The purpose of this study is to apply Andersen's Behavioral Model of Health Service Use to men's prisons to assess the direct and indirect effects of inmate predisposing characteristics through multiple types of need. Also examined are the effects of prison-specific enabling factors and the variation in use of health services across prisons. This study uses a nationally representative U.S. sample of men incarcerated in state prisons (n = 8816) and generalized structural equation and multilevel modeling. Five types of need-medical condition, illness, dental problem, unintentional injury, and intentional injury-are assessed for their association with use of health services.
Findings indicate that a number of inmate predisposing (age, race, education) and vulnerability (mood/anxiety disorder,) characteristics are associated with use of health services but are partially mediated by enabling and need factors. Each type of medical need has strong direct effects with mood/anxiety disorder emerging as the strongest total effect (including both direct effects and indirect effects through need). There is significant variation in rates of health service utilization across prisons that is not accounted for by the prison-level factors included in the multilevel model.
The varying patterns of health service use across prisons suggest that incarceration may be an important circumstance that shapes health. In other words, where someone is incarcerated may influence their ability to access and use services in response to medical need. It is important that prisons provide integrated services for inmates with mood/anxiety disorder given high comorbidity with other health conditions.
This research output has an Altmetric Attention Score of 2. 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 12 July 2017.
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#16,436,707
of 26,367,306 outputs
Outputs from Health & Justice
#172
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Outputs of similar age
#187,374
of 336,970 outputs
Outputs of similar age from Health & Justice
#4
of 5 outputs
Altmetric has tracked 26,367,306 research outputs across all sources so far. This one is in the 36th percentile – i.e., 36% of other outputs scored the same or lower than it.
So far Altmetric has tracked 257 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 25.7. This one is in the 31st percentile – i.e., 31% of its peers scored the same or lower than it.
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