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Abstract: 

Little is known about the effect of health insurance at prison admission on health and life quality for older adults incarcerated in state prisons and about how coverage type affects such measures. Using secondary data drawn from face-to-face interviews with older adults incarcerated in Kentucky prisons, this study used a series of independent sample t-tests and associated standardized effects to examine differences in health and life-quality measures between older adults with and without health insurance at prison admission and between those with private versus public coverage. The study also used binary logistic regression to examine the contribution of health insurance to multimorbidity in the sample. Older adults without insurance at admission were found to have significantly better health than those with coverage at admission across numerous measures (Cohen’s d range: –0.35 to 0.33). Among prisoners with insurance at admission, those with private coverage fared better than those with public coverage regarding life quality, mental health, and functional impairment (Cohen’s d range: –0.55 to 0.57). Results of the regression model indicate that having health insurance at prison admission was associated with increased odds of multimorbidity in the sample (eβ = 2.23). Implications for policy and correctional health practice are described, and areas for future research are identified.

Keywords: Older adult, prison, health insurance, chronic illness, life quality

Affiliations:  1: University of Louisville; 2: University of Louisville; 3: University of Louisville; 4: University of Louisville; 5: University of Louisville.