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Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study

Flora I. Matheson (MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada; ICES, Toronto, Canada and Dalla Lana School of Public Health and Centre for Criminology and Socio-Legal Studies, University of Toronto, Toronto, Canada)
Arthur McLuhan (MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada)
Ruth Croxford (ICES, Toronto, Canada)
Tara Hahmann (MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada)
Max Ferguson (MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada)
Cilia Mejia-Lancheros (MAP Centre for Urban Health Solutions, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada)

International Journal of Prisoner Health

ISSN: 1744-9200

Article publication date: 5 September 2023

Issue publication date: 28 November 2023

33

Abstract

Purpose

Continuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators.

Design/methodology/approach

Participants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits.

Findings

Superjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants.

Originality/value

This empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto “walk-in clinics” for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.

Keywords

Acknowledgements

Ontario Trillium Foundation LP95856.

Citation

Matheson, F.I., McLuhan, A., Croxford, R., Hahmann, T., Ferguson, M. and Mejia-Lancheros, C. (2023), "Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study", International Journal of Prisoner Health, Vol. 19 No. 4, pp. 709-723. https://doi.org/10.1108/IJPH-01-2023-0004

Publisher

:

Emerald Publishing Limited

Copyright © 2023, Emerald Publishing Limited

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