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Incarceration History and Health Insurance and Coverage Changes in the U.S.

Published:November 18, 2022DOI:https://doi.org/10.1016/j.amepre.2022.09.023

      Introduction

      This study examines the association of incarceration history and health insurance coverage and coverage changes in the U.S.

      Methods

      Individuals with and without incarceration history were identified from the National Longitudinal Survey of Youth 1997 with follow-up through 2017–2018 (n=7,417). Generalized estimating equations were used to examine the associations between incarceration history and health insurance and coverage changes in the past 12 months. This study also assessed variation in associations by incarceration duration, frequency, and recency and reoffence history. Analysis was conducted in 2022.

      Results

      Individuals with incarceration history were more likely to be uninsured (AOR=1.69; 95% CI=1.55, 1.85) and to experience year-long uninsurance (AOR=1.34; 95% CI=1.12, 1.59) and were less likely to have stable health insurance coverage (AOR=1.30; 95% CI=1.08, 1.56) than individuals without incarceration history. Longer duration and more frequent incarcerations were associated with a higher likelihood of lack of and unstable insurance coverage and year-long uninsurance.

      Conclusions

      People with an incarceration history had worse access to health insurance coverage. Targeted programs to improve health insurance coverage may reduce disparities associated with incarceration.
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