Abstract

This study investigates patterns of homeless shelter use among formerly incarcerated men for nearly eight years post release and risk factors associated with pattern variation. I use life course theory and administrative data from Pennsylvania to identify four distinct forms of homelessness among formerly incarcerated men: persistent homelessness beginning soon after release, a short spell of homelessness years after release, long periods of homelessness years after release, and intermittent homelessness. The results also indicate that risk factors such as age, race, drug dependency, and full sentence completion are better at distinguishing whether formerly incarcerated men become homeless than they are at predicting what kind of homelessness the men experience.

Keywords: incarceration; prison; homelessness; homeless trajectories; reentry

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.