Promoting healthy behaviors and appropriate health care utilization among African American men recently released from incarceration

Background: Nearly six out of ten Maryland prisoners released from Maryland correctional facilities return to the City of Baltimore. The annual per capita release rate is 6.8 released prisoners for every 1,000 residents. Of those returning to Baltimore 90% are male and 89% are black. There are tremendous health needs among this special population of minority men. There are higher rates of alcohol and other drug problems, mental health problems, HIV, other infectious diseases such as TB and chronic health conditions such as hypertension and diabetes.

Through agreements with transitional housing organizations in Baltimore City, African American men released from prison in the past year were recruited to participate in a study to gather information on their health knowledge, attitudes and beliefs, self reported health status and health care utilization with the intent of gaining insights that might assist in the formulation of strategies to increase access to and utilization of appropriate health care by this population.

Methods: The study participants completed a self administered questionnaire to gather demographic data, health status, and health care utilization. After the initial data collection, each participant attended two group sessions: one with a peer counselor for a discussion on the health related impact of incarceration and a session with a health educator who provided information on the major health concerns affecting men and on available health care resources. At follow-up, the men were queried on their use of health care since the intervention, their perceptions on the care received and future intentions related to health care utilization.

Results: Before the intervention, most of the men reported having seen a health care provider in the past year yet less than half of the men reported having some form of health coverage. More than a third of the men reported using the emergency room for that care. At follow-up, those without health coverage before the intervention had enrolled in a publicly funded health plan.

Conclusions: When consciously made aware of the impact of incarceration on their health seeking behaviors and provided information on available health care resources, personal health seeking behaviors improved for these men.