Although women and men in
jails bear a burden of health problems, little is known about factors
associated with their health care use. We conducted a cross-sectional survey of
preincarceration health care use with 596 jail inmates. Descriptive statistics
and correlates of participants’ health care use were assessed.
A year before
incarceration, 54% of participants used an emergency room, 24% were
hospitalized, and 39% used primary care. Correlates of health care use included
gender, health insurance status, and drug dependence. For participants without
mental health problems, use was associated with living in neighborhoods where a
higher percentage of residents did not complete high school.
Findings suggest
individual and community factors that can be targeted by reentry programs to
improve health care use after jail.
...There was an interesting interaction between individual- and
community-level variables, however, which was that ER use and hospitalizations
were significant only for the group of participants without a mental health
diagnosis and living in a neighborhood with low educational status. Factors
associated with primary care use included having health insurance, not
reporting drug dependence, and having a mental health diagnosis. Thus, we found
that although community-level factors may have a role in health care use
patterns, individual-level factors such as gender, health insurance status,
drug dependence, and mental health diagnosis history were important correlates
of preincarceration health care use for our sample.
...The model [Andersen’s Behavioral Model of Health Services Use, Andersen, 1995; Harzke et al., 2006;Leukefeld et al., 2006; Webster et al., 2005] however, fails to explain our finding that
low educational status at the community level is associated with health care
that is used for emergency and more serious conditions, but only for those
without mental health problems. Low educational status at the community level
could be a proxy for community-level social capital (Bourdieu,
1986), which has been associated with both health outcomes and
health care access (Chuang, Ennett, Bauman, & Foshee, 2005; Kirby & Kaneda, 2005). It could also
signal lack of investment by the health care sector in poor, disadvantaged
communities where the economic capital of residents is compromised by their
collective educational status. It is interesting, however, that other potential
associations with social capital variables were not significant and suggest the
need to repeat this study with other populations. Our finding that community
matters only for those without mental health problems can perhaps be explained
by the magnitude of the mental health burden on inmates. Mental health as an
indicator of health need may determine the relative impact of community on
health care use for this group of women and men. Given that one national study
found that 64% of people in the jails had a mental health problem (James
& Glaze, 2006), the burden unique to this population is
significant and perhaps more significant than any community-level factors...
Full article at: http://goo.gl/QsDbjg
By:
1Department of Preventive Medicine and
Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
2Department of Biostatistics, University of
Kansas School of Medicine, Kansas City, KS, USA
3Department of Counseling Psychology,
University of Wisconsin–Madison, Madison, WI, USA
4Department of Emergency Medicine,
University of Kansas Medical Center, Kansas City, KS, USA
5School of Nursing, University of
Missouri–Kansas City, Kansas City, MO, USA
Corresponding Author: Megha Ramaswamy, PhD, MPH, Preventive
Medicine and Public Health, University of Kansas School of Medicine, 3901
Rainbow Blvd., MS 1008, Kansas City, KS 66160, USA.
More at: https://twitter.com/hiv insight
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