Trying to Put the Best Foot Forward: Understanding the Medical Difficulties Encountered by Newly Released Prisoners in Louisiana

Background: Formerly incarcerated persons (FIPs) face a disproportionate risk of morbidity and mortality in the immediate post-release period, making it a critical time to initiate community-based care for chronic conditions and behavioral disorders. Little is known about the unique transitional health and social support needs of FIPs in Louisiana, the state with the highest incarceration rate in the world. As the average age of prisoners in the United States rises, the release of older prisoners with chronic conditions will become increasingly common. This poses an alarming public health problem, with increased health care utilization and cost.

Methods: We partnered with a community organization to identify FIPs in the Greater New Orleans area.  We conducted semi-structured, in-person, audio-recorded interviews to assess FIPs’ experiences with and barriers to receiving health care during and post-incarceration. We also explored the desires for services and attitudes toward health and healthcare of FIPs. Interviews were transcribed and independently coded by two researchers

Results:  Interviewees reported negative experiences with health care during incarceration, and limited health guidance during the prerelease process.  Post-release concerns included lack of insurance, difficulty accessing medical care and medications. Participants expressed interest in learning about healthy lifestyles.      

Conclusions: These results suggest a need for transitional care in Louisiana.  Findings are being used to inform development of a transitional care delivery model that will include: pre-release prison in-reach to provide information about the availability of services, basic primary care, insurance enrollment assistance, case management support, and community-based health education.