title: Bringing it all back home: Understanding the medical difficulties encountered by newly released prisoners in New Orleans, Louisiana - a qualitative study.
abstract: Formerly incarcerated persons (FIPs) face a disproportionate risk of death and serious illness in the immediate post-release period. Therefore, it is a critical time to initiate community-based care for chronic illnesses and behavioural disorders. Little is known about the unique transitional health and social support needs of FIPs in Louisiana, which has 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. The aim of this study was to explore the healthcare experiences of FIPs in Louisiana in order to inform delivery of services tailored to this population. This research was done in partnership with a community organisation that advocates for restoration of voting rights to FIPs and helps newly released individuals transition back into society. This organisation identified FIPs in the Greater New Orleans area, and from January to May 2015, we conducted 24 semi-structured, in-person, audio-recorded interviews at the community organisation's transitional living facility. The interviews assessed FIPs' experiences with and barriers to receiving healthcare during and after incarceration. These discussions also explored FIPs' desires for services and attitudes towards health and healthcare. Interviews were transcribed and independently coded by two researchers. Interviewees reported negative experiences with healthcare during incarceration, and limited health guidance during the pre-release process. Post-release concerns included lack of insurance, difficulty accessing care and medication, and interest in learning about healthy lifestyles. Results suggest a need for a formalised system of transitional healthcare for FIPs. Findings are being used to inform a pilot transitional care clinic in New Orleans, Louisiana.
authors.affiliation: Tulane Medical School and School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.|Albert Einstein College of Medicine / Montefiore Medical Center: Department of Medicine, The Bronx, New York, USA.
authors.forename: William Lee
authors.identifier: 0000-0002-9618-1787
authors.initials: WL
authors.lastname: Vail
authors.affiliation: Tulane University School of Medicine: Section of General Internal Medicine, New Orleans, Louisiana, USA.
authors.forename: Anjali
authors.initials: A
authors.lastname: Niyogi
authors.affiliation: VOTE (Voice of the Experienced), New Orleans, Louisiana, USA.
authors.forename: Norris
authors.initials: N
authors.lastname: Henderson
authors.affiliation: Tulane University School of Medicine: Section of General Internal Medicine, New Orleans, Louisiana, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Wennerstrom
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D055820:New Orleans; D011329:Prisoners; D036301:Qualitative Research; D000069341:Transitional Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D035502:Trust
keywords: Louisiana; New Orleans; community healthcare; community re-entry; primary care; prison health; social and health services