The Impact of Incarceration on Health and Health Care Utilization: a System Perspective

Abstract

Background: Previously incarcerated individuals report high rates of chronic disease and reduced health care access. We characterized the impact of recent incarceration in jail or prison on chronic disease burden and health care utilization.

Methods and findings: Incarceration data over 10 years were matched to health system data and patients were classified by recent incarceration status. Each cohort was stratified by gender and neighborhood socioeconomic status for utilization analysis. Main outcomes were chronic disease incidence and health care utilization. Incarceration had a significant but small effect on chronic disease incidence. Incarceration had a moderate to large effect on emergency department and behavioral health utilization, with additional differences seen by gender and socioeconomic status.

Conclusion: Incarceration's impact on quantity and type of health care utilization varies with socioeconomic status and gender. Future work should evaluate the impact of length or number of cycles of incarceration on health or health care utilization.