Evidence map›Paper›PMID 27638837›Full record

ArticleJournal of general internal medicine2016

Health Insurance Trends and Access to Behavioral Healthcare Among Justice-Involved Individuals-United States, 2008-2014.

Tyler N A Winkelman, Edith C Kieffer, Susan D Goold, Jeffrey D Morenoff, Kristen Cross, John Z Ayanian

Registry-linked trialAbstract read
In one paragraph

Article in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03799315 (Reducing Tobacco-Related Health Disparities Among Incarcerated Individuals in Hennepin County), which is not on this map. Cited by 43 papers.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03799315 nacompletednot on this mapstarted 2019, after this paper: background citation

Reducing Tobacco-Related Health Disparities Among Incarcerated Individuals in Hennepin County

TypeinterventionalSponsorHennepin Healthcare Research InstituteRan2019 to 2020Enrolled66ConditionsTobacco UseArmsNicotine Replacement Therapy, Counseling
3 · Its place in the literature

Who cites it

43 citing papers in PubMed.

  1. Review
  2. County health rankings, provider shortages, and the health of incarcerated women with opioid use disorder.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026
    Article
  3. Article
  4. Observational
  5. Article
  6. Access to Healthcare Among Young Adult Probationers Participating in a Pilot Health-Focused Reentry Program.International journal of offender therapy and comparative criminology · 2025
    Article
  7. Article
  8. Article
  9. Association Between Recent Criminal Legal Involvement and Functional Status Among US Adults with Diabetes: 2015-2019.Journal of urban health : bulletin of the New York Academy of Medicine · 2025
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Inequities in Mental Health Services: A 16-Year Longitudinal Study of Youth in the Justice System.Journal of the American Academy of Child and Adolescent Psychiatry · 2024
    Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Tyler N A WinkelmanRobert Wood Johnson Foundation Clinical Scholars Program, North Campus Research Center (NCRC), University of Michigan, Ann Arbor, MI, USA. tywink@med.umich.edu.
Edith C KiefferInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
Susan D GooldInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
Jeffrey D MorenoffPopulation Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Kristen CrossUniversity of Michigan Medical School, Ann Arbor, MI, USA.
John Z AyanianInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.

Funding

Scientific/Technical CoreP2CHD041028 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Sarah A. Burgard · 2017 to 2026
$6.5M
NICHD NIH HHS P2C HD041028
6 · The paper itself

Abstract

backgroundA large proportion of justice-involved individuals have mental health issues and substance use disorders (SUD) that are often untreated due to high rates of uninsurance. However, roughly half of justice-involved individuals were estimated to be newly eligible for health insurance through the Affordable Care Act (ACA).

objectiveWe aimed to assess health insurance trends among justice-involved individuals before and after implementation of the ACA's key provisions, the dependent coverage mandate and Medicaid expansion, and to examine the relationship between health insurance and treatment for behavioral health conditions.

designRepeated and pooled cross-sectional analyses of data from the National Survey on Drug Use and Health (NSDUH).

participantsNationally representative sample of 15,899 adults age 19-64 years between 2008 and 2014 with a history of justice involvement during the prior 12 months. MAIN MEASURES: Uninsurance rates between 2008 and 2014 are reported. Additional outcomes include adjusted treatment rates for depression, serious mental illness, and SUD by insurance status. KEY

resultsThe dependent coverage mandate was associated with a 13.0 percentage point decline in uninsurance among justice-involved individuals age 19-25 years (p < 0.001). Following Medicaid expansion, uninsurance declined among justice involved individuals of all ages by 9.7 percentage points (p < 0.001), but remained 16.3 percentage points higher than uninsurance rates for individuals without justice involvement (p < 0.001). In pooled analyses, Medicaid, relative to uninsurance and private insurance, was associated with significantly higher treatment rates for illicit drug abuse/dependence and depression.

conclusionGiven the high prevalence of mental illness and substance use disorders among justice-involved populations, persistently elevated rates of uninsurance and other barriers to care remain a significant public health concern. Sustained outreach is required to reduce health insurance disparities between individuals with and without justice involvement. Public insurance appears to be associated with higher treatment rates, relative to uninsurance and private insurance, among justice-involved individuals.

Indexed as

AdultCriminal LawCross-Sectional StudiesFemaleHealth Services AccessibilityHumansInsurance CoverageInsurance, HealthMaleMental DisordersMiddle AgedPatient Protection and Affordable Care ActSubstance-Related DisordersUnited Statescriminal justicehealthcare reformhealth policyvulnerable populations

Identifiers

PMID27638837
PMCPMC5130958

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.