Health Status and Health Care Utilization of US Adults Under Probation: 2015–2018

Abstract

Objectives. To compare the health and health care utilization of persons on and not on probation nationally. Methods. Using the National Survey of Drug Use and Health, a population-based sample of US adults, we compared physical, mental, and substance use disorders and the use of health services of persons (aged 18–49 years) on and not on probation using logistic regression models controlling for age, race/ethnicity, gender, poverty, and insurance status. Results. Those on probation were more likely to have a physical condition (adjusted odds ratio [AOR] = 1.3; 95% confidence interval [CI] = 1.2, 1.4), mental illness (AOR = 2.4; 95% CI = 2.1, 2.8), or substance use disorder (AOR = 4.2; 95% CI = 3.8, 4.5). They were less likely to attend an outpatient visit (AOR = 0.8; 95% CI = 0.7, 0.9) but more likely to have an emergency department visit (AOR = 1.8; 95% CI = 1.6, 2.0) or hospitalization (AOR = 1.7; 95% CI = 1.5, 1.9). Conclusions. Persons on probation have an increased burden of disease and receive less outpatient care but more acute services than persons not on probation. Public Health Implications. Efforts to address the health needs of those with criminal justice involvement should include those on probation. (Am J Public Health. Published online ahead of print July 16, 2020: e1–e7. doi:10.2105/AJPH.2020.305777)