Who is not coming to Thanksgiving dinner?

We are getting ready to sit down and have Thanksgiving dinner with those we love. We purchased our plane tickets and booked our rental cars. The turkeys will be perfectly trimmed, mashed potatoes piled up on our plates, and we will happily overindulge on cakes and pies.

However, this Thanksgiving, we should reflect on those that are not coming to dinner.  We should remember the 2.3 million people across the United States that will not be joining their families for Thanksgiving because they are incarcerated.

{mosads}The United States has the highest incarceration rate per capita in the world. Most of the over 2 million people are in state prisons and local jails. Over 460,000 individuals in local jails have not been convicted of a crime. One in five people are behind bars simply because they cannot afford to post bail. Almost 60 percent of prisoners are parents to children under 18, this means over 5 million children will forgo Thanksgiving dinner with their parent due to incarceration.

However, there is hope and steps we can take to end the mass incarceration of this country’s people. Just this week, bipartisan support from members in the U.S. Senate have worked together to change criminal justice sentencing with the First Step Act. With expected support from President Trump, this proposed legislation is slated to increase rehabilitation support in federal prisons and may allow more judiciary discretion with regards to sentencing. This is has been especially welcomed news for the proponents for criminal justice reform, such as the American Civil Liberties Union and celebrities.

Research at Ann & Robert H. Lurie Children’s Hospital and Northwestern University has demonstrated that young adults who have had a parent incarcerated are more likely to smoke cigarettes, have drinking problems, misuse prescription drugs, and engage in high-risk sexual practices as young adults. These same young adults are less likely to seek certain types of health care.

Black and Hispanic children as well as rural and low-income children have the highest rates of parental incarceration. Children who experience this distinct type of loss grapple with a unique set of challenges. Grief, trauma, and depression are common biopsychosocial experiences for children with an incarcerated parent and can manifest in maladaptive ways within these children’s beliefs, attitudes, and behaviors.

For example, one young girl whose father had been recently imprisoned started to become easily agitated and exhibited aggressive behavior. Interventions with her routinely focused on her emotionality rather than addressing the true trauma of losing her father to the prison system.

Sadly, a lack of understanding around how children, especially, racial and ethnic minority children express and cope with grief, trauma, and depression following their parent’s incarceration by professionals, such as physicians, teachers, school administrators, and mental health professionals, who interact with these children can bring about further harm. The harm can come in the form of misdiagnosis, improper levels of care, and encounters with systems relegated for juvenile delinquency, which sustain the school-to-prison pipeline cycle.

As these children grow up, they do not escape the impact of incarceration on their own lives. The incarceration of a parent places children at higher risk for mental health problems and behavior problems. Perhaps, even more striking is that the influence of parental incarceration can extend beyond mental health. The incarceration of a parent can impact the physical health, health behaviors, and health care use of these children into adulthood. Young adults that have had a parent incarcerated are more likely to have asthma, HIV, and AIDS.

{mossecondads}With the recent midterms behind us, it is critical that we understand our elected leaders’ positions on mass incarceration and how their policy agendas support or dismantle this corrosive practice. Our leaders should create alternatives to prison for non-violent, lower-level offenses in addition to supporting legislation that reduces the length of sentences. The focus should be on prevention.

Legislation that helps formerly incarcerated individuals, once released, with employment, housing, education, or voting access is essential to reduce recidivism and prison churn.

So as you enjoy seconds of your favorite Thanksgiving dinner, think about those that are missing, the invisible, the impact on their kids, and what we can do to end it.

Dr. Nia Heard-Garris is a pediatrician, researcher and instructor of pediatrics at Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University, and a Public Voices Ffellow with The Op-Ed Project.

Dr. Nevin Heard is an assistant professor of clinical counseling at Roosevelt University, where his research, teaching and service focus on bringing about social justice.