Laura Hawks, David Bor, and Danny McCormick are with the Cambridge Health Alliance, Cambridge, MA, and Harvard Medical School, Boston, MA. Emily A. Wang and Benjamin Howell are with Yale School of Medicine, New Haven, CT. Benjamin Howell is also with National Clinician Scholars Program, New Haven, CT, and VA Connecticut Healthcare System, West Haven, CT. Steffie Woolhandler and David U. Himmelstein are with Hunter College, City University of New York, New York, NY, and Harvard Medical School.
Am J Public Health. 2020 Sep;110(9):1411-1417. doi: 10.2105/AJPH.2020.305777. Epub 2020 Jul 16.
To compare the health and health care utilization of persons on and not on probation nationally. Using the National Survey of Drug Use and Health, a population-based sample of US adults, we compared physical, mental, and substance use disorders and the use of health services of persons (aged 18-49 years) on and not on probation using logistic regression models controlling for age, race/ethnicity, gender, poverty, and insurance status. Those on probation were more likely to have a physical condition (adjusted odds ratio [AOR] = 1.3; 95% confidence interval [CI] = 1.2, 1.4), mental illness (AOR = 2.4; 95% CI = 2.1, 2.8), or substance use disorder (AOR = 4.2; 95% CI = 3.8, 4.5). They were less likely to attend an outpatient visit (AOR = 0.8; 95% CI = 0.7, 0.9) but more likely to have an emergency department visit (AOR = 1.8; 95% CI = 1.6, 2.0) or hospitalization (AOR = 1.7; 95% CI = 1.5, 1.9). Persons on probation have an increased burden of disease and receive less outpatient care but more acute services than persons not on probation. Efforts to address the health needs of those with criminal justice involvement should include those on probation.
为了比较全国范围内在押和不在押缓刑犯的健康和医疗保健利用情况。我们使用了全国毒品使用和健康调查(National Survey of Drug Use and Health),这是一项基于美国成年人的人口抽样调查,通过逻辑回归模型比较了在押和不在押缓刑犯的身体、心理和物质使用障碍以及使用医疗服务的情况,同时控制了年龄、种族/民族、性别、贫困和保险状况等因素。在押缓刑犯更有可能患有身体疾病(调整后的优势比 [AOR] = 1.3;95%置信区间 [CI] = 1.2,1.4)、精神疾病(AOR = 2.4;95% CI = 2.1,2.8)或物质使用障碍(AOR = 4.2;95% CI = 3.8,4.5)。他们不太可能接受门诊治疗(AOR = 0.8;95% CI = 0.7,0.9),但更有可能去急诊(AOR = 1.8;95% CI = 1.6,2.0)或住院(AOR = 1.7;95% CI = 1.5,1.9)。在押缓刑犯的疾病负担增加,接受门诊治疗的比例较低,但接受急诊和住院治疗的比例较高。为解决有刑事司法参与的人的健康需求,应包括在押缓刑犯。