Chronic Disease Burden and Healthcare Utilization by Gender Among US Adults with Lifetime Criminal Legal Involvement.

IF 4.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Journal of General Internal Medicine Pub Date : 2025-04-01 Epub Date: 2025-02-10 DOI:10.1007/s11606-025-09416-7
Amelia Papadimitriou, Laura Hawks, Joni S Williams, Leonard E Egede
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引用次数: 0

Abstract

Background: Criminal legal involvement (CLI) has been associated with increased burden of disease, worse health outcomes, and high healthcare utilization. The health needs of women with CLI are often overlooked despite the rising proportion of women in the US legal system.

Objective: Examine differences by binary gender in the prevalence of disease and healthcare utilization among individuals with lifetime CLI.

Design/setting: Cross-sectional nationally representative multivariate logistic regression and negative binomial regression.

Participants: Adult respondents with lifetime CLI (N = 37,279) with response rate of 66-69%.

Measures: The primary independent variable was binary gender (woman/man). Outcomes included medical conditions, substance use disorders, mental illness, and healthcare utilization. Covariates included sociodemographic confounders.

Results: Women comprised 29.1% of respondents with lifetime CLI and reported 0.83 times the odds of chronic heart disease compared to men (95%CI 0.74, 0.92; p = 0.001), but 1.86 times the odds of COPD (95%CI 1.63, 2.13; p < 0.001), 1.78 times the odds of asthma (95%CI 1.63, 1.93; p < 0.001), and 1.30 times the odds of cancer (95%CI 1.08, 1.53; p = 0.005). While women were less likely to have a substance use disorder (OR 0.84; 95%CI 0.78, 0.90), they were more likely to currently smoke (OR 1.29, 95%CI 1.20, 1.28; p < 0.001) and to have any mental illness (OR 2.45; 95%CI 2.26, 2.63; p < 0.001). Women reported increased rates of all forms of healthcare utilization compared to men after adjustments.

Conclusions: Women with lifetime CLI experience a different profile of diseases compared to men with increased prevalence of any mental illness and chronic disease, especially respiratory diseases. They also had higher rates of healthcare utilization. Additional research should focus on interventions tailored to the unique needs of this population.

慢性疾病负担和医疗保健利用在美国成人终身刑事法律参与的性别。
背景:刑事法律介入(CLI)与疾病负担增加、健康结果恶化和医疗保健利用率高有关。尽管女性在美国法律体系中的比例不断上升,但患有CLI的女性的健康需求往往被忽视。目的:探讨终身CLI患者在疾病患病率和医疗保健利用方面的性别差异。设计/设置:具有全国代表性的横断面多元逻辑回归和负二项回归。参与者:终身CLI的成年受访者(N = 37279),应答率为66-69%。测量方法:主要自变量为二元性别(女/男)。结果包括医疗状况、物质使用障碍、精神疾病和医疗保健利用。协变量包括社会人口学混杂因素。结果:女性占终身CLI应答者的29.1%,报告慢性心脏病的几率是男性的0.83倍(95%CI 0.74, 0.92;p = 0.001),但患COPD的几率是前者的1.86倍(95%CI 1.63, 2.13;p结论:与男性相比,患有终身CLI的女性经历了不同的疾病概况,任何精神疾病和慢性疾病,特别是呼吸系统疾病的患病率都有所增加。他们的医疗保健使用率也较高。进一步的研究应侧重于针对这一人群的独特需求量身定制的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of General Internal Medicine
Journal of General Internal Medicine 医学-医学:内科
CiteScore
7.70
自引率
5.30%
发文量
749
审稿时长
3-6 weeks
期刊介绍: The Journal of General Internal Medicine is the official journal of the Society of General Internal Medicine. It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine. Its articles focus on topics such as clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and numerous other non-traditional themes, in addition to classic clinical research on problems in internal medicine.
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