Discrimination based on criminal record and healthcare utilization among men recently released from prison: a descriptive study
Healthcare discrimination based on race/ethnicity is associated with decreased healthcare access and utilization among racial/ethnic minority patients. Discrimination based on criminal record may also negatively impact healthcare access and utilization among ex-prisoners.
We conducted a secondary analysis of data from a cross-sectional survey of 172 men recently released from state prison. We examined the association between self-reported criminal record discrimination by healthcare workers and utilization of 1) emergency department (ED) and 2) primary care services. We created staged logistic regression models, adjusting for sociodemographic characteristics and self-reported racial/ethnic discrimination.
Among 172 male participants, 42% reported a history of criminal record discrimination by healthcare workers. Participants who reported discrimination were older (mean, 42 vs. 39 years; p = .01), more likely to be college educated (26% vs. 11%; p = .03), and had more extensive incarceration histories (median years incarcerated, 16 vs. 9; p = .002) compared to those who did not report discrimination. Self-reported criminal record discrimination by healthcare workers was significantly associated with frequent ED utilization [odds ratio (OR) = 2.7, 95% confidence interval 24 (CI) 1.2-6.2] but not infrequent primary care utilization [OR = 1.6, 95% CI 0.7-3.8].
Recently released prisoners report criminal record discrimination by healthcare workers, and this experience may impact healthcare utilization. Future studies should seek to further characterize criminal record discrimination by healthcare workers and prospectively examine its impact on health outcomes.
- Ahalt C, Binswanger IA, Steinman M, Tulsky J, Williams BA: Confined to ignorance: the absence of prisoner information from nationally representative health data sets. Journal of General Internal Medicine 2012,27(2):160–166. CrossRef
- Benatar SR, Upshur RE: Dual loyalty of physicians in the military and in civilian life. American Journal of Public Health 2008,98(12):2161–2167. CrossRef
- Benjamins MR: Race/ethnic discrimination and preventive service utilization in a sample of whites, blacks, Mexicans, and Puerto Ricans. Medical Care 2012,50(10):870–876. CrossRef
- Binswanger I, Krueger P, Steiner J: Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population. Journal of Epidemiology & Community Health 2009,63(11):912–919. CrossRef
- Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG, Koepsell TD: Release from prison–a high risk of death for former inmates. New England Journal of Medicine 2007,356(2):157–165. CrossRef
- Blanchard J, Lurie N: R-E-S-P-E-C-T: patient reports of disrespect in the health care setting and its impact on care. Journal of Family Practice 2004,53(9):721–730.
- Casagrande SS, Gary TL, LaVeist TA, Gaskin DJ, Cooper LA: Perceived discrimination and adherence to medical care in a racially integrated community. Journal of General Internal Medicine 2007,22(3):389–395. CrossRef
- Cooper LA, Roter DL, Carson KA, Beach MC, Sabin JA, Greenwald AG, Inui TS: The associations of clinicians’ implicit attitudes about race with medical visit communication and patient ratings of interpersonal care. American Journal of Public Health 2012,102(5):979–987. CrossRef
- Crawford ND, Ford C, Galea S, Latkin C, Jones KC, Fuller CM: The relationship between perceived discrimination and high-risk social ties among illicit drug users in new york city, 2006–2009. AIDS and Behavior 2013,17(1):419–426. CrossRef
- Cuellar AE, Cheema J: As roughly 700,000 prisoners are released annually, about half will gain health coverage and care under federal laws. Health Affairs (Project Hope) 2012,31(5):931–938. CrossRef
- Glaze LE, Bonczar TP: Probation and Parole in the United States, 2010. Washington, DC: Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice; 2011.
- Guerino P, Harrison PM, Sabol WJ: Prisoners in 2010. Washington, DC: Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice; 2011.
- Hausmann LR, Hannon MJ, Kresevic DM, Hanusa BH, Kwoh CK, Ibrahim SA: Impact of perceived discrimination in healthcare on patient-provider communication. Medical Care 2011,49(7):626–633. CrossRef
- Hausmann LR, Jeong K, Bost JE, Ibrahim SA: Perceived discrimination in health care and use of preventive health services. Journal of General Internal Medicine 2008,23(10):1679–1684. CrossRef
- Kessler RC, Mickelson KD, Williams DR: The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior 1999,40(3):208–230. CrossRef
- Klonoff EA, Landrine H: Cross-validation of the schedule of racist events. Journal of Black Psychology 1999, 25:231–254. CrossRef
- Kressin NR, Raymond KL, Manze M: Perceptions of race/ethnicity-based discrimination: a review of measures and evaluation of their usefulness for the health care setting. Journal of Health Care for the Poor and Underserved 2008,19(3):697–730. CrossRef
- Krieger N: Embodying inequality: a review of concepts, measures, and methods for studying health consequences of discrimination. International Journal of Health Services 1999,29(2):295–352. CrossRef
- Kulkarni SP, Baldwin S, Lightstone AS, Gelberg L, Diamant AL: Is incarceration a contributor to health disparities? Access to care of formerly incarcerated adults. Journal of Community Health 2010,35(3):268–274. CrossRef
- Landrine H, Klonoff EA, Corral I, Fernandez S, Roesch S: Conceptualizing and measuring ethnic discrimination in health research. Journal of Behavioral Medicine 2006,29(1):79–94. CrossRef
- LaVeist TA, Nickerson KJ, Bowie JV: Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Medical Care Research and Review 2000,57(Suppl 1):146–161. CrossRef
- Major B, O’Brien LT: The social psychology of stigma. Annual Review of Psychology 2005, 56:393–421. CrossRef
- Marlow E, White MC, Chesla CA: Barriers and facilitators: parolees’ perceptions of community health care. Journal of Correctional Health Care 2010,16(1):17–26. CrossRef
- Maruschak L, Beavers R: HIV in Prisons, 2007–08. Washington, DC: Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice; 2009.
- Matejkowski J, Harron A, Festinger DS: Opportunities for Information-Sharing Between Criminal Justice And Community Substance Abuse Treatment Systems: Community Oriented Correctional Health Services. 2012. http://www.cochs.org/files/hieconf/OPPORTUNITIES.pdf. Accessed 10 October 2013
- Mellow J, Greifinger RB: Successful reentry: the perspective of private correctional health care providers. Journal of Urban Health 2007,84(1):85–98. doi: 10.1007/s11524–006–9131–9 CrossRef
- Minton TD: Jail Inmates at Midyear 2010 - Statistical Tables. Washington DC: Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice; 2011.
- Newman WJ, Scott CL: Brown v. Plata: Prison Overcrowding in California. J Am Acad Psychiatry Law 2012,40(4):547–552.
- Pager D: The mark of a criminal record. American Journal of Sociology 2003,108(5):937–975. CrossRef
- Pager D, Shepherd H: The sociology of discrimination: racial discrimination in employment, housing, credit, and consumer markets. Annual Review of Sociology 2008, 34:181–209. CrossRef
- Pager D, Western B, Bonikowski B: Discrimination in a low-wage labor market: a field experiment. American Sociological Review 2009,74(5):777–799. CrossRef
- Pager D, Western B, Sugie N: Sequencing disadvantage: barriers to employment facing young black and white men with criminal records. The Annals of the American Academy of Political and Social Science 2009,623(1):195–213. CrossRef
- Paradies Y: A systematic review of empirical research on self-reported racism and health. International Journal of Epidemiology 2006,35(4):888–901. CrossRef
- Patterson EJ: The dose-response of time served in prison on mortality: New York State, 1989–2003. American Journal of Public Health 2013,103(3):523–528. CrossRef
- Pletcher MJ, Kertesz SG, Kohn MA, Gonzales R: Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA 2008,299(1):70–78. CrossRef
- Schnittker J, John A: Enduring stigma: the long-term effects of incarceration on health. Journal of Health and Social Behavior 2007,48(2):115–130. CrossRef
- Shavers VL, Fagan P, Jones D, Klein WM, Boyington J, Moten C, Rorie E: The state of research on racial/ethnic discrimination in the receipt of health care. American Journal of Public Health 2012,102(5):953–966. doi:10.2105/AJPH.2012.300773 CrossRef
- Smedley BD, Stith AY, Nelson AR: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Edited by: N. A. Press. Washington, D.C: Institute of Medicine; 2003.
- Pew Center on the States: One in 31: The Long Reach of American Corrections. Washington, DC: The Pew Charitable Trusts; 2009.
- Trivedi AN, Ayanian JZ: Perceived discrimination and use of preventive health services. Journal of General Internal Medicine 2006,21(6):553–558. CrossRef
- Uggen C, Manza J: Democratic contraction? Political consequences of felon disenfranchisement in the United States. American Sociological Review 2002, 67:777–803. CrossRef
- Uggen C, Manza J, Behrens A (Eds): Less than the Average Citizen: Stigma, Role Transition, and the Civic Reintegration of Convicted Felons. Cullompton, England: Willan Publishing; 2004.
- Van Houtven CH, Voils CI, Oddone EZ, Weinfurt KP, Friedman JY, Schulman KA, Bosworth HB: Perceived discrimination and reported delay of pharmacy prescriptions and medical tests. Journal of General Internal Medicine 2005,20(7):578–583. CrossRef
- Wang EA, Wang Y, Krumholz HM: A high risk of hospitalization following release from correctional facilities in Medicare beneficiaries: a retrospective matched cohort study, 2002 to 2010. JAMA Internal Medicine 2013,173(17):1621–1628. CrossRef
- Williams DR, Mohammed SA: Discrimination and racial disparities in health: evidence and needed research. Journal of Behavioral Medicine 2009,32(1):20–47. CrossRef
- Wilper AP, Woolhandler S, Boyd JW, Lasser KE, McCormick D, Bor DH, Himmelstein DU: The health and health care of US prisoners: results of a nationwide survey. American Journal of Public Health 2009,99(4):666–672. CrossRef
- Young M, Stuber J, Ahern J, Galea S: Interpersonal discrimination and the health of illicit drug users. American Journal of Drug and Alcohol Abuse 2005,31(3):371–391. CrossRef
- Discrimination based on criminal record and healthcare utilization among men recently released from prison: a descriptive study
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Health & Justice
- Online Date
- March 2014
- Online ISSN
- Springer Berlin Heidelberg
- Additional Links
- Author Affiliations
- 1. Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, US
- 2. Denver Veterans Affairs Medical Center, Denver, CO, USA
- 3. Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
- 4. Department of Sociology, University of Washington, Seattle, WA, USA
- 5. Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- 6. Urban Health Program, RTI International, San Francisco, CA, USA