Uplifting the Social Determinants of Health of Adults Exiting Carceral Settings May Aid Health Care Access.

Victoria D Ojeda, Sarah Hiller-Venegas, Silvia Castillo, Gustavo Vega, Arthur Groneman, Jerrica Barksdale, Rosalinda Rodriguez, Angela R Bazzi, Tommi Gaines, Zephon Lister, Todd Gilmer
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Abstract

This article investigates health care access (i.e., health insurance coverage, usual source of care, doctor visit) among adults exiting carceral settings. Between 2022 and 2024, adults aged 18 and over (N = 202) enrolled in two health studies in San Diego, California. Surveys collected demographic and health care access data. Logistic regression models assessed factors independently associated with health care access. Overall, 27% of participants were uninsured, 66% had Medicaid insurance, and 21% lacked a usual place of care. In logistic regression models, adults released from custody within 6 months or who had high school or fewer years of education were significantly less likely to be insured. Increasing age and high school or fewer years of education, one to two chronic conditions, or a positive anxiety screener were significantly associated with having a usual source of care, whereas those recently returned to communities were less likely to have a usual source of care. Reliable transportation was significantly associated with a doctor visit in the past 6 months. Coordinated interventions are needed to bolster the social determinants of health among adults who have experienced incarceration; particularly education, employment, and transportation. Policy interventions (e.g., Medicaid expansion), expansive community outreach, and transportation supports for low-income or underemployed adults can address financial and logistical barriers to health care access.

提高成人离开拘留所后健康的社会决定因素可能有助于获得医疗保健。
本文调查了离开收容所的成年人获得医疗保健的机会(即,医疗保险覆盖范围、通常的护理来源、医生访问)。2022年至2024年间,18岁及以上的成年人(N = 202)参加了加州圣地亚哥的两项健康研究。调查收集了人口统计和保健获取数据。Logistic回归模型评估了与卫生保健获取相关的独立因素。总体而言,27%的参与者没有医疗保险,66%有医疗补助保险,21%缺乏常规护理场所。在逻辑回归模型中,6个月内从拘留所释放的成年人或受过高中或更少教育的成年人投保的可能性显著降低。年龄增加,高中或更少的教育年限,一到两种慢性疾病,或积极的焦虑筛查与通常的护理来源显著相关,而那些最近返回社区的人不太可能有通常的护理来源。在过去6个月内,可靠的交通工具与医生就诊显著相关。需要采取协调的干预措施,加强有过监禁经历的成年人健康的社会决定因素;特别是教育、就业和交通。政策干预(例如,扩大医疗补助计划)、扩大社区外展以及为低收入或就业不足的成年人提供交通支持可以解决获得医疗保健的财务和后勤障碍。
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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