Social Environment and Hospitalisation after Release from Prison: A Prospective Cohort Study
1
Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne 3010, Australia
2
Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne 3052, Australia
3
Mater Research Institute-UQ, University of Queensland, Brisbane 4072, Australia
4
Griffith Criminology Institute, Griffith University, Brisbane 4222, Australia
5
School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia
6
Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth 6009, Australia
7
National Drug Research Institute, Curtin University, Perth 6008, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2017, 14(11), 1406; https://doi.org/10.3390/ijerph14111406
Received: 30 September 2017 / Revised: 9 November 2017 / Accepted: 14 November 2017 / Published: 17 November 2017
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
This study examined the association between remoteness and area disadvantage, and the rate of subsequent hospitalisation, in a cohort of adults released from prisons in Queensland. A baseline survey of 1267 adult prisoners within 6 weeks of expected release was prospectively linked with hospital, mortality and reincarceration records. Postcodes were used to assign remoteness and area disadvantage categories. Multivariate Andersen–Gill regression models were fitted to test for associations between remoteness, area disadvantage and hospitalisation after release from prison. Over a total of 3090.9 person-years of follow-up, the highest crude incidence rates were observed in areas characterised by remoteness and area disadvantage (crude incidence rate (IR) = 649; 95%CI: 526–791), followed by remoteness only (IR = 420; 95%CI: 349–501), severe area disadvantage only (IR = 403; 95%CI: 351–461), and neither of these factors (IR = 361; 95%CI: 336–388). Unadjusted analyses indicated that remoteness (hazard ratio (HR) = 1.32; 95%CI: 1.04–1.69; p = 0.024) was associated with increased risk of hospitalisation; however, this attenuated to the null after adjustment for covariate factors. The incidence of hospitalisation for those who live in remote or socio-economically disadvantaged areas is increased compared to their counterparts in more urban and less socio-economically disadvantaged areas. Experiencing both these factors together may compound the hospitalisation in the community.
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Keywords:
hospitalization; health equity; health priorities; health services; environmental health; population health
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Love, A.D.; Kinner, S.A.; Young, J.T. Social Environment and Hospitalisation after Release from Prison: A Prospective Cohort Study. Int. J. Environ. Res. Public Health 2017, 14, 1406.
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