203741 Coming home: Poor health status and high risk of homelessness for geriatric prisoners

Tuesday, November 10, 2009

Rebecca G. Lindsay, MS , Joint Medical Program, UC Berkeley - UC San Francisco, Berkeley, CA
James F. McGuire, PhD , Community Care, U.S. Department of Veterans Affairs, Los Angeles, CA
Brie Williams, MD, MS , Assistant Professor of Medicine, UCSF Division of Geriatrics, University of California-San Francisco, San Francisco, CA
Background. An estimated 95% of prisoners will eventually be released. Despite the increasing number of geriatric prisoners, who are at high risk for adverse health outcomes after release, very little is known about health or post-release plans of geriatric prisoners. The few services that do exist for former geriatric prisoners are geared towards veterans. The study objectives were to characterize the health status and risk of homelessness of geriatric prisoners who will reenter community healthcare systems in the next two years, and to compare veterans to nonveterans.

Methods. This was a cross-sectional study of 360 prisoners, aged 55 or older, within two years of release from prison, who participated in the 2004 Survey of Inmates in State and Federal Correctional Facilities. The outcome variables were health status and risk of post-release homelessness. Health status was based on self-report of 11 chronic medical conditions and 7 psychiatric diagnoses. Risk of post-release homelessness was determined by self-report of homelessness before arrest and homelessness within the year prior to arrest. The main predictor variable was veteran status, determined by having ever served in the U.S. armed forces. Veterans and nonveterans were compared using chi-square test for proportions (for categorical variables) or t-test (for continuous variables).

Results. The mean age was 61 years (55 84), 40% were veterans, 94% were male, 56% were white, and the average number of prior arrests was 3.35. Veterans and nonveterans had similarly high rates of chronic medical and psychiatric conditions, with 2.5 medical conditions per veteran and 2.1 per nonveteran (p-value < 0.08). Veterans had on average 0.5 psychiatric conditions and nonveterans had 0.3 (p-value < 0.9). Paralysis and PTSD accounted for the majority of difference between veteran and nonveteran diagnoses. In the year prior to arrest, 8.7% of veterans and 6.6% of nonveterans reported being homeless (p-value = 0.5). There was no appreciable difference between risk of post-release homelessness according to veteran status with all p-values > 0.2.

Conclusion. Geriatric veterans and nonveterans within two years of release from prison have a high burden of medical and psychiatric conditions and are at high risk for post-release homelessness, regardless of veteran status. These findings suggest that reentry and homelessness prevention programs already targeting veteran prisoners could also benefit nonveterans.

Learning Objectives:
1) Describe the health status of geriatric prisoners within two years of release from prison. 2) Assess the risk of homelessness of geriatric prisoners within two years of release from prison. 3) Compare the health and risk of homelessness of veterans to nonveterans. 4) Recognize the need for reentry and homelessness prevention programs targeting prisoners.

Keywords: Prisoners Health Care, Homelessness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.