Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.3567 Dr. Emily Lupton Lupez et al.
Points
- A 2023 study analyzing data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates found significant healthcare access issues among the U.S. prison population, with increased chronic physical and mental health conditions since 2004.
- The study revealed that 61.7% of prisoners reported having one or more chronic physical conditions, and 40.1% reported a history of mental health issues, both up from previous years.
- A substantial portion of prisoners with health conditions received no treatment, with 13.8% of those with physical conditions and 33.0% of those with mental health conditions not seeing a clinician since incarceration.
- The study highlighted that 41.7% of prisoners experiencing severe psychological distress did not receive any mental health treatment.
- Higher co-payment requirements in prisons were associated with reduced healthcare access, with those in facilities requiring co-payments exceeding one week’s wage being significantly less likely to receive necessary healthcare visits.
Summary
In a comprehensive cross-sectional study analyzing data from the Bureau of Justice Statistics 2016 Survey of Prison Inmates, researchers sought to evaluate the health status, healthcare access, and co-payments impact on healthcare utilization among the incarcerated population in the United States. This study, conducted in October 2023, examined a nationally representative sample of adults housed in state or federal prisons, comparing specific metrics with data from 2004. The primary focus was on individuals with health problems or pregnancy, assessing their access to health services about the co-payment requirements of their respective prisons.
The results highlighted significant healthcare access issues among the prison population, with a reported increase in chronic physical and mental health conditions compared to data from 2004. Of the 1,421,700 prisoners surveyed in 2016, 61.7% reported having one or more chronic physical conditions—an increase from 55.9% in 2004. Furthermore, 40.1% indicated a history of mental health issues, up from 24.5% in the previous survey. Notably, a large portion of these individuals received no treatment, with 13.8% of those with physical conditions and 33.0% with mental health conditions not seeing a clinician since incarceration. The situation was dire for those experiencing severe psychological distress, as 41.7% received no mental health treatment.
The association between co-payments and access to care was pronounced, revealing that higher co-payment requirements correlated with reduced healthcare access. In prisons where co-payments exceeded one week’s wage, the adjusted odds ratio (aOR) for not receiving a needed healthcare visit was significantly higher at 2.17 (95% CI, 1.61-2.93), compared to facilities with lower or no co-payments. These findings underscore the potential barriers that financial costs within prison systems pose to accessing essential healthcare services, suggesting a need for policy reconsideration to ensure that incarcerated individuals receive adequate care, aligning with their constitutional rights.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2821730
References Lupez, E. L., Woolhandler, S., Himmelstein, D. U., Hawks, L., Dickman, S., Gaffney, A., Bor, D., Schrier, E., Cai, C., Azaroff, L. S., & McCormick, D. (2024). Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.3567
