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Chan PY, Kaba F, Lim S, Katyal M, MacDonald R. Identifying demographic and health profiles of young adults with frequent jail incarceration in New York City during 2011-2017. Ann Epidemiol 2020; 46:41-48.e1. [PMID: 32451196 DOI: 10.1016/j.annepidem.2020.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/21/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to investigate incarceration patterns among young adults in New York City jails from mid-2011 through 2017, with an aim that identification of frequently incarcerated young "hot spotters" may inform early interventions. METHODS We examined electronic health records for 3114 individuals with no known prior jail admission and admitted within 4.5 years after turning age 18 years. We used group-based trajectory analysis to identify hot spotters and compared their characteristics with those of other trajectory groups. We repeated the analysis for three older adult groups for additional comparison. RESULTS Five percent of the young individuals became hot spotters (mean = 7.7 incarcerations). They were more likely to be homeless (27.1% vs. 7.2%-16.4% in other trajectory groups), have substance use disorders (95.2% vs. 73.2%-89.8%), and mental health needs (65.7% vs. 28.5%-53.3%), and be incarcerated for theft-related charges (52.7% vs. 32.0%-49.6%) and misdemeanors (34.8 vs. 25.5%-29.4%). They differed in charge profile and homelessness compared with older hot spotters. CONCLUSIONS Some young adults are at risk of frequent incarceration. Tailored health- and behavior-related interventions may preclude cyclical incarceration and address barriers to well-being and stability.
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Affiliation(s)
- Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY.
| | - Fatos Kaba
- Correctional Health Services, New York City Health + Hospitals, New York, NY
| | - Sungwoo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY
| | - Monica Katyal
- Correctional Health Services, New York City Health + Hospitals, New York, NY
| | - Ross MacDonald
- Correctional Health Services, New York City Health + Hospitals, New York, NY
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Martin RA, Couture R, Tasker N, Carter C, Copeland DM, Kibler M, Whittle JS. Emergency medical care of incarcerated patients: Opportunities for improvement and cost savings. PLoS One 2020; 15:e0232243. [PMID: 32339213 PMCID: PMC7185724 DOI: 10.1371/journal.pone.0232243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 04/11/2020] [Indexed: 11/18/2022] Open
Abstract
In the United States (US), the lifetime incidence of incarceration is 6.6%, exceeding that of any other nation. Compared to the general US population, incarcerated individuals are disproportionally affected by chronic health conditions, mental illness, and substance use disorders. Barriers to accessing medical care are common in correctional facilities. We sought to characterize the local incarcerated patient population and explore barriers to medical care in these patients. We conducted a retrospective, observational cohort study by reviewing the medical records of incarcerated patients presenting to the adult emergency department (ED) of a single academic, tertiary care facility with medical or psychiatric (med/psych) and trauma-related emergencies between January 2012 and December 2014. Data on demographics, medical complexity, trauma intentionality, and barriers to medical care were analyzed using descriptive statistics, unpaired student’s t-test or one-way analysis of variance for continuous variables, and chi-square analysis or Fisher’s exact test as appropriate. Trauma patients were younger with fewer medical comorbidities and were less likely to be admitted to the hospital than med/psych patients. 47.8% of injuries resulted from violence or were self-inflicted. Most trauma-related complaints were managed by the emergency medicine physician in the ED. While barriers to medical care were not correlated with hospital admission, 5.4% of med/psych and 2.9% of trauma patients reported barriers as a contributing factor to the ED encounter. Med/psych patients commonly reported a lack of access to medications, while trauma patients reported a delay in medical care. Trauma-related presentations were less medically complex than med/psych-related complaints. Medical management of most injuries required no hospital resources outside of the ED, indicating a potential role for outpatient management of trauma-related complaints. Additional opportunities for health care improvement and cost savings include the implementation of programs that target violence, prevent injuries, and promote the continuity of medical care while incarcerated.
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Affiliation(s)
- Rebecca A. Martin
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
- * E-mail:
| | - Rosanna Couture
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
| | - Nicole Tasker
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
| | - Christine Carter
- The University of Tennessee College of Medicine, Memphis, Tennessee, United States of America
| | - David M. Copeland
- The University of Tennessee College of Medicine, Memphis, Tennessee, United States of America
| | - Mary Kibler
- Erlanger Health System, Chattanooga, Tennessee, United States of America
| | - Jessica S. Whittle
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
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