| Title |
Health Insurance Trends and Access to Behavioral Healthcare Among Justice-Involved Individuals—United States, 2008–2014
|
|---|---|
| Published in |
Journal of General Internal Medicine, September 2016
|
| DOI | 10.1007/s11606-016-3845-5 |
| Pubmed ID | |
| Authors |
Tyler N. A. Winkelman, Edith C. Kieffer, Susan D. Goold, Jeffrey D. Morenoff, Kristen Cross, John Z. Ayanian |
| Abstract |
A large proportion of justice-involved individuals have mental health issues and substance use disorders (SUD) that are often untreated due to high rates of uninsurance. However, roughly half of justice-involved individuals were estimated to be newly eligible for health insurance through the Affordable Care Act (ACA). We aimed to assess health insurance trends among justice-involved individuals before and after implementation of the ACA's key provisions, the dependent coverage mandate and Medicaid expansion, and to examine the relationship between health insurance and treatment for behavioral health conditions. Repeated and pooled cross-sectional analyses of data from the National Survey on Drug Use and Health (NSDUH). Nationally representative sample of 15,899 adults age 19-64 years between 2008 and 2014 with a history of justice involvement during the prior 12 months. Uninsurance rates between 2008 and 2014 are reported. Additional outcomes include adjusted treatment rates for depression, serious mental illness, and SUD by insurance status. The dependent coverage mandate was associated with a 13.0 percentage point decline in uninsurance among justice-involved individuals age 19-25 years (p < 0.001). Following Medicaid expansion, uninsurance declined among justice involved individuals of all ages by 9.7 percentage points (p < 0.001), but remained 16.3 percentage points higher than uninsurance rates for individuals without justice involvement (p < 0.001). In pooled analyses, Medicaid, relative to uninsurance and private insurance, was associated with significantly higher treatment rates for illicit drug abuse/dependence and depression. Given the high prevalence of mental illness and substance use disorders among justice-involved populations, persistently elevated rates of uninsurance and other barriers to care remain a significant public health concern. Sustained outreach is required to reduce health insurance disparities between individuals with and without justice involvement. Public insurance appears to be associated with higher treatment rates, relative to uninsurance and private insurance, among justice-involved individuals. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 6 | 67% |
| Unknown | 3 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 67% |
| Scientists | 3 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 85 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 85 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 14% |
| Other | 10 | 12% |
| Student > Master | 10 | 12% |
| Student > Ph. D. Student | 9 | 11% |
| Student > Doctoral Student | 8 | 9% |
| Other | 15 | 18% |
| Unknown | 21 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Social Sciences | 14 | 16% |
| Medicine and Dentistry | 13 | 15% |
| Nursing and Health Professions | 13 | 15% |
| Psychology | 3 | 4% |
| Arts and Humanities | 2 | 2% |
| Other | 8 | 9% |
| Unknown | 32 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 129. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 January 2017.
All research outputs
#295,807
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#249
of 7,806 outputs
Outputs of similar age
#5,625
of 298,448 outputs
Outputs of similar age from Journal of General Internal Medicine
#5
of 84 outputs
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