Lack of Health Insurance Among Juvenile Offenders: A Predictor of Inappropriate Healthcare Use and Reincarceration?

• NCJ Number: 254347
• Journal: Public Health Volume: 166 Dated: January 2019 Pages: 25-33
• Author(s): S. Baggio; N. T. Tran; E. S. Barnert; L. Getaz; P. Heller; H. Wolff
• Date Published: January 2019
• Length: 9 pages
• Grant Number(s): 2000-MU-MU-0007, 2005-JK-FX-K001, 2007-MU-FX-0002
• Sponsoring Agency: Office of Juvenile Justice and Delinquency Prevention (OJJDP)
• Publication Format: Article
• Publication Type: Research (Applied/Empirical); Report (Study/Research); Report (Grant Sponsored); Program/Project Description
• Language: English
• Country: United States of America

Annotation

This study had two objectives: (1) to examine trajectories of health insurance coverage and healthcare use among serious juvenile offenders transitioning into adulthood; and (2) to explore associations between the lack of health insurance, healthcare use and reincarceration.

Abstract

Relationships between the health insurance status and healthcare use among justice-involved youths transitioning into adulthood is an underexplored topic, even though transition to adulthood is a crucial time period for healthcare outcomes. The current study sought to address this research gap. It conducted a secondary analysis of the data from the U.S. longitudinal Pathways to Desistance study between ages 20 and 23 years (2000-2010). Participant data on health insurance coverage, healthcare use, reincarceration and sociodemographic variables (n = 1,215) were extracted and analyzed using descriptive statistics, generalized linear regressions, and cross-lagged panel models. The analysis found that about half of the young offenders had no health insurance coverage or intermittent coverage between the age of 20 and 23 years. Emergency services were used (17.4 percent), notably more by insured participants and were increasingly used over time. Being uninsured at the age of 20 years was associated with reincarceration at the age of 23 years (b = 0.052, p = 0.014, odd-ratio = 0.95), but incarceration at the age of 20 years did not predict the insurance status at the age of 23 years (b = 0.009, p = 0.792). The overall conclusion of this analysis is that serious juvenile offenders, especially if uninsured, faced major barriers to accessing healthcare and often reported an inappropriate healthcare use. This likely led to reincarceration. The lack of continuity of care and of access to healthcare may, therefore, increase health disparities. Efforts are needed to mitigate detrimental outcomes for juvenile offenders through effective coordination of health insurance coverage and health services, whether in or out of detention. (publisher abstract modified)