Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Byron Kennedy


Individuals who are exposed to the carceral system—specifically, solitary confinement are uniquely vulnerable to psychological and physical health conditions. However, the relationship between solitary confinement and physical health conditions are relatively underexamined, compared to mental health disorders. This analysis examines the potential for a risks’ association between solitary confinement and cardiovascular disease risk factors. Additionally, this study examines the relationship between spirituality as a self-efficacious coping measure for health-related outcomes. A cross-sectional analysis of 302 survey participants with a prior history of incarceration in a housing study (New Haven, CT) with a prior history of incarceration from Fall 2017 – March 2018 was used to explore the relationship between solitary confinement and several health outcomes (cardiovascular disease risk factors, anxiety disorders symptoms, and impaired daily activity) to decipher the association between solitary confinement and self-reported health outcomes. 175 participants in total reported solitary confinement history; further, 60% of participants who reported a cardiovascular disease risk factor reported a history of solitary confinement—but, the association was statistically insignificant. However, among individuals with a history of general incarceration: the risks for self-reported ‘impaired daily activity’ increased with older age. Additionally, self-reported physical chronic conditions increased the relative risk of self-reported ‘impaired daily activity’. Also, self-reported anxiety disorder symptoms increased the risks of self-reported impaired daily activity. Participants of a younger age; as well as, individuals who reported physical chronic conditions maintained increased risks of self-reported anxiety disorder symptoms. Notably, Black participants demonstrated a decreased risk of anxiety disorder symptoms within the sample population. Additionally, higher spirituality scores increased the risk of self-reported anxiety disorder symptoms. Moreover, higher spirituality scores were systematically located in the ‘impaired daily activity’ group, compared to participants who reported no such limitations. This analysis provides further evidence that carceral system exposure (particularly among low-income individuals) is associated with a notable prevalence of mental and physical chronic conditions—while exploring the potential for self-efficacious coping mechanisms (such as faith-based systems) to be further evaluated in research studies.


This is an Open Access Thesis.

Open Access

This Article is Open Access