to pursue a successful research career in this area. In response, we propose developing The ARCH (Aging Research in Criminal justice & Health) Network to build research capacity in this emerging field and catalyze the impactful research needed to develop evidence-based interventions that meet the needs of this historically overlooked population of older adults. To meet these goals, we propose two specific aims: (1) to establish a multidisciplinary national research network to develop and refine the research agenda, measures, and methods needed to advance research on the health and social drivers of criminal justice involvement and health disparities among older adults over the life course and the consequences of criminal justice involvement on health in later life; and (2) to support new and established scientists to develop and implement life course research on the health of criminal justice-involved older adults by offering a research technical assistance program, creating a national mentorship program for junior investigators, directly funding pilot and exploratory research, and creating formal opportunities for networking to develop new multidisciplinary research collaborations. The ARCH Network will ensure that geriatric principles are front and center in studying the health and healthcare needs of criminal justice-involved older adults and will develop a research agenda that can inform correctional and community healthcare systems of opportunities across the life course where programmatic and policy interventions can be tested to reduce health disparities for this population.