Health status and health-care utilization among men recently released from a superjail: a matched prospective cohort study

• Date: 05 September 2023
• Pages: 709-723
• DOI: https://doi.org/10.1108/IJPH-01-2023-0004
• Published date: 05 September 2023
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Flora I. Matheson,Arthur McLuhan,Ruth Croxford,Tara Hahmann,Max Ferguson,Cilia Mejia-Lancheros

Health status and health-care utilization

among men recently released from a

superjail: a matched prospective

cohort study

Flora I. Matheson, Arthur McLuhan, Ruth Croxford, Tara Hahmann, Max Ferguson and

Cilia Mejia-Lancheros

Abstract

Purpose –Continuity of care and access to primary care have been identified as important contributors to

improved health outcomes and reduced reincarceration among people who are justice-involved. While the

disproportionate burden of health concerns amongincarcerated populations is well documented, less is known

about their health service utilization, limiting the potential for effective improvements to current policy and

practice. This study aims to examine health status and health care utilization among men recently releasedfrom

a superjail in a large metropolitan area to betterunderstand patterns of use, risk factors and facilitators.

Design/methodology/approach –Participants included adult men (n ¼106) matched to a general

population group (n ¼530) in Ontario, Canada, linked to medical records (88 .5% linkage) to examine

baseline health status and health utilization three-months post-release. The authors compared differences

between the groups in baseline health conditions and es timated the risk of emergency department, primary

care, inpatient hospitalization and specialist amb ulatory care visits.

Findings –Superjail participantshad a significantly higher prevalence of respiratoryconditions, mental

illness, substance useand injuries. Substance use was a significant risk factorfor all types of visits and

emergencydepartment visits were over three timeshigher among superjail participants.

Originality/value –This empiricalcase is illustrative of an emerging phenomenonin some regions of the

world where emergency departments serve as de facto ‘‘walk-in clinics’’ for those with criminal justice

involvement.Strategic approaches to health services are requiredto meet the complex social and health

needs and disparitiesin access to care experienced by men released from custody.

Keywords Health status, Health service utilization, Prison/superjail, Criminal justice,

Emergency medical care, Men

Paper type Research paper

Introduction

Across a range of indicators –physical and mental illness, substance use, communicable

and infectious illnesses, traumatic brain injury and developmental disabilities –the health

status of incarcerated individuals worldwide is poor relative to the general population

(O’Rourke et al., 2016;Matheson et al.,2020;Fazel and Baillargeon, 2011;Kouyoumdjian

et al., 2016;Wilper et al.,2009;Baquero et al.,2020;Allely, 2016;Fazel et al.,2016;

Sepehrmanesh et al., 2014). While thereis little research focusing on the health of men who

experience incarceration in Canada, emerging evidence suggests a similar set of health

challenges (Kouyoumdjian et al., 2016;Kouyoumdjian et al.,2019;Kouyoumdjian et al.,

2018a,2018b;Kouyoumdjian et al., 2020;Baumann et al.,2019;Matheson et al.,2020;

Macleod et al.,2021;McIsaac et al., 2016a,2016b).

(Informationabout the

authorscan be found at the

end of this article.)

Received 16 January 2023

Revised 20 March 2023

29 June 2023

Accepted 19 July 2023

Ontario Trillium Foundation

LP95856.

DOI 10.1108/IJPH-01-2023-0004 VOL. 19 NO. 4 2023,pp. 709-723, ©Emerald Publishing Limited,ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 709