The Road Home: Predictors of Health Care Utilization Among Older Returning African American Men

Abstract

Black or African American men face disproportionate rates of incarceration and poor health outcomes. Recent changes in sentencing policy have allowed individuals to return to communities after substantial periods of incarceration. Returning citizens often reenter with numerous challenges: housing, employment, medical assistance, and transportation. Analyses were conducted using multivariable logistic regression to examine the relationship between health care utilization for returning men and need (chronic health conditions), predisposing (age, race, marital status, education, and housing situation), enabling (income, health coverage, employment status, and education) factors. Findings indicated that men 50 and above years (odds ratio [OR] = 1.83, 95% confidence interval [CI] = [1.04, 3.24]), Black or African American men (OR = 4.66, 95% CI = [2.35, 9.22]), those with college education (OR = 1.97, CI [1.07, 3.63]) and those having health coverage (OR = 3.34, CI [2.18, 5.11]) were more likely to utilize health care. These findings suggest the need for a greater need to establish linkages to community-based care during reentry planning. This is particularly relevant for reentering citizens who are not eligible for Medicare due to age or whose linkage to employer bases insurance is limited due to work history, employment discrimination, or education.