School of Nursing assistant professor works to improve the health of women who are incarcerated.

By Susan Loyacano

Amanda Emerson, Ph.D., is an assistant professor at the University of Kansas School of Nursing. But her first career was as an American literature professor at the University of South Dakota. Administrators there convinced her to be the women’s studies coordinator and get a minor in women’s studies established. She taught courses and mentored thesis and honor students.

“I never said no, and I never got published, so I basically burned out,” Emerson said.

Her previous interest in women’s issues of the 18^th century and on women’s issues today helped lead to her second career in nursing.

“I got a job as a domestic violence advocate and then as a job as a nursing assistant,” Emerson said. “I then became a nurse in the cardiac unit at St. Luke’s Hospital in
Kansas City.”

While working on her Ph.D. in nursing at the University of Missouri- Kansas City, Emerson became involved with an NIH-funded project at KU. The focus of the initiative was delivering a cervical cancer and sexual health empowerment intervention to women in Johnson and Wyandotte County adult detention centers.

“I came to work on it as a research associate,” she said. “Every week we would go for five days, for two hours each day and meet with a group of women to give them information about cervical cancer risk and prevention.”

The participants changed each week, and through a variety of conversations, it became more than a good research experience.

“It was a small group interactive discussion, which was wonderful because it really helped us get in touch with the community we were trying to help,” Emerson said. “And I think it was great for them because we were coming to the jail with the express purpose of hearing their stories and not treating them like statistics and problems.”

Emerson led the ethnographic portion of the project, which explored cultural phenomena after the women left their incarceration. The research showed there were epigenetic changes from exposure to that environment. In essence, part of their genetic code changed as a result.

“We had about 15 women who we continued to do periodic interviews with to trace their experiences,” she said. “We are still in contact with some of them even nine years later. So far, it’s the longest running study of its kind.”

Emerson wrote her doctoral dissertation on a group of interviews that came out of the study. Subsequent studies grew out of the original research, and with two colleagues, Emerson has started writing a book about the transformative experiences.

“It’s really about how women navigate relationships in the context of trauma and incarceration.”

Emerson said she wanted to research the health of older women who are incarcerated.

“Older women are a largely invisible, because the numbers are pretty small.”

Emerson said only about 12% of people in jails and prison are women — and only about 18% of that group are women 50 and older.

One issue is that age acceleration happens with incarcerated older women. Emerson said trauma is the response to being in jail, and if women have already experienced violence and sexual abuse, being subjected to other people’s control and dehumanization can add to that trauma.

Now her research is part of much bigger data sets, including a 30-year study where a group of 20,000 people are surveyed periodically. Her research focuses on the 230 women who had been incarcerated within
that group.

“We were able to see that those women had 176 times greater odds of becoming frail, as compared to the 8,000 women in the study who had not been incarcerated.”

Although the average age of women in the study was 61, they showed physical levels of strength, speed, exhaustion and vitality seen more commonly in people over 80.

Emerson says there have only been 24 studies in the last quarter century that focus on this demographic of women.

“How can we expect to know enough to design health programs to help them if the basic research isn’t there?” she said.

Emerson is involved in further studies to engage older women about their fears and priorities to help them age in more healthy ways. Meetings with the first participants are done at the KU School of Nursing and are focused on gathering information about planning further studies and training future researchers.

“As nurses, it’s important to speak the language of policymakers and communicate with them in ways that reach them and make sense to them in order to make changes in the system,” Emerson said. “It’s about healing and understanding where the women are coming from and seeing them as part of the community as they
are aging.”