A secondary analysis was conducted on the data of the U.S. longitudinal Pathways to Desistance study between ages 20 and 23 years (2000-2010). Participant data on health insurance coverage, healthcare use, reincarceration, and sociodemographic variables (n = 1,215) were extracted and analyzed, using descriptive statistics, generalized linear regressions, and cross-lagged panel models. The study found that about half of the young offenders had no health insurance coverage or intermittent coverage between the age of 20 and 23 years old. Emergency services were used (17.4 percent), notably more by insured participants, and were increasingly used over time. Being uninsured at the age of 20 years old was associated with reincarceration at the age of 23 years (b = 0.052, p = 0.014, odd-ratio = 0.95), but incarceration at the age of 20 years did not predict the insurance status at the age of 23 years (b = 0.009, p = 0.792). Serious juvenile offenders, especially if uninsured, faced major barriers to accessing health care and often reported an inappropriate healthcare use. This likely led to reincarceration. The lack of continuity of care and of access to health care may, therefore, increase health disparities. Efforts are needed to mitigate detrimental outcomes by effective in and out of detention coordination of health insurance coverage and among health services. (publisher abstract modified)
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