Abstract
BackgroundIndividuals who are incarcerated have greater healthcare needs than non-justice-involved individuals, yet incarcerated individuals often report substandard care. There are disproportionate numbers of black, indigenous, and people of color (BIPOC) in prison, who, even in general society face greater obstacles to accessing healthcare and have worse health outcomes due to structural racism. Regardless of race, people with criminal justice involvement often report stigma from the non-carceral healthcare system. Providing sufficient healthcare in carceral settings themselves is complicated by lack of privacy and the inherent dialectic of prisons that restrict freedom and providers focusing on healing and health. Based on these adverse experiences, people who are incarcerated may have decreased distrust in the healthcare system, deterring individuals from getting adequate medical care.MethodsIn this exploratory study, health care system distrust was evaluated among 200 people who were incarcerated using the Revised Health Care System Distrust scale, a community-validated, 9-item measure comprised of 2 subscales (values and competence distrust).ResultsDistrust was moderately and positively associated with participant age (rs = 0.150, p = 0.034), with the second-oldest quintile (33 to 42-year-olds) reporting the highest level of overall and competence distrust. Participants identifying as Non-Latinx White reported higher competence distrust compared to Latinx and Non-Latinx/Non-White respondents.ConclusionsThese preliminary findings suggest that select groups of prisoners may be less likely to trust the healthcare system, highlighting an impediment to receiving adequate care while incarcerated. Further study of this topic is warranted.
Highlights
Individuals who are incarcerated have greater healthcare needs than non-justice-involved individuals, yet incarcerated individuals often report substandard care
All participants were told that their participation decision would not impact their total incarceration time; that all responses would be kept confidential; and that no information provided during the study would be shared with research staff of the clinical trials from which they were recruited, Department of Corrections (DOC) staff, court or parole officers, or anyone else involved in the correctional setting
Forty-seven (23.5%) individuals identified as Latinx, 99 (49.5%) as Non-Latinx White, and 54 (27%) as Non-Latinx/Non-White
Summary
Individuals who are incarcerated have greater healthcare needs than non-justice-involved individuals, yet incarcerated individuals often report substandard care. There are disproportionate numbers of black, indigenous, and people of color (BIPOC) in prison, who, even in general society face greater obstacles to accessing healthcare and have worse health outcomes due to structural racism. Providing sufficient healthcare in carceral settings themselves is complicated by lack of privacy and the inherent dialectic of prisons that restrict freedom and providers focusing on healing and health Based on these adverse experiences, people who are incarcerated may have decreased distrust in the healthcare system, deterring individuals from getting adequate medical care. The poor healthcare and health status of incarcerated individuals is further complicated by the disproportionately high representation of black, indigenous and people of color (BIPOC) in prison, who at baseline face greater obstacles to accessing healthcare and have worse health outcomes due to structural racism. The inequitable distribution of (and access to) other societal resources and goods that promote individual health (i.e., housing, education, employment, earnings, benefits, credit, media, and so on) further increase the risk for adverse health outcomes among BIPOC persons (Bailey et al, 2017)
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