Is Incarceration a Contributor to Health Disparities?

Access to Care of Formerly Incarcerated Adults

This article examines the relationship between a history of incarceration and access to medical care. The United States releases more than 600,000 ex-offenders from state and federal prisons each year. Inmates have a higher burden of chronic disease than the general public and face disruptions in health care both during and after incarceration. However, little is known about ex-offenders access to and use of medical care after release compared to the general population.

The study took place in Los Angeles County, which has the largest population of former prisoners of any area in the United States. The authors analyzed data from 985 adults interviewed in the 2007 Los Angeles Country Health Survey (LACHS). LACHS is a telephone survey conducted in six languages with an 18 percent response rate.

Key Findings:

  • Ten percent of the survey population had a history of incarceration. Rates of previous incarceration were much higher for men. There was not a statistically significant difference in incarceration rates between White, Black and Latino respondents.
  • There were no statistically significant differences between ex-offenders and the general population in rates of health insurance, self-reported difficulty in accessing health care, or self-reported health status.
  • Ex-offenders were three times as likely to report not receiving medical care because of concerns about cost. They were also significantly less likely to receive dental care than the general public.

This research suggests that previously incarcerated people may experience health disparities based on the cost of health care, though several measures of health access were not statistically different for this population. Programs designed to improve the health of communities with large formerly incarcerated populations may want increase efforts to enable access to care for ex-offenders.