title: Access to primary care in adults in a provincial correctional facility in Ontario.
abstract: BACKGROUND
  Little is known about access to primary care either prior to or following incarceration in Canada. International data demonstrate that the health of people in prisons and jails is poor, and access to primary care in the community may be inadequate for incarcerated persons. We aimed to describe the primary care experience of adults in custody in a provincial correctional facility in Ontario in the 12 months prior to admission.
  
  
  METHODS
  We conducted a written survey, and invited all persons in the institution to participate, excluding those in segregation.
  
  
  RESULTS
  One hundred and twenty-five persons participated, 16.8% of whom were women. The median age was 33. In the 12 months prior to admission to custody, 32.2% (95% CI 23.5-40.8%) of respondents did not have a family doctor or other primary care provider and 48.2% (95% CI 38.8-57.6%) had unmet health needs. Participants reported a mean of 2.1 (SD = 2.8) emergency department visits in the 12 months prior to admission.
  
  
  CONCLUSIONS
  Study participants report a lack of access to primary care, a high mean number of emergency department visits, and high unmet health care needs in the 12 months prior to incarceration. Time in custody may present an opportunity for connecting this population with primary care and improving health.
authors.affiliation: Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. greensa@smh.ca.
authors.forename: Samantha
authors.initials: S
authors.lastname: Green
authors.affiliation: Department of Political Science, McMaster University, Hamilton, ON, Canada. foran.jessica@gmail.com.
authors.forename: Jessica
authors.initials: J
authors.lastname: Foran
authors.affiliation: Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada. fiona.kouyoumdjian@utoronto.ca.
authors.forename: Fiona G
authors.initials: FG
authors.lastname: Kouyoumdjian
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000941:ethics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D009864:Ontario; D011320:Primary Health Care / Q000941:ethics / Q000706:statistics & numerical data*; D011329:Prisoners; D012189:Retrospective Studies