More than 7 million people are released each year from U.S. jails or prisons, many with chronic diseases that would benefit from primary care in their returning communities. This study analyzed primary care need and utilization by all individuals ever detained in one county detention facility over a 7-year period. The authors found that having more jail bookings was associated with fewer primary care visits, though not one-time access. This finding was driven by subgroups with chronic disease, who most need regular primary care. Even after accounting for other variables, being Black was also linked to fewer primary care visits. Therefore, the authors argue that it is not enough to focus on initial access to healthcare, but also to promote continued engagement with primary care. For example, medicaid expansion should be coupled with specialized, tailored support to promote engagement in primary care.
By Michele M. Easter, Nicole L. Schramm-Sapyta, Marvin S. Swartz, Maria A. Tackett, and Lawrence H. Greenblatt.