Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Psychological Distress and Health Insurance Coverage among Formerly Incarcerated Young Adults in the United States

1 Department of Human Studies, School of Education, University of Alabama - Birmingham, 901 13th Street South, EB 210A, Birmingham, AL 35294-1250, USA;
2 Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive Suite #208, Columbia, SC 29210, USA;
3 South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive Suite #204, Columbia, SC 29210, USA;
4 Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208, USA

Special Issues: Addressing Understudied and Vulnerable Populations and Health Systems

The United States incarcerates more people per capita than any other nation. Studies have consistently demonstrated higher prevalence of serious mental illness among the incarcerated. Although health care may be available to individuals while incarcerated, research is needed to understand the context of health care coverage and mental health after incarceration. The purpose of this study is to estimate the point prevalence of psychological distress (PD) among young adults with incarceration experience, while comparing the prevalence to that of young adults in the general population. Additionally, this study characterizes the relationship between incarceration experience and PD, while also examining this association given an individual's health insurance coverage status among young adults. Lastly, we examine if other individual, contextual, and behavioral factors influences the relationship between incarceration experience and PD, in addition to their health insurance coverage status. This study utilizes data from the 2008 panel of the National Longitudinal Survey of Youth 97, a population based survey dataset from the U.S. Department of Labor. Andersen's Behavioral Model of Health Services Use provided the conceptual framework for the study. The Mental Health Index 5 (MHI-5) was used to determine PD or normal mental health. Chi-square testing and multivariate logistic regression were performed to examine incarceration experience in association to PD. The sample with incarceration experience reported almost double the proportion of PD (21%) compared to those without an incarceration experience (11%). Young adults who have been incarcerated reported greater odds of PD than those with no incarceration experience (COR 2.18; 95% CI, 1.68-2.83) and the association was diminished in the presence of health insurance status and model covariates. Future health prevention and health management efforts should consider the impact of health insurance coverage status, health behaviors, and life satisfaction on mental health status among young adults with incarceration experience.
  Article Metrics

Keywords incarceration; psychological distress; young Adults; mental Health; health insurance

Citation: Larrell L. Wilkinson, Saundra H. Glover, Janice C. Probst, Bo Cai, Lisa T. Wigfall. Psychological Distress and Health Insurance Coverage among Formerly Incarcerated Young Adults in the United States. AIMS Public Health , 2015, 2(3): 227-246. doi: 10.3934/publichealth.2015.3.227


  • 1. Wilper AP, Woolhandler S, Boyd JW, et al. (2009) The Health and Health Care of US Prisoners: Results of a Nationwide Survey. Am J Public Health 99.
  • 2. Freudenberg N (2001) Jails, Prisons, and the Health of Urban Populations: A Review of the Impact of the Correctional System on Community Health. J Urban Health 78: 214-235.    
  • 3. Teplin LA (1990) The Prevalence of Severe Mental Disorder Among Male Urban Jail Detainees: Comparison with the Epidemiologic Catchment Area Program. Am J Public Health 80: 663-669.    
  • 4. Fogel C (1992) Determining risk status in a primary care setting. Applied Nursing Research 5: 140-145.    
  • 5. Jordan B, Schlenger W, Fairbank J, et al. (1996) Prevalence of Psychiatric Disorders Among Incarcerated Women II. Convicted Felons Entering Prison. JAMA Psychiatry 53: 513-519.
  • 6. Williams R, Hollis H (1999) Health beliefs and reported symptoms among a sample of incarcerated adolescent females. J AdolescHealth 24: 21-27.
  • 7. Brown S, Ireland C (2006) Coping style and distress in newly incarcerated male adolescents. J Adolesc Health 38: 656-661.    
  • 8. Ireland J, Brown S, Ballarini S (2006) Maladaptive personality traits, coping styles and psychological distress: A study of adult male prisoners. Pers Individ Dif 41: 561-573.    
  • 9. Binswanger I, Krueger P, Steiner J (2009) Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population. J Epidemiol Community Health 63: 912-919.    
  • 10. NCCHC (2002) The health status of soon-to-be-released inmates. Washington, DC: National Commission on Correctional Health Care.
  • 11. Binswanger I, Stern M, Deyo R, et al. (2007) Release from Prison—A High Risk of Death for Former Inmates. N Engl J Med 356: 157-165.    
  • 12. Hughes T, Wilson D (2003) Reentry trends in the United States. Washington, D.C.: Bureau of Justice Statistics.
  • 13. Hornung C, Greifinger R, Gadre S (2002) A projection model of the prevalence of selected chronic diseases in the inmate population. A Report to Congress. Chicago, IL: National Commission of Correctional Health Care.
  • 14. Kulkarni S, Baldwin S, Lightstone A, et al. (2010) Is Incarceration a Contributor to Health Disparities? Access to Care of Formerly Incarcerated Adults. J Community Health 35: 268-274.
  • 15. Visher C, Kachnowski V, La Vigne N, et al. (2004) Baltimore prisoners' experiences returning home. Washington, D.C.: The Urban Institute.
  • 16. Wells KB, Manning J, Willard G, Valdez RB (1989) The Effects of Insurance Generosity on the Psychological Distress and Well-Being of a General Population. Santa Monica, CA: The RAND Corporation. 1-35 p.
  • 17. Sturm R, Wells K (2000) Health Insurance May Be Improving - But Not for the Individuals with Mental Illness. Health Serv Res 35: 253-262.
  • 18. Pratt LA, Dey AN, Cohen AJ (2007) Characteristics of Adults with Serious Psychological Distress as Measured by the K6 Scale: United States, 2001-2004. Hyattsville, MD: National Center for Health Statistics. 1-19 p.
  • 19. Hughes T, Wilson D, Statisticians B (2003) Reentry Trends in the United States. Washington, D.C.: U.S. Department of Justice.
  • 20. Denavas-Walt C, Proctor BD, Smith JC (2010) Income, Poverty, and Health Insurance Coverage in the United States: 2009. Washington, D.C.: U.S. Government Printing Office. P60-238 p.
  • 21. DoL (2010) National Longitudinal Survey of Youth 97. National Longitudinal Survey of Youth 97.
  • 22. Gerend M, Magloire Z (2008) Awareness, knowledge, and beliefs about human papillomavirus in a racially diverse of young adults. J Adolesc Health 42: 237-242.    
  • 23. Andersen RM (2008) National Health Surveys and the Behavioral Model of Health Services Use. Med Care 46: 647-653.    
  • 24. Gelberg L, Andersen RM, Leake BD (2000) The Behavioral Model for Vulnerable Populations: Application to Medical Care Use and Outcomes for Homeless People. Health Serv Res 34: 1273-1301.
  • 25. Gore JL, Krupski T, Kwan L, et al. (2005) Mental health of low income uninsured men with prostate cancer. J Urology: 1323-1326.
  • 26. Strand BH, Dalgard OS, Tambs K, et al. (2003) Measuring the mental health status of the Norwegian population: A comparison of the instrutments SCL-25, SCL-10, and MHI-5 (SF-36). Nord J Psychiatry 57: 113-118.    
  • 27. McCabe CJ, Thomas KJ, Brazier JE, et al. (1996) Measuring the mental health status of a population: a comparison of the GHQ-12 and the SF-36 (MHI-5). Br J Psychiatry 169: 517-521.
  • 28. Means-Christensen AJ, Arnau RC, Tonidandel AM, et al. (2005) An efficient mehtod of identifying major depression and panic disorder in primary care. J Behav Med 28: 565-572.    
  • 29. Strodl E, Kenardy J (2008) The 5-item Mental Health Index Predicts the initial diagnosis of nonfatal stroke in older women. J Womens Health (Larchmt) 17: 979-986.    
  • 30. Fone D, Dunstan F, Williams G, et al. (2007) Places, people and mental health: A multilevel analysis of economic activity. Soc Sci Med 64: 633-645.    
  • 31. Yamazaki S, Fukuhara S, Green J (2005) Usefulness of five-item and three-item Mental Health Inventories to screen for depressive symptoms in the general population of Japan. Health Qual Life Outcomes 3: 1-7.    
  • 32. Cuellar A, Cheema J (2012) As Roughly 700,000 Prisoners Are Released Annually, About Half Will Gain Health Coverage And Care Under Federal Laws. Health Affairs 31: 931-938.    
  • 33. Jackson JS, Knight KM (2006) Race and Self-Regulatory Health Behaviors: The Role of the Stress Response and the HPA Axis. In: LL C, KW S, editors. Social Structure, Aging and Self-regulation in the Elderly. New York: Springer. pp. 189-240.
  • 34. Cuijpers P, Smits N, Donker T, et al. (2009) Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory. Pyschiatry Res 168: 250-255.    
  • 35. Kelly M, Dunstan F, Lloyd K, et al. (2008) Evaluating cutpoints for the MHI-5 and MCS using the GHQ-12: a comparison of five different methods. BMC Psychiatry 8: 1-9.    
  • 36. MCClellan M, Newhouse J (2000) Overview of the special supplemental issue. Health Serv Res 35: 1061-1069.
  • 37. Hadley J, Waidman T (2006) Health insurance and health at age 65: implications for medical care spending on new Medicare beneficiaries. Health Serv Res 41: 429-451.    
  • 38. DHHS (2010) News. HHSgov.


Reader Comments

your name: *   your email: *  

Copyright Info: 2015, Larrell L. Wilkinson, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Copyright © AIMS Press All Rights Reserved