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Health Conditions and Treatment Utilization Among Older Male Veterans Incarcerated in Prisons

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Abstract

Background

More than 50,000 older male veterans incarcerated in prisons are expected to return to their communities and utilize the Veterans Health Administration (VHA) and community healthcare systems. To support the continuity of healthcare and overall successful community reentry of older incarcerated veterans, an understanding of their health profiles and treatment utilization while in correctional care is needed.

Objective

To assess the health status of older male veterans incarcerated in state prisons and explore demographic, military, and VHA-related factors associated with medical conditions, disabilities, behavioral conditions, and medical and behavioral treatment utilization.

Design/Participants

Cross-sectional observational study of 880 male veterans aged 50 + incarcerated in state prisons using data from the 2016 Bureau of Justice Statistics Survey of Prison Inmates.

Main Measures

Veteran status, self-report health status, and treatment utilization since prison admission. Prevalence rates for conditions and treatment utilization were calculated. Logistic regression models were used to examine the association of characteristics with conditions and treatment utilization.

Key Results

Among the 880 older male veterans in state prisons, the majority reported having a current medical condition (79.3%) or disability (61.6%), almost half had history of a mental health condition (44.5%), and more than a quarter (29%) had a substance use disorder. Compared to White veterans, Black veterans were less likely to report a disability or mental health condition. Few demographic, military, and VA-related characteristics were associated with medical or behavioral conditions or treatment utilization.

Conclusion

Our results suggest that the VHA and community healthcare systems need to be prepared to address medical and disability conditions among the majority of older male veterans who will be leaving prison and returning to their communities. Integrated medical and behavioral healthcare delivery models may be especially important for these veterans as many did not receive behavioral health treatment while in prison.

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Funding

Research reported in this publication was supported by the National Institute on Aging (R24AG065175), National Institute on Drug Abuse (K23DA043651), and the Department of Veterans Affairs Health Services Research & Development (IIR 20–040 and RCS 00–001). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Department of Veterans Affairs (VA), or the US government. NIH and the VA had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

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Authors and Affiliations

  1. Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Rd (152-MPD), Menlo Park, CA, 94025, USA

    Lance Washington MA, Christine Timko PhD, Jessica Blue-Howells MSW & Andrea K. Finlay PhD

  2. Abt Associates, Rockville, MD, USA

    Jennifer Bronson PhD

  3. Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, San Diego, USA

    Benjamin Han MD

  4. Veterans Affairs San Diego Healthcare System, San Diego, USA

    Benjamin Han MD

  5. National Center On Homelessness Among Veterans, Veterans Health Administration, Menlo Park, CA, USA

    Andrea K. Finlay PhD

Authors
  1. Lance Washington MA
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Correspondence to Lance Washington MA.

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Washington, L., Bronson, J., Timko, C. et al. Health Conditions and Treatment Utilization Among Older Male Veterans Incarcerated in Prisons. J GEN INTERN MED (2024). https://doi.org/10.1007/s11606-023-08587-5

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