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Abstract
Introduction Incarcerated individuals experience increased health problems, presenting additional challenges as they leave prison and re-enter the community. These challenges are disproportionally experienced by racial and ethnic minorities. Despite these trends, little is known regarding the availability of medical services within the communities to which incarcerated individuals return.
Methods We examined all prison returns in the state of Florida between 2008 and 2017. We examined the odds of returning from prison to a community that is formally designated as medically underserved by the Health Resources and Services Administration. We also examined whether Florida communities with a greater proportion of racial and ethnic minority returns were more likely to be designated as medically underserved.
Results Overall, each SD increase in community return rate resulted in a 20% increase in the odds of medical underservice designation. For each SD increase in the proportion of black and Latino returns, the odds of medical underservice designation increased by 50% and 14%, respectively, compared with the proportion of white returns.
Discussion Within Florida, previously incarcerated individuals are more likely to return to communities with limited availability of medical services. These findings are even more pronounced for communities with more black returnees. Previously incarcerated individuals are more likely to return to communities that lack the medical infrastructure required to address their unique healthcare needs, potentially leading to worsened health, and increased racial and ethnic health disparities.
- ETHNIC GROUPS
- HEALTHCARE DISPARITIES
- PRIMARY HEALTH CARE
- PUBLIC HEALTH
- SOCIAL SCIENCES
Data availability statement
Data are available in a public, open access repository. Anonymised replication data and code used to estimate statistical models have been deposited in the Harvard Dataverse (https://doi.org/10.7910/DVN/TT2BP1). Due to the sensitive nature of the data from the Florida Department of Corrections, anonymised replication data are provided. More specifically, in order to protect the personal information and identities of the individual releasees included in this study, any identifying information that discloses individual addresses, identities, or the specific Census tracts they returned to was removed. For replication purposes, Census tract IDs were replaced with pseudo-IDs that prevent the identification of specific tracts but still allow for the replication of all estimated statistical models. All relevant syntax files used to run all estimated models are provided.
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Data availability statement
Data are available in a public, open access repository. Anonymised replication data and code used to estimate statistical models have been deposited in the Harvard Dataverse (https://doi.org/10.7910/DVN/TT2BP1). Due to the sensitive nature of the data from the Florida Department of Corrections, anonymised replication data are provided. More specifically, in order to protect the personal information and identities of the individual releasees included in this study, any identifying information that discloses individual addresses, identities, or the specific Census tracts they returned to was removed. For replication purposes, Census tract IDs were replaced with pseudo-IDs that prevent the identification of specific tracts but still allow for the replication of all estimated statistical models. All relevant syntax files used to run all estimated models are provided.
Footnotes
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Contributors JAS, Y-AK, TD and SES designed the research; JAS and Y-AK prepared the data for analysis; JAS and Y-AK analysed the data; TD and SES substantially contributed to the operationalisation of key study measures; JAS wrote the manuscript; Y-AK, TD and SES provided extensive edits to the paper and provided key insights into the framing and presentation of primary findings; JAS oversaw all stages of research including design, data preparation, analysis, writing of the the manuscript, and presentation of the findings and is the guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Competing interests None declared.
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