Incarceration and Relative Poverty in Cross-National Perspective: The Moderating Roles of Female Employment and the Welfare State

Inside Out: Change Through Art

Background: Over the past three decades, there has been a 900% increase in the number of women experiencing incarceration in Minnesota. We wished to test whether handwriting, as creative visual art expression for women in jail, would be a positive experience for them as well as for individuals viewing the artwork during expositions. Methods: Over a 2-year period, the principal artist invited women residents from four separate county jails in Minnesota, to handwrite their thoughts on a sheet of paper. Two hundred twenty-three women residents participated in the artist-led handwriting/visual art sessions and gave permission to use their authentic script, anonymously, for presentation in a 3-D visual art form. At the conclusion of the sessions, a survey was offered at each venue, which asked three questions relative to the participation in the handwriting art project: (1) Did it have a positive impact on me? (2) Would you recommend it to other women who are incarcerated? (3) Do you want to participate in more projects such as this during your incarceration? The resulting artwork of more than 1,000 sculptures, each exhibiting a portion of the women's original script, was displayed at several public showings and a survey was offered at each venue, which asked: (1) Did the exhibition increase awareness of mass incarceration of women? (2) Did it help the viewer see women who are incarcerated? (3) Did it make the viewer realize that action is needed to reduce incarceration of women? Survey questions were graded from 1 to 5, with a sliding scale from strongly disagree to strongly agree. Results: The impact of this project of art activism has been very positive on both participants and the larger audience. The vast majority of women residents responding to the survey either agreed or strongly agreed that their participation in the project (1) had a positive effect on them (94%), (2) would recommend it to other incarcerated women (94%), and (3) would want to participate in more projects such as this (93%). A total of 425 surveys were collected among the audience at several sites: the law school (N = 87), open studios (N = 268), and a public library (N = 62). The vast majority of individuals responding to the survey either agreed or strongly agreed that the exhibited work (1) increased awareness of the problem (93%), (2) showed the humanity behind the script (88%), and (3) suggested that interventions were needed to address the problem (86%). Conclusions: Women under incarceration in county jails, who participated in a visual art handwriting program, as part of a collaborative visual art project led by principal artist, found great value in the sessions and agreed that such programs should be available to other women in detention. The overwhelming majority of the audience of the resulting exhibitions in public venues strongly agreed that interventions are needed to address the mass incarceration of women in Minnesota, suggesting the importance of art as a vehicle for increasing awareness about social problems and perhaps social change.

The Effect of Health Insurance on Health Care Utilization in the Justice-Involved Population: United States, 2014-2016

Objectives. To examine the impact of health insurance coverage on utilization of outpatient, hospital, and emergency department care among justice-involved individuals in the United States.Methods. We performed repeated cross-sectional analyses with data from the National Survey of Drug Use and Health. The study population included 6086 adults with justice involvement within the past year. We used logistic regression to examine the odds of health care utilization based on either a dichotomous or categorical measure of health insurance coverage. We used negative binomial regression to examine the number of times a specific type of care was utilized with both a dichotomous measure of health insurance coverage and a categorical measure of type of health insurance.Results. Health insurance was associated with increased utilization of outpatient, inpatient, and emergency department care.Conclusions. Health insurance coverage was associated with increased utilization of outpatient, inpatient, and emergency department health care among justice-involved individuals. Therefore, expanding access to health insurance in this population has the potential to increase care utilization of all types and decrease barriers to medical services.