Stress Among Older Adults With an Incarcerated Family Member: Testing the Buffering Model of Social Support

Abstract

Objectives

This study investigates whether levels of social support moderate the association between age and stress among a sample of individuals who have a family member incarcerated.

Methods

Survey responses from individuals who are members of a nonprofit organization for individuals with a family member incarcerated in Texas were used (n = 376). Ordinary least squares regression analysis was conducted to assess the interaction between age and levels of social support on stress.

Results

Findings demonstrated a negative interaction between social support and age (b = −0.040, p = .027), indicating that higher levels of social support buffer against stress for older adults.

Discussion

The theoretical mechanisms linking social support to reductions in stress among older individuals experiencing highly stressful life events (i.e., familial incarceration), as well as the policy and practical implications for enhancing social support among older individuals with a family member incarcerated, are discussed.

Unprecedented growth of the American criminal justice system in the last few decades has led to a wave of research documenting the indirect repercussions of incarceration (Kirk & Wakefield, 2018). The impact of incarceration is far-reaching, often touching the lives of family members (Wildeman et al., 2019). Indeed, one in two adults has experience with an immediate family member’s incarceration (Elderbroom et al., 2018). Moreover, extended family members—such as grandparents and cousins—are not included in such estimates, creating more conservative figures, as many families are structured around older generations (Elderbroom et al., 2018) and the age structure of the incarcerated population has grown increasingly older over time (Porter et al., 2016).

A family member’s incarceration has been shown to increase the risk of several deleterious health outcomes including depression, psychological distress, hypertension, substance use, and other health limitations (Baquero et al., 2020; Sirois, 2020). Although this area of research is growing, the focus on older adults has received inadequate attention, despite the fact that older adults carry the burden of health problems due to the natural aging process (Jaul & Barron, 2017). The negative health consequences via vicarious incarceration exposure will continue to influence adults of all ages in the years to come, but will have a profound effect on the older population considering the subsequent fallout of mass incarceration alongside the aging of the general U.S. population. This combination will inevitably generate more older adults with a family member incarcerated and potentially contribute to associated health burdens. Notably, distinctive consequences for older adults are sure to emerge in forthcoming decades related to differences in coping strategies, stress, and level of worry. For example, although older adults tend to worry less on average than their younger counterparts, they are substantially more likely to express worry about the well-being of family members (Gonçalves & Byrne, 2013; Hunt et al., 2003).

A primary way to combat the effects of stress is through social support, that is, the perceived emotional, instrumental, or informational assistance garnered from family, friends, and significant others (Thoits, 1995). One of the most durable findings in the social support literature is its ability to buffer against the health consequences of life stress (Smith et al., 1994). Furthermore, social support activates more powerfully during major life transitions and unexpected crises (Cobb, 1976; Jetten et al., 2012; Krause, 2007; Thoits, 1995), such as having a child or spouse incarcerated (Fahmy & Wallace, 2018). As an influential and cost-effective resource, social support is compelling in its ability to moderate life stress, particularly when it is mobilized early in the stress process (Uchino et al., 2020).

The sociological study of stress is primarily divided between life events and more enduring, or recurrent, chronic strains (Pearlin, 1989). Incarceration produces both segments of stress on the family: the distinct consternation of the punishment as shocking and the ongoing burden felt throughout the loved one’s incarceration. Within the context of stressful occurrences, someone who can mobilize strong, supportive resources from their social ties has a better chance of minimizing the negative effects of stressors on health (Cohen & Wills, 1985). Under the stress buffering model, social support can intervene at two different points in the chain between an individual’s stressful experience and a deleterious outcome (Cohen & Wills, 1985). When the stressor first presents itself, social support works to influence whether someone initially interprets the event as stressful (Thoits, 1986). Having sufficient social support can also intervene during the stress process by providing resources to cope with the stressful condition or by inhibiting maladaptive coping strategies (Cohen & Wills, 1985). Thus, for older adults, social support can not only condition the effects of stressors, but it can decrease the chances of social disconnectedness and perceived isolation resulting from stressful events (Cornwell & Waite, 2009).

Past research on the stress process model has limited links to prisons (e.g., Fahmy & Wallace, 2019), particularly for older adults. However, incarceration can be viewed as one setting to expand the stress process model to family-based events and include a new stressor: family member incarceration. Little research to date has focused on the interplay of stress and social support among older adults who have a family member incarcerated. We seek to address this critical gap in the literature by examining the unique intersection of age and social support on stress levels among a sample of adults with an incarcerated family member.

Data

The data used are from a cross-sectional survey of members of a nonprofit organization with family members incarcerated in Texas—Texas Inmate Family Association (TIFA). Respondents were recruited through a web-based flyer embedded in the weekly TIFA newsletter between July and August 2020 to participate in the online survey. More information on the sampling technique can be found in Supplementary Appendix A. The survey asked a series of questions related to the respondent’s demographics, mental and physical health, as well as relationship to and perceptions of the experiences of the incarcerated person. Although 517 respondents participated in the survey, the current study draws on data from 376 individuals with valid responses to all relevant questions. Patterns of missing data are reported in Supplementary Appendix B. The study was approved by The University of Texas at San Antonio Institutional Review Board (#20–125).

Dependent Variable

The focal dependent variable is the Perceived Stress Scale (PSS), a global measure of perceived chronic stress (Cohen et al., 1983) with high reliability and validity among diverse samples (Lee, 2012). Respondents were asked about the degree to which they appraised having a family member incarcerated as stressful. The 10 PSS items are listed in Supplementary Appendix C. Responses included never (0) to very often (4). Responses were summed into a scale that ranges from 8 to 37 (α = .885).

Independent Variable

Respondent age is a measure of age in years based on respondent self-reports.

Moderating Variable

Social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). The MSPSS is measured by asking respondents how they feel regarding 12 statements, listed in Supplementary Appendix C. Respondents answered on a continuum of strongly disagree (0) to strongly agree (4). Responses were summed into a single scale and divided by 12, resulting in a continuous measure ranging from 0 to 4 (α = .934).

Control Variables

Control variables include respondent race/ethnicity (White [reference], Black, Hispanic, other race/ethnicity), respondent sex (1 = female), whether the respondent is currently married (1 = currently married), respondents’ education level (1 = college graduate), and self-rated health (1 = good/excellent; 0 = poor/fair). Self-rated health was originally measured using four categorical responses, but very few individuals reported being in poor or excellent health, effectively leaving a binary distribution. A scale of material hardship (see Supplementary Appendix C) asks respondents about household experiences in the past year (α = .830). Measures related to the incarcerated person include the number of times they have been incarcerated, the respondent’s relationship to the incarcerated person (child [reference], spouse, or other), and crime type the individual was convicted of (violent [reference], sex offense, drug/alcohol offense, or other).

Method

We assess associations between age, social support, and stress using ordinary least squares (OLS) regression. Models include base terms for age, social support, and the product term between the two measures, as well as covariates. For the interaction terms, age and social support were mean centered (Aiken et al., 1991).

Results

The descriptive statistics for the full sample are presented in Table 1. The sample is about 57 years old on average and ranges from 26 to 86 years old. Most of the sample is composed of older adults aged 60 or older (50.3%). It is most common for a respondent to report the incarceration of a child (54.0%) or spouse (32.2%). Table 2 presents the OLS regression assessing the interaction between age and social support on stress. The results demonstrate a negative and statistically significant interaction between social support and age (b = −0.040, p = .027), which indicates that higher levels of social support significantly reduce stress for older adults. The results of this interaction term are displayed in Figure 1. Specifically, this figure shows values for the social support measure at the 25th percentile (low social support), 50th percentile (moderate social support), and 75th percentile (high social support) and plots age against the stress scale. These results show that for older adults, levels of stress substantially decline as social support rises such that at the highest levels of social support, older adults report the lowest levels of stress of any age group. For instance, among those with high social support, the predicted level of stress is 24.9 for a 26-year-old adult, compared with 20.3 for a 76-year-old adult. This is an approximately 4-point reduction in a stress scale that ranges from 8 to 37 (i.e., 29-point range).

Table 1.

Summary Statistics of Analytic Sample (N = 376)

Variables	Mean	Percent	SD	Minimum	Maximum
Dependent variable
Stress scale	22.15	—	4.15	8	37
Respondent age	57.51	—	12.97	26	86
Moderating variable
Social support scale	2.91	—	1.00	0	4
Female	—	94.1%	—	0	1
Respondent race/ethnicity
White	—	71.5%	—	0	1
Black	—	9.6%	—	0	1
Hispanic	—	17.3%	—	0	1
Other	—	1.6%	—	0	1
Married	—	60.1%	—	0	1
College graduate	—	36.4%	—	0	1
Good health	—	64.6%	—	0	1
Hardship scale	0.61	—	1.27	0	6
Relationship to incarcerated person
Child	—	54.0%	—	0	1
Spouse	—	32.2%	—	0	1
Other	—	13.8%	—	0	1
Prior incarceration	—	35.4%	—	0	1
Crime type
Violent	—	52.1%	—	0	1
Sex offense	—	22.6%	—	0	1
Drug/alcohol	—	17.3%	—	0	1
Other	—	8.0%	—	0	1

Table 2.

Ordinary Least Squares Regression of Stress Scale on Age × Social Support

Variables	b	SE
Age	−0.059**	(0.021)
Social support scale	−0.341	(0.246)
Age × Social support scale	−0.040*	(0.018)
Female	1.096	(0.854)
White (reference)	—	—
Black	−2.550**	(0.935)
Hispanic	−0.181	(0.700)
Other	−0.232	(1.211)
Married	0.327	(0.424)
College graduate	0.045	(0.425)
Good health	−1.146*	(0.452)
Hardship scale	0.377*	(0.187)
Child (reference)	—	—
Spouse	−0.537	(0.551)
Other	0.133	(0.718)
Prior incarceration	−0.397	(0.523)
Violent (reference)	—	—
Sex offense	−0.103	(0.525)
Drug/alcohol	−0.250	(0.579)
Other	0.845	(0.814)
Constant	22.102***	(1.002)
Observations	376
R 2	0.117

Notes: Robust SE in parentheses.

***p < .001, **p < .01, *p < .05.

Figure 1.

Results of ordinary least squares (OLS) regression: stress scale on age × social support. Notes: Low social support is measured at the 25th percentile, moderate social support is measured at the 50th percentile, and high social support is measured at the 75th percentile. Variables of age and social support are mean centered. OLS regression uses robust SE.

Discussion

The findings of the current study highlight that social support is an important factor that buffers stress among older adults with a family member incarcerated. The spillover effects on the families of the millions of people behind bars are, in many ways, experiencing the ramifications of their loved one’s punishment for years. This is especially true for older adults who tend to worry more about health and their family as they age (Hunt et al., 2003). Notably, for older adults who are approaching end of life, social support is derived primarily from family members (Cobb, 1976). Nevertheless, other forms of support, and from people outside the family such as friends or coworkers, are important to maintain social ties and overall well-being. Belonging to multiple social groups—whether faith-based or those centered around a shared hobby—is a critical source of coping with stressors. For example, older adults can mobilize social support via digital media to help strengthen existing relationships with friends near and far (Quan-Haase et al., 2017). Indeed, group membership can enhance one’s social capital and act as a “social cure” to chronic ailments and loneliness (Jetten et al., 2012).

Chronic and enduring stressors, such as familial incarceration, erode the very resources that older people need to cope with said stressor and regain the feeling of control (Krause, 2007). Thus, minimizing feelings of loneliness—via social support—becomes even more important for older adults’ health and well-being (Chen & Feeley, 2014; Cornwell & Waite, 2009), particularly in comparison to younger adults who may garner their sociability via other people and circumstances. Loneliness—or a lack of fulfillment of one’s social needs within their network—indicates a feeling of inadequacy particularly within intimate or other close, interpersonal relationships, whereas isolation is the lack of social connectedness or social integration with others (Cornwell & Waite, 2009). The aging process often coincides with a decline in social network members, which may trigger perceptions of loneliness (Chen & Feeley, 2014). Accordingly, social support, as measured by provision of emotional or instrumental support from family and friends, is a crucial mechanism by which impressions of social disconnectedness are thwarted, leading to enhanced well-being (Arthur, 2006; Chen & Feeley, 2014). Thus, minimizing both social isolation and loneliness vis-à-vis social support for older adults is an essential aspect of coping with their family member’s incarceration. However, the majority of research on the stress buffering model for older adults is structured around traumatic events occurring within the past year, neglecting the effects of ongoing stressors. Here, we consider the effects of chronic stress given that the average length of time in the sample of a loved one’s incarceration is 20 years.

The present study is not without limitations. First, results are based on a small, local sample in Texas that is mainly comprised of females and therefore may not be generalizable to other populations. Although the sample consists of mostly females, the literature in this area demonstrates collateral consequences of incarceration for women are felt at a higher rate than men, given that incarcerated males make up the vast majority of the prison population, whereas women tend to be the primary caregivers on the outside (Wildeman et al., 2012). Second, since the sample was surveyed based on TIFA membership, individuals in the sample may be more inclined to actively seek out support. Third, the survey was conducted during the summer of 2020, when the COVID-19 pandemic, among a plethora of social justice and political issues, reached a peak. The timing of these events may have influenced levels of stress and social support among survey participants. Fourth, the study questionnaire asked about general perceived social support, rather than support related specifically to their loved one’s incarceration. Similarly, although the study utilized a general measure of stress, the survey’s lead-in to the questions signaled that the respondent should consider their stress level as it pertains to their incarcerated family member. Still, future research should assess a specific measure of stress based on familial incarceration.

Interventions targeted at prosocial coping strategies after the loss of a loved one to incarceration should be amplified in this era of mass incarceration. Seeking support from nonprofit organizations—such as TIFA—may be the key to assisting in an older adult’s process of decreasing the effects of stress. Social isolation at this age exerts powerful effects on the mind and body, which may be especially meaningful during this time when many are confined in their homes due to the COVID-19 pandemic, lacking social connections (Cornwell & Waite, 2009). Additionally, pursuing communication with others who are in a similar position (i.e., dealing with the impacts of familial incarceration) may serve to help with the empathetic connections and shared sense of resolve.

Funding

Research reported in this article was supported by funding from the ARCH Network R24 of the National Institutes of Health under award number R24AG065175. The content is solely the responsibility of the author(s) and does not necessarily represent the official views of the National Institutes of Health.

Author Contributions

C.F. conceptualized and designed the study. A.T. conducted the statistical analyses. C.F. drafted the initial manuscript. Both authors interpreted the results and revised the manuscript. Both authors approved the final manuscript as submitted.

Conflict of Interest

None declared.