Wennerstrom Ashley, Sugarman Meredith, Martin Dolfinette, Lobre Christine Breland, Haywood Catherine G, Niyogi Anjali
Department of Behavioral & Community Health Sciences, Center for Healthcare Value and Equity, LSU Health Sciences Center - New Orleans, New Orleans, Louisiana, USA.
Center for Healthcare Value and Equity, LSU Health Sciences Center - New Orleans, New Orleans, Louisiana, USA.
Health Soc Care Community. 2022 Sep;30(5):1763-1774. doi: 10.1111/hsc.13556. Epub 2021 Aug 27.
Globally, the rate of incarceration among women is rising, and in the U.S., women's incarceration has grown at twice the rate for men over the last four decades. Louisiana has the second highest rate of incarceration in the U.S. There is evidence that men in Louisiana prisons do not receive adequate healthcare, but little is known about their women counterparts. We aimed to document formerly incarcerated women's experiences with receiving healthcare during incarceration in Louisiana to inform policy and practice change. In partnership with two community-based organisations in New Orleans, Louisiana, between August 2016 and April 2018, we conducted semi-structured 1-hr interviews with 22 formerly incarcerated women who had been incarcerated in the state for at least one consecutive year. A convenience sample of participants was recruited through community-based organisations' re-entry and health programmes. Our interview guide included questions about experiences with accessing care, reproductive health needs, interactions with providers and preventive care during incarceration. We used applied thematic analysis techniques to interpret data. Over 90% of interviewees identified as Black. Their mean age was 50.7. The average length of incarceration was 8.4 years. Participants reported multiple barriers to accessing care including punishment for seeking care, long wait times, costs, lack of respect from providers and health concerns being dismissed. Participants reported limited mental health, preventive and dental services; an insufficient number of providers; and poor health outcomes as a result of delayed care. Overall, women did not have access to adequate, timely care during incarceration. Findings suggest a need for policy changes related to the provision of carceral healthcare services and external oversight of prison conditions and healthcare delivery. Further research into women's experiences of ageing during incarceration and tailored transitional health models is needed.
在全球范围内，女性的监禁率正在上升，在美国，过去四十年来女性监禁率的增长速度是男性的两倍。路易斯安那州的监禁率在美国排名第二。有证据表明，路易斯安那州监狱中的男性没有得到足够的医疗保健，但对于女性情况却知之甚少。我们旨在记录路易斯安那州曾被监禁女性在监禁期间接受医疗保健的经历，以为政策和实践变革提供参考。2016年8月至2018年4月期间，我们与路易斯安那州新奥尔良市的两个社区组织合作，对22名曾被监禁至少连续一年的女性进行了为期1小时的半结构化访谈。通过社区组织的重新融入和健康项目招募了方便样本的参与者。我们的访谈指南包括关于获得护理的经历、生殖健康需求、与提供者的互动以及监禁期间的预防保健等问题。我们使用应用主题分析技术来解释数据。超过90%的受访者为黑人。她们的平均年龄为50.7岁。平均监禁时长为8.4年。参与者报告了获得护理的多重障碍，包括因寻求护理而受到惩罚、等待时间长、费用、得不到提供者的尊重以及健康问题被忽视。参与者报告心理健康、预防和牙科服务有限；提供者数量不足；以及因护理延迟导致健康状况不佳。总体而言，女性在监禁期间无法获得足够、及时的护理。研究结果表明需要对监禁医疗保健服务的提供以及监狱条件和医疗保健提供的外部监督进行政策变革。还需要进一步研究女性在监禁期间的衰老经历以及量身定制的过渡性健康模式。
