Women's Health

A year after leaving jail, half of women lack health insurance or use primary care

One year after release from a New York City jail, half of 511 women studied had health insurance coverage (56 percent) and about half used primary care (47 percent). Only about half of the women suffering from diabetes, asthma, or depression reported using primary care. This represents a lost opportunity to guide women with serious health conditions to the primary care that might help to improve their health and reduce medical expenses (for example, by reducing avoidable emergency department use and hospitalizations), notes Joshua Lee, M.D., of Weill Cornell Medical College. Dr. Lee and colleagues examined primary care use, health insurance, and health status of women between 1997 and 2001, for 1 year after they left a New York City jail.

The women participated in Health Link, a program designed to help incarcerated women and adolescent males reduce drug use and HIV risk after they leave New York City jails to return to their communities. The current study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00066). Researchers found that, since release from jail, primary care use was more likely among women who were HIV-infected (73 percent), pregnant (58 percent), or had pregnancy complications (61 percent). These findings may indicate the success of outreach programs that have worked to link pregnant and HIV-infected women to health and social services over the past decade.

Extending such outreach services to women with other chronic conditions such as asthma, diabetes, or depression may help them as well, note the researchers. Primary care use was also more likely among women who received public benefits, had health insurance coverage, had moderate social support, and avoided illegal activity. Health insurance coverage was associated with receipt of public benefits, hospitalization, primary care, and avoiding re-arrest. These findings suggest the health and social benefits of programs that aid incarcerated individuals in obtaining health insurance coverage and appropriate benefits upon release.

See "Primary care and health insurance among women released from New York City jails," by Dr. Lee, David Vlahov, Ph.D., and Nicholas Freudenberg, Dr.P.H., in the February 2006 Journal of Health Care for the Poor and Underserved 17, pp. 200-217.

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