Accumulation of Jail Incarceration and Hardship, Health Status, and Unmet Health Care Need Among Women Who Use Drugs
Accumulation of Jail Incarceration and Hardship, Health Status, and Unmet Health Care Need Among Women Who Use Drugs
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DOI：
10.1016/j.whi.2018.05.005
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发表时间：
2018-09-01
影响因子：
3.2
通讯作者：
Lorvick, Jennifer
中科院分区：
文献类型：
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作者：
Lambdin, Barrot H.;Comfort, Megan;Lorvick, Jennifer
背景：监狱经常被描述为一个“旋转门”，这可能会对进出监狱系统的人产生深刻的不稳定性。然而，缺乏研究试图了解监禁事件的积累对吸毒妇女的影响。我们研究了监狱监禁的频率与困难，感知健康状况和未满足的医疗保健需求之间的妇女使用drugs.Methods：我们的社区为基础的样本包括妇女使用海洛因，甲基苯丙胺，快克可卡因，和/或粉末可卡因（N = 624）在奥克兰，加州，从2012年至2014年。建立了具有稳健方差的泊松回归模型，以估计监狱监禁频率与艰苦程度、感知健康和未满足的医疗保健需求之间的调整后患病率，并对一组先验指定的协变量进行调整。我们观察到高水平的监狱频率和更高水平的无家可归者之间的联系（p = 0.024），对生活状况感到不安全（p = 0.011），压力（p = 0.047），精神健康状况一般或较差（p = 0.034），未满足的精神卫生保健需求（p = 0.037）和未满足的身体卫生保健需求（p = 0.041）。我们没有观察到监狱的频率和未满足的生存需求得分或公平差的身体health.Conclusions：我们观察到较高水平的监狱频率和较高的患病率之间的关联的困难，精神健康状况不佳，和未满足的医疗保健需求。我们的研究结果建议进行更多的研究，以解开频繁监禁对妇女健康和福祉的影响。(C)2018由Elsevier Inc.出版代表雅各布妇女健康研究所
Background: Jail is frequently described as a "revolving door," which can be profoundly destabilizing to people moving in and out of the system. However, there is a dearth of research attempting to understand the impacts of the accumulation of incarceration events on women who use drugs. We examined the association of the frequency of jail incarceration with hardship, perceived health status, and unmet health care need among women who use drugs.Methods: Our community-based sample included women who use heroin, methamphetamine, crack cocaine, and/or powder cocaine (N = 624) in Oakland, California, from 2012 to 2014. Poisson regression models with robust variances were built to estimate adjusted prevalence ratios between the frequency of jail incarcerations and measures of hardship, perceived health, and unmet health care need, adjusting for a set of a priori specified covariates.Results: We observed associations between high levels of jail frequency and higher levels of homelessness (p =.024), feeling unsafe in their living situation (p = .011), stress (p = .047), fair to poor mental health (p = .034), unmet mental health care need (p = .037), and unmet physical health care need (p = .041). We did not observe an association between jail frequency and unmet subsistence needs score or fair to poor physical health.Conclusions: We observed associations between higher levels of jail frequency and a higher prevalence of hardship, poor mental health, and unmet health care need. Our findings suggest areas for additional research to untangle the impacts of frequent incarceration on women's health and well-being. (C) 2018 Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.