Health Care During Incarceration: A Policy Position Paper From the American College of Physicians

Kendig, Newton E.; Butkus, Renee; Mathew, Suja; Hilden, David; Beachy, Micah; Curry, William T.; Hollon, Matthew F.; Jumper, Cynthia; Mellacheruvu, Pranav; Parshley, Marianne; Sagar, Ankita; Slocum, Jamar; Tan, Michael; Doren, Vanessa E. Van; Yousef, Elham

doi:10.7326/m22-2370

Cited by 10 publications

(2 citation statements)

References 68 publications

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“…Criminalization of OUD leads to stigmatization of the disease, the patients, and the treating clinicians, and ultimately leads to punishment rather than objective, mortality-reducing treatment with medication for OUD. Our medical organizations recognize what the carceral system fails to address: incarceration is a major social determinant of health, disproportionally affecting people from lower socioeconomic backgrounds, historically marginalized populations, and people with mental illness and/or substance use disorder . Offering all 3 medications for OUD to patients who are incarcerated saves lives and is cost-effective .…”

mentioning

confidence: 99%

“…Offering all 3 medications for OUD to patients who are incarcerated saves lives and is cost-effective . Withholding health care should not be part of punishment; by preventing access to medication for OUD and treatment of hepatitis C, HIV, and psychiatric illnesses, the carceral system perpetuates a cycle of racial disparity, poor mental health, and generational trauma and poverty . Having a parent who is incarcerated is an adverse childhood experience that increases the risk of developing substance use disorder, which society views as a moral disease deserving punishment and incarceration.…”

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confidence: 99%

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Opioid Use Disorder Treatment for Patients Who Are Incarcerated—Reply

South,

Lofwall,

Fanucchi

2023

JAMA

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mentioning

confidence: 99%

mentioning

confidence: 99%

Opioid Use Disorder Treatment for Patients Who Are Incarcerated—Reply

South,

Lofwall,

Fanucchi

2023

JAMA

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Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons

Lupez,

Woolhandler,

Himmelstein

et al. 2024

JAMA Intern Med

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ImportanceDecades-old data indicate that people imprisoned in the US have poor access to health care despite their constitutional right to care. Most prisons impose co-payments for at least some medical visits. No recent national studies have assessed access to care or whether co-pays are associated with worse access.ObjectiveTo determine the proportion of people who are incarcerated with health problems or pregnancy who used health services, changes in the prevalence of those conditions since 2004, and the association between their state’s standard prison co-payment and care receipt in 2016.Design, Setting, and ParticipantsThis cross-sectional analysis was conducted in October 2023 and used data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, a nationally representative sample of adults in state or federal prisons, with some comparisons to the 2004 version of that survey.ExposuresThe state’s standard, per-visit co-payment amount in 2016 compared with weekly earnings at the prison’s minimum wage.Main Outcomes and MeasuresSelf-reported prevalence of 13 chronic physical conditions, 6 mental health conditions, and current severe psychological distress assessed using the Kessler Psychological Distress Scale; proportion of respondents with such problems who did not receive any clinician visit or treatment; and adjusted odds ratios (aORs) comparing the likelihood of no clinician visit according to co-payment level.ResultsOf 1 421 700 (unweighted: n = 24 848; mean [SD] age, 35.3 [0.3] years; 93.2% male individuals) prison residents in 2016, 61.7% (up from 55.9% in 2004) reported 1 or more chronic physical conditions; among them, 13.8% had received no medical visit since incarceration. A total of 40.1% of respondents reported ever having a mental health condition (up from 24.5% in 2004), of whom 33.0% had received no mental health treatment. A total of 13.3% of respondents met criteria for severe psychological distress, of whom 41.7% had not received mental health treatment in prison. Of state prison residents, 90.4% were in facilities requiring co-payments, including 63.3% in facilities with co-payments exceeding 1 week’s prison wage. Co-payments, particularly when high, were associated with not receiving a needed health care visit (co-pay ≤1 week’s wage: aOR, 1.43; 95% CI, 1.10-1.86; co-pay &gt;1 week’s wage: aOR, 2.17; 95% CI, 1.61-2.93).Conclusions and RelevanceThis cross-sectional study found that many people who are incarcerated with health problems received no care, particularly in facilities charging co-payments for medical visits.

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The Social History

Ellis,

Thronson

2023

The Patient-Centered Approach to Medical Note-Writing

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Health Care During Incarceration: A Policy Position Paper From the American College of Physicians

Cited by 10 publications

References 68 publications

Opioid Use Disorder Treatment for Patients Who Are Incarcerated—Reply

Opioid Use Disorder Treatment for Patients Who Are Incarcerated—Reply

Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons

The Social History

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