Navigation Link

1215 South Walnut Ave.
Demopolis, AL 36732 map map 

Access to Care: 800.239.2901

Health Policy & Advocacy
Basic InformationMore InformationLatest News
3 Million Americans Say They Carry Handguns Every DayMany Dermatology Guideline Authors Get Industry PaymentsDoctors Urged to Speak With Patients About FirearmsStates That Make You Wait to Buy Guns Have Fewer Deaths: StudyHomicides Devastate Black Communities, But Prevention Gets Little FundingBetter Patient Communication Needed After Urgent CareQuality Issues for Both Paper-, Electronic-Based Health RecordsRide-Sharing Services Could Cut Alcohol-Related CrashesLow-Cost Services a Major Player in Unnecessary Health SpendingMedical License Questions Sway Doctors' Mental Health Help'Heat-Not-Burn Cigarettes' Aiming for U.S. MarketFDA Approves Test to Screen Donated Blood for Zika21 Percent of Americans Report Experiencing a Medical ErrorUber Can Help Cut Car Crashes, But Not EverywhereThe Unexpected Faces of the UninsuredHealth Tip: Giving BloodCommunication Program Doesn't Raise Hospital Liability CostsSame Pregnancy Meds Can Cost $200 -- or $11,000Americans More Open About Mental Health Issues, But Stigma Lingers1 in 5 Have Been Hit By a Medical Error, Survey ShowsOpioid Manufacturers to Provide Doctor TrainingPatients' E-Records Still Not Widely AvailableU.S. Gun Injuries Nearing $3 Billion in ER, Hospital CostsState Laws Can Promote Hepatitis C Virus ScreeningTeens Mixed Up With the Law May Fall Through Medicaid CracksState Policies Can Reduce Alcohol-Related MurdersCDC Launches Opioid Campaign in Hard-Hit StatesU.S. Pays a Hefty Price for ObesityBlacks, Elderly Missing From U.S. Cancer Clinical TrialsFood Stamp Benefits May Lower Health Care CostsDrone Sets New Record for Transporting Blood SamplesGun Injuries Add Millions of Dollars to Hospital CostsACP Does Not Support Legalization of Assisted SuicideAAP: Few Doctors Provide Firearm Injury Prevention Info in ER9 of 10 Docs Unprepared to Prescribe MarijuanaThis Mistake Can Cost Athletes' Lives in Cardiac ArrestDrills Assess ER Response to Communicable DiseaseDo Nursing Home Workers Change Gloves Often Enough?Minorities Exposed to Dirtier Air, U.S. Study FindsPhysicians Tweeting About Drugs May Have Conflict of InterestHealth Tip: Overcoming the Obesity EpidemicU.S. Military Surgeons Helped More Than 6,000 Afghan AdultsWhat You Can Do to Help Fight the Opioid EpidemicAre Physicians Obligated to Help on Planes?Median Cost of Cancer Drug Development $648.0 MillionDoes Study Claim a Cure? Beware of Scientific 'Spin'Vaccine Campaign in Poor Countries to Save 20 Million LivesThird Dose of MMR Vaccine Could Help Curb Mumps OutbreaksDocs Should Be Aware of Family Beliefs Regarding NondisclosureIncrease in Medical Exemptions From Immunization in California
Questions and AnswersVideosLinksBook Reviews
Related Topics

Health Insurance

Teens Mixed Up With the Law May Fall Through Medicaid Cracks

HealthDay News
by By Maureen Salamon
HealthDay Reporter
Updated: Oct 2nd 2017

new article illustration

MONDAY, Oct. 2, 2017 (HealthDay News) -- Teens on Medicaid who have been arrested at least once are more likely to seek costly emergency room care and less apt to receive preventive primary care, a new study suggests.

For the study, researchers reviewed medical and criminal records of nearly 90,000 U.S. youths, aged 12 to 18, on Medicaid. The investigators found those involved with the justice system also had more and longer gaps in Medicaid coverage than peers without arrest records.

"As a psychologist that works with justice-involved youth, the part that didn't surprise me is [they] don't go to the doctor as often and go to the emergency department more than non-justice-involved youth. That's what folks in the field thought to be true for a long time," said study author Matthew Aalsma. He's a professor of pediatrics and psychology at Indiana University School of Medicine.

"What surprised me was ... they're still going to the doctor for an annual visit, just at lower rates," Aalsma added.

Primary care interventions are "really important for everyone to do," Aalsma said. And teens who've been in trouble have higher rates of mental health, physical health, and drug and alcohol use disorders than their peers, the study noted -- issues that could be addressed by a doctor.

"We want to do everything we can to get them to that doctor's visit so we can limit [co-existing health conditions], improve health outcomes and reduce emergency department visits," he added.

More than 900,000 U.S. youths under age 18 were arrested in 2015, according to a commentary accompanying the study. While that number is 68 percent lower than its 1996 peak, it still represents one in every 36 children between ages 10 and 17 -- one in 26 boys, and one in 16 black youths.

Aalsma and his team sought to analyze the relationship between juvenile justice involvement and use of health care services. The term "justice-involved youth" includes a spectrum of teenagers, ranging from those arrested and sent home with a warning to those convicted of violent offenses.

The study examined data on about 88,600 teens enrolled in Medicaid in Marion County, Ind., from 2004 through 2011. About 23 percent of those youths had had a brush with the law.

Health care service use was identified using claims data for Medicaid, the publicly funded insurance program for the poor.

Teens outside the criminal justice system sought annual well-care health visits significantly more than teens in the legal system, the study found. Conversely, teens with a prior arrest had significantly higher annual rates of emergency department visits.

Dr. David Chen, a hospitalist with Christiana Care Hospitalist Partners in Wilmington, Del., has experience caring for kids and adults after incarceration. He praised the new study for focusing on a group typically left out of research efforts.

"What is notable," Chen said, "is the [youths'] decreased use of primary care even though they had Medicaid. It speaks to the importance of having continuity in insurance coverage as well as primary care."

Deena Chisolm is principal investigator at the Center for Innovation in Pediatric Practice at Nationwide Children's Hospital in Columbus, Ohio. Primary health care "is not just important for the health of such youth, but also for their further engagement with the justice system," she said.

"Primary care providers have the potential to identify and address [drug and alcohol] use and behavior health problems that are often the underlying cause of contact with the justice system," added Chisolm, who wrote the commentary accompanying the new research.

Chisolm said the best way to improve the health and health care of justice-involved youth is to prevent them from getting in trouble with the law in the first place.

"The important change is to provide youths with nonjudgmental, integrated care in the settings where the youths feel safe," she said. "Schools, detention facilities and community centers with co-located primary care, behavioral health and social work have the potential to address both health and risk factors for further justice involvement into adulthood."

Aalsma said one "realistic outcome" of his research would be for states to increase efforts to enroll law-involved teens in Medicaid, helping prevent health services gaps.

Other measures to help this group could include increasing their access to school-based health care, the study authors noted. School-based health centers typically offer immunizations, testing for pregnancy and sexually transmitted infections, asthma management and mental health counseling, among other services, which could lower these teens' emergency department use.

The study and accompanying editorial were released online Oct. 2 and will be published in the November print issue of the journal Pediatrics.

More information

The U.S. Department of Education offers tips for teens after incarceration.