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Bundy H. "Don't fuss at our staff": A moral economy of volunteerism in South Carolina safety net clinics. Soc Sci Med 2024; 347:116706. [PMID: 38489962 DOI: 10.1016/j.socscimed.2024.116706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 03/17/2024]
Abstract
In South Carolina, a state that has foregone Medicaid expansion, working poor residents often rely on safety net clinics for medical care. This care often occurs far from major hospitals, in different, inferior, spaces where limited services are provided in lesser circumstances. The temporary and conditional aid provided in these clinics is meant as a last resort, but often serves as the only source of care for many working poor patients, who must manage the effects of sustained precarity and protracted immiseration with conditional aid provided by volunteers. Here I explore the function that volunteering plays in regulating patients' utilization, and ability to contest, the quality of safety net care. Using ethnographic examples and interview data I show how the needs of patients-referred to in the clinics as "clients"-are managed and contained by a moral economy of volunteer care. These reciprocal obligations of debt and duty preclude working poor patients from making demands of, or lodging complaints against, the free clinics' staff, due to their capacity as volunteers, and leaves the state's safety net effectively unassailable to accusations of inefficacy or neglect. Consequently, patients must defer care, ignore episodes of maltreatment, and ration and share prescription medications, lest they be considered recusant or deemed not sufficiently appreciative of the volunteer staff dedicating their time to them. As a result of this moral economy, the plight of the state's uninsured working poor residents goes under-recognized as the safety net absorbs their cases, hiding the attritional nature of the ostensibly free care they receive and ration.
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Affiliation(s)
- Henry Bundy
- Department of Social Sciences and Health Policy, Wake Forest University, 475 Vine Street, Winston-Salem, NC, 27101, USA.
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2
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Engelberg RS, Scheidell JD, Islam N, Thorpe L, Khan MR. Associations Between Incarceration History and Risk of Hypertension and Hyperglycemia: Consideration of Differences among Black, Hispanic, Asian and White Subgroups. J Gen Intern Med 2024; 39:5-12. [PMID: 37507551 PMCID: PMC10817868 DOI: 10.1007/s11606-023-08327-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Studies have shown that adults with a history of incarceration have elevated cardiovascular (CVD) risk. Research on racial/ethnic group differences in the association between incarceration and CVD risk factors of hypertension and hyperglycemia is limited. OBJECTIVE To assess racial/ethnic group differences in the association between incarceration and hypertension and hyperglycemia. DESIGN We performed a secondary data analysis using the National Longitudinal Survey of Adolescent to Adult Health (Add Health). Using modified Poisson regression, we estimated the associations between lifetime history of incarceration reported during early adulthood with hypertension and hyperglycemia outcomes measured in mid-adulthood, including incident diagnosis. We evaluated whether associations varied by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Asian). PARTICIPANTS The analytic sample included 4,015 Add Health respondents who self-identified as non-Hispanic White, Non-Hispanic Black, Hispanic, and Asian, and provided incarceration history and outcome data. MAIN MEASURES Outcome measures included (1) hypertension (2) systolic blood pressure ≥ 130 mmHg, and (3) hyperglycemia. KEY RESULTS In non-Hispanic Black and non-Hispanic White participants, there was not evidence of an association between incarceration and measured health outcomes. Among Hispanic participants, incarceration was associated with hyperglycemia (Adjusted Risk Ratio (ARR): 2.1, 95% Confidence Interval (CI): 1.1-3.7), but not with hypertension risk. Incarceration was associated with elevated systolic blood pressure (ARR: 3.1, CI: 1.2-8.5) and hypertension (ARR: 1.7, CI: 1.0-2.8, p = 0.03) among Asian participants, but not with hyperglycemia risk. Incarceration was associated with incident hypertension (ARR 2.5, CI 1.2-5.3) among Asian subgroups. CONCLUSIONS Our findings add to a growing body of evidence suggesting that incarceration may be linked to chronic disease outcomes. Race/ethnic-specific results, while limited by small sample size, highlight the need for long-term studies on incarceration's influence among distinct US groups.
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Affiliation(s)
- Rachel S Engelberg
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
- Division of General Internal Medicine, NYU Grossman School of Medicine, New York, NY, USA.
| | - Joy D Scheidell
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Nadia Islam
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lorna Thorpe
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Maria R Khan
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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3
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Ventriglio A, Bhugra D. Neoliberal capitalism policies and mental health. Int J Soc Psychiatry 2023; 69:1301-1302. [PMID: 37750397 DOI: 10.1177/00207640231200545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
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4
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Abstract
Rates of mental illness have increased dramatically over the past 15 years in the United States [Products-Data Briefs-Number 283-August 2017. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db283.htm . Published August 15, 2017]. Additionally, life expectancy has fallen over the past several years due to increases in death from suicide, opioid overdose, and alcoholic liver cirrhosis as reported by Case and Deaton [Deaths of despair and the future of capitalism. Princeton University Press, 2020]. Over the last decade some have questioned whether these changes are due to neoliberal capitalist policies and ideologies. Neoliberal capitalism incorporates theories of eliminating all restrictions on the market and decreasing government assistance programs as reported by Harvey [A brief history of neoliberalism, Oxford University Press, 2005]. Since then these policies have led to income inequality, disempowerment of workers, outsourcing of manufacturing jobs, inadequate social services, mass incarceration and an expensive and ineffective healthcare system as reported by Case and Deaton [Deaths of despair and the future of capitalism. Princeton University Press, 2020] and Nkansah-Amankra et al. [International Journal of Health Services 43(2):217-240, 2013]. Studies have shown that the consequences of these policies and ideologies likely have a role in increasing rates of mental illness. This paper will discuss how these factors increase mental distress and postulate ways that mental health professionals can advocate for change.
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Affiliation(s)
- Anna Zeira
- University of Maryland/Sheppard Pratt Residency Psychiatry Program, 701 W Pratt Street, Baltimore, MD, 21201, USA.
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5
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Zeira A. Mental Health Challenges Related to Neoliberal Capitalism in the United States. Community Ment Health J 2022; 58:205-212. [PMID: 34032963 PMCID: PMC8145185 DOI: 10.1007/s10597-021-00840-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/14/2021] [Indexed: 11/29/2022]
Abstract
Rates of mental illness have increased dramatically over the past 15 years in the United States [Products-Data Briefs-Number 283-August 2017. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db283.htm . Published August 15, 2017]. Additionally, life expectancy has fallen over the past several years due to increases in death from suicide, opioid overdose, and alcoholic liver cirrhosis as reported by Case and Deaton [Deaths of despair and the future of capitalism. Princeton University Press, 2020]. Over the last decade some have questioned whether these changes are due to neoliberal capitalist policies and ideologies. Neoliberal capitalism incorporates theories of eliminating all restrictions on the market and decreasing government assistance programs as reported by Harvey [A brief history of neoliberalism, Oxford University Press, 2005]. Since then these policies have led to income inequality, disempowerment of workers, outsourcing of manufacturing jobs, inadequate social services, mass incarceration and an expensive and ineffective healthcare system as reported by Case and Deaton [Deaths of despair and the future of capitalism. Princeton University Press, 2020] and Nkansah-Amankra et al. [International Journal of Health Services 43(2):217-240, 2013]. Studies have shown that the consequences of these policies and ideologies likely have a role in increasing rates of mental illness. This paper will discuss how these factors increase mental distress and postulate ways that mental health professionals can advocate for change.
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Affiliation(s)
- Anna Zeira
- University of Maryland/Sheppard Pratt Residency Psychiatry Program, 701 W Pratt Street, Baltimore, MD, 21201, USA.
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6
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Jagannathan S, Rai R. The necropolitics of neoliberal state response to the Covid-19 pandemic in India. ORGANIZATION 2021. [DOI: 10.1177/13505084211020195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We draw from the experience of the Covid-19 pandemic in India to outline that the neoliberal consolidation of the state is enabled by precariousness, violence, and inequality in overlapping planes of marginality. The pandemic showed the abysmal state of public health institutions in India as people experienced an erosion of dignity in both life and death. The harsh and sudden lockdown announced by the Indian state rendered workers jobless, hungry, exhausted, and on the borders of death. Instead of providing social security to workers, the state embarked on a neoliberal agenda of deregulation, weakening job security, and collective bargaining legislation. The state enacted a violent discourse of Hindu nationalism to blame Muslims for the spread of the pandemic in India to deflect attention from its abdication of responsibility in making healthcare and social security available to vulnerable segments of the Indian population. The neoliberal policy response of the state during the pandemic was embedded in the necropolitics of protecting the middle class and elite lives while directing structural violence against the working class and Muslims, making their lives disposable.
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Affiliation(s)
| | - Rajnish Rai
- Indian Institute of Management, Ahmedabad, India
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7
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Ruprecht MM, Wang X, Johnson AK, Xu J, Felt D, Ihenacho S, Stonehouse P, Curry CW, DeBroux C, Costa D, Phillips Ii G. Evidence of Social and Structural COVID-19 Disparities by Sexual Orientation, Gender Identity, and Race/Ethnicity in an Urban Environment. J Urban Health 2021; 98:27-40. [PMID: 33259027 PMCID: PMC7706696 DOI: 10.1007/s11524-020-00497-9] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2020] [Indexed: 11/22/2022]
Abstract
The ongoing COVID-19 pandemic has had widespread social, psychological, and economic impacts. However, these impacts are not distributed equally: already marginalized populations, specifically racial/ethnic minority groups and sexual and gender minority populations, may be more likely to suffer the effects of COVID-19. The COVID-19 Resiliency Survey was conducted by the city of Chicago to assess the impact of COVID-19 on city residents in the wake of Chicago's initial lockdown, with particular focus on the experiences of minority populations. Chi-square tests of independence were performed to compare COVID-19-related outcomes and impacts on heterosexual vs. sexual minority populations, cisgender vs. gender minority populations, and White vs. racial/ethnic minority subgroups. Marginalized populations experienced significant disparities in COVID-19 exposure, susceptibility, and treatment access, as well as in psychosocial effects of the pandemic. Notably, Black and Latinx populations reported significant difficulties accessing food and supplies (p = 0.002). Healthcare access disparities were also visible, with Black and Latinx respondents reporting significantly lower levels of access to a provider to see if COVID-19 testing would be appropriate (p = 0.013), medical services (p = 0.001), and use of telehealth for mental health services (p = 0.001). Sexual minority respondents reported significantly lower rates of using telehealth for mental health services (p = 0.011), and gender minority respondents reported significantly lower levels of primary care provider access (p = 0.016). There are evident COVID-19 disparities experienced in Chicago especially for Black, Latinx, sexual minority, and gender minority groups. A greater focus must be paid to health equity, including providing increased resources and supplies for affected groups, adapting to inequities in the built environment, and ensuring adequate access to healthcare services to ameliorate the burden of COVID-19 on these marginalized populations.
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Affiliation(s)
- Megan M Ruprecht
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Xinzi Wang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Amy K Johnson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jiayi Xu
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Dylan Felt
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Siobhan Ihenacho
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Patrick Stonehouse
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Caleb W Curry
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Catherine DeBroux
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Diogo Costa
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gregory Phillips Ii
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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8
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Should bariatric surgery be offered to prisoners? Surg Obes Relat Dis 2020; 16:1332-1335. [PMID: 32636179 DOI: 10.1016/j.soard.2020.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/06/2020] [Accepted: 05/24/2020] [Indexed: 01/22/2023]
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9
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Wiersema JJ, Cruzado-Quiñones J, Cosme Pitre CG, Jordan AO. Client Outcomes From a Multilevel Intervention to Support Persons Living With HIV and Returning to the Community After Incarceration in Puerto Rico. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:181-195. [PMID: 32749876 DOI: 10.1521/aeap.2020.32.3.181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The twin epidemics of HIV and incarceration impact Puerto Rico, which has limited resources to address the social and structural determinants of health in incarcerated populations. A Special Programs of National Significance grant supported a Puerto Rican community-based organization to implement the evidence-informed Transitional Care Coordination intervention among incarcerated persons living with HIV, targeting changes at the individual, organization, and systems levels. After implementation (November 2015-July 2018; n = 69), 93.1% of eligible clients were linked to community-based HIV care, 86.3% remained in care for 6 months, and 78.6% remained for 12 months. A greater proportion reported consistent HIV care, ART adherence, food security, and transportation to access care. Integrating HIV case management with housing and employment services, and developing buy-in and collaboration from partners across systems of care, including after a natural disaster, led to positive client outcomes. This intervention shows promise for adaptation to other HIV care and service delivery systems.
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Affiliation(s)
- Janet J Wiersema
- NYC Health + Hospitals Correctional Health Services, New York, New York
| | | | | | - Alison O Jordan
- NYC Health + Hospitals Correctional Health Services, New York, New York
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10
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Ahlberg BM, Hamed S, Thapar-Björkert S, Bradby H. Invisibility of Racism in the Global Neoliberal Era: Implications for Researching Racism in Healthcare. FRONTIERS IN SOCIOLOGY 2019; 4:61. [PMID: 33869384 PMCID: PMC8022523 DOI: 10.3389/fsoc.2019.00061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/24/2019] [Indexed: 06/12/2023]
Abstract
This paper describes the difficulties of researching racism in healthcare contexts as part of the wider issue of neoliberal reforms in welfare states in the age of global migration. In trying to understand the contradiction of a phenomenon that is historical and strongly felt by individuals and yet widely denied by both institutions and individuals, we consider the current political and socioeconomic context of healthcare provision. Despite decades of legislation against racism, its presence persists in healthcare settings, but data on these experiences is rarely gathered in Europe. National systems of healthcare provision have been subject to neoliberal reforms, where among others, cheaper forms of labor are sought to reduce the cost of producing healthcare, while the availability of services is rationed to contain demand. The restriction both on provision of and access to welfare, including healthcare, is unpopular among national populations. However, the explanations for restricted access to healthcare are assumed to be located outside the national context with immigrants being blamed. Even as migrants are used as a source of cheap labor in healthcare and other welfare sectors, the arrival of immigrants has been held responsible for restricted access to healthcare and welfare in general. One implication of (im)migration being blamed for healthcare restrictions, while racism is held to be a problem of the past, is the silencing of experiences of racism, which has dire consequences for ethnic minority populations. The implications of racism as a form of inequality within healthcare and the circumstances of researching racism in healthcare and its implication for the sociology of health in Sweden are described.
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Affiliation(s)
- Beth Maina Ahlberg
- Department of Sociology, Uppsala University, Uppsala, Sweden
- Skaraborg Institute for Research and Development, Skövde, Sweden
| | - Sarah Hamed
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | | | - Hannah Bradby
- Department of Sociology, Uppsala University, Uppsala, Sweden
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11
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Komesaroff PA. Author reply. Intern Med J 2019; 49:936-937. [DOI: 10.1111/imj.14350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Paul A. Komesaroff
- School of Public HealthMonash University, Alfred Hospital Melbourne Victoria Australia
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12
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Grasso DJ, Ford JD, Greene CA. Preliminary psychometrics of the Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A) in an urban prenatal healthcare clinic. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2019; 11:927-935. [PMID: 31135171 DOI: 10.1037/tra0000476] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The primary objective of the current study was to examine preliminary psychometric characteristics of the Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A), a novel self-report instrument that inventories childhood and adulthood trauma-related experiences and assesses symptoms of posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual for Mental Disorders (5th ed.; [DSM-5] American Psychiatric Association, 2013). Designed for efficient administration and interpretation by nonclinically trained professionals, the STRESS-A is a promising tool for use in settings where mental health professionals are lacking. METHOD A sample of 170 women in their third trimester of pregnancy and receiving services at an urban prenatal health care clinic completed the STRESS-A and a battery of instruments measuring mental health functioning, perceived stress, and emotion dysregulation. Tests of reliability and validity were conducted, including confirmatory factor analysis to examine the fit of STRESS-A symptom criteria relative to PTSD symptom structures supported in the literature. RESULTS Results provide initial support for internal consistency, reliability, and convergent and construct validity in a largely Hispanic pregnancy sample. The STRESS-A symptom structure fit well with several that have been supported in the literature, including the 4-factor model of the DSM-5. CONCLUSION The STRESS-A is a promising tool for assessing risk associated with trauma exposure and probable DSM-5-based PTSD. Findings support its utility in a high-risk pregnancy cohort, a population that is underserved, yet shows high rates of trauma exposure and associated symptoms. Addressing maternal trauma-related impairment may have important implications for healthy fetal and child development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Gebremariam MK, Nianogo RA, Arah OA. Weight gain during incarceration: systematic review and meta-analysis. Obes Rev 2018; 19:98-110. [PMID: 29024549 DOI: 10.1111/obr.12622] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 08/25/2017] [Accepted: 09/07/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Existing evidence suggests that the prevalence of overweight and obesity among prisoners in different settings is high. Evaluating weight change during incarceration would allow for the investigation of whether the prison environment indeed contributes to unfavourable weight changes. OBJECTIVES This study aimed to do a systematic review and a meta-analysis of existing evidence regarding weight change during incarceration. METHODS AND RESULTS We conducted a systematic literature search by using five different online databases and included grey literature. A total of 16 studies, all conducted in developed countries, were identified. Weight change was computed in 11 of these studies and was self-reported in five studies. Only two studies included youth. In all but 1 of the 11 studies using actual assessment of weight change, there was an increase in body weight or body mass index on average or weight gain occurred among a significant proportion of participants. A meta-analysis of eight of these studies showed an average weight gain of 0.43 (95% CI 0.14, 0.72) lb/week. In all studies including perceived weight change, a high proportion (43% to 73%) of participants reported weight gain during incarceration. CONCLUSION Health promotion activities within prisons should incorporate initiatives aimed at combating unhealthy weight developments.
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Affiliation(s)
- M K Gebremariam
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.,Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R A Nianogo
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - O A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.,UCLA Center for Health Policy Research, Los Angeles, CA, USA.,California Center for Population Research, UCLA, Los Angeles, CA, USA
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Green S, Foran J, Kouyoumdjian FG. Access to primary care in adults in a provincial correctional facility in Ontario. BMC Res Notes 2016; 9:131. [PMID: 26923923 PMCID: PMC4770553 DOI: 10.1186/s13104-016-1935-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 02/12/2016] [Indexed: 01/21/2023] Open
Abstract
Background Little is known about access to primary care either prior to or following incarceration in Canada. International data demonstrate that the health of people in prisons and jails is poor, and access to primary care in the community may be inadequate for incarcerated persons. We aimed to describe the primary care experience of adults in custody in a provincial correctional facility in Ontario in the 12 months prior to admission. Methods We conducted a written survey, and invited all persons in the institution to participate, excluding those in segregation. Results One hundred and twenty-five persons participated, 16.8 % of whom were women. The median age was 33. In the 12 months prior to admission to custody, 32.2 % (95 % CI 23.5–40.8 %) of respondents did not have a family doctor or other primary care provider and 48.2 % (95 % CI 38.8–57.6 %) had unmet health needs. Participants reported a mean of 2.1 (SD = 2.8) emergency department visits in the 12 months prior to admission. Conclusions Study participants report a lack of access to primary care, a high mean number of emergency department visits, and high unmet health care needs in the 12 months prior to incarceration. Time in custody may present an opportunity for connecting this population with primary care and improving health.
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Affiliation(s)
- Samantha Green
- Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
| | - Jessica Foran
- Department of Political Science, McMaster University, Hamilton, ON, Canada.
| | - Fiona G Kouyoumdjian
- Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada.
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15
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Freudenberg N, Heller D. A Review of Opportunities to Improve the Health of People Involved in the Criminal Justice System in the United States. Annu Rev Public Health 2016; 37:313-33. [PMID: 26789388 DOI: 10.1146/annurev-publhealth-032315-021420] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the past decade, many constituencies have questioned the efficacy, cost, and unintended consequences of mass incarceration in the United States. Although substantial evidence now demonstrates that US incarceration policies have had unintended adverse health consequences, we know less about the strategies and policies that can prevent or reduce these problems for justice-involved individuals and how the criminal justice system (CJS) can contribute to the Healthy People 2020 national goal of eliminating inequities in health. This review examines strategies that have been used to improve the health of people at various stages of CJS involvement, including diversion from jail and prison stays into community settings, improvements to the social and physical environments within correctional facilities, provision of health and other services to inmates, assistance for people leaving correctional facilities to make the transition back to the community, and systems coordination and integration.
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Affiliation(s)
- Nicholas Freudenberg
- School of Public Health, City University of New York, New York, NY 10027; , .,Hunter College, New York, NY 10035
| | - Daliah Heller
- School of Public Health, City University of New York, New York, NY 10027; ,
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16
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Nkansah-Amankra S, Tettey G. Association between depressive symptoms in adolescence and birth outcomes in early adulthood using a population-based sample. Prev Med Rep 2015; 2:371-8. [PMID: 26844093 PMCID: PMC4721474 DOI: 10.1016/j.pmedr.2015.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Adolescent female depressive symptomatology is an unrecognized mood disorder that impairs health in adolescence or adulthood. However, the long-term effects of pre-pregnancy depressive symptoms on birth outcomes in adulthood have not been given adequate empirical assessments. METHOD In this study, we assessed the relationship between the life time duration of depressive symptoms over a 14-year period and birth outcomes (LBW and PTB) among a sample of 6023 female respondents who took part in the National Longitudinal Study of Adolescent to Adult Health (Add Health). We used the generalized estimating equation (GEE) models to assess these relationships. RESULTS Exposure to elevated depressive symptoms in late adolescence, but not in adulthood, was associated with increased odds of LBW by more than 2-fold in early and young adulthoods (adjusted odds ratio [aOR] = 2.19; 95% confidence interval, CI: 1.56, 3.08). Depressive symptoms in early adulthood were independently associated with increased odds of PTB and were higher for black mothers. Maternal race modified the relationship between consistent reporting of depressive symptoms in adolescence and LBW or PTB in adulthood. CONCLUSION This study provides compelling evidence that effects of elevated depressive symptomatology on LBW or PTB appear to be linked to a specific development period in adolescence. National policies to address social inequalities and stratification particularly in health at all stages of human development, will provide an important step in reducing depressive symptoms prior to early adulthood and in pregnancy and childbirth.
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Affiliation(s)
- Stephen Nkansah-Amankra
- Central Michigan University School of Health Sciences, Health Professions Building, Room 2209, Mount Pleasant, MI 48859, United States
| | - Grace Tettey
- Department of Community & Behavioral Health, College of Public Health, East Tennessee State University, P.O. Box 70674, Johnson City, TN 37614-1709, United States
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17
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Affiliation(s)
- Juliette Forstenzer Espinosa
- Juliette Forstenzer Espinosa is an Assistant Research Professor of Health Policy and Marsha Regenstein is a Professor of Health Policy at The George Washington University, Milken Institute School of Public Health in Washington, D.C
| | - Marsha Regenstein
- Juliette Forstenzer Espinosa is an Assistant Research Professor of Health Policy and Marsha Regenstein is a Professor of Health Policy at The George Washington University, Milken Institute School of Public Health in Washington, D.C
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18
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David RJ, Collins JW. Layers of inequality: power, policy, and health. Am J Public Health 2013; 104 Suppl 1:S8-S10. [PMID: 24354842 DOI: 10.2105/ajph.2013.301765] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Richard J David
- Richard J. David is with the Division of Neonatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, and the Department of Pediatrics, College of Medicine, University of Illinois at Chicago. James W. Collins is with the Division of Neonatology, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, and the Department of Pediatrics, Northwestern University Medical School, Chicago, IL
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