학술논문

The relationship between community public health, behavioral health service accessibility, and mass incarceration
Document Type
article
Source
BMC Health Services Research, Vol 22, Iss 1, Pp 1-11 (2022)
Subject
Jail population
Access to care
Community service accessibility
Behavioral health
Mass incarceration
Community public health
Public aspects of medicine
RA1-1270
Language
English
ISSN
1472-6963
Abstract
Abstract Background The relationship between healthcare service accessibility in the community and incarceration is an important, yet not widely understood, phenomenon. Community behavioral health and the criminal legal systems are treated separately, which creates a competing demand to confront mass incarceration and expand available services. As a result, the relationship between behavioral health services, demographics and community factors, and incarceration rate has not been well addressed. Understanding potential drivers of incarceration, including access to community-based services, is necessary to reduce entry into the legal system and decrease recidivism. This study identifies county-level demographic, socioeconomic, healthcare services availability/accessibility, and criminal legal characteristics that predict per capita jail population across the U.S. More than 10 million individuals pass through U.S. jails each year, increasing the urgency of addressing this challenge. Methods The selection of variables for our model proceeded in stages. The study commenced by identifying potential descriptors and then using machine learning techniques to select non-collinear variables to predict county jail population per capita. Beta regression was then applied to nationally available data from all 3,141 U.S. counties to identify factors predicting county jail population size. Data sources include the Vera Institute’s incarceration database, Robert Wood Johnson Foundation’s County Health Rankings and Roadmaps, Uniform Crime Report, and the U.S. Census. Results Fewer per capita psychiatrists (z-score = -2.16; p = .031), lower percent of drug treatment paid by Medicaid (-3.66; p