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      Associations Between Supported Accommodation and Health and Re-offending Outcomes: a Retrospective Data Linkage Study

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          Abstract

          Following release from prison, housing and health issues form a complex and mutually reinforcing dynamic, increasing reincarceration risk. Supported accommodation aims to mitigate these post-release challenges. We describe the impact of attending Rainbow Lodge (RL), a post-release supported accommodation service for men in Sydney, Australia, on criminal justice and emergency health outcomes. Our retrospective cohort study using linked administrative data includes 415 individuals referred to RL between January 2015 and October 2020. Outcomes of interest were rates of criminal charges, emergency department (ED) presentations and ambulance attendance; and time to first reincarceration, criminal charge, ED presentation and ambulance attendance. The exposure of interest was attending RL; covariates included demographic characteristics, release year and prior criminal justice and emergency health contact. Those who attended RL ( n = 170, 41%) more commonly identified as Aboriginal or Torres Strait Islander (52% vs 41%; p = 0.025). There was strong evidence that attending RL reduced the incidence criminal charges (adjusted rate ratio [ARR] = 0.56; 95% confidence interval [CI] 0.340.86; p = 0.009). Absolute rates indicate a weak protective effect of RL attendance on ED presentation and ambulance attendance; however, adjusted analyses indicated no evidence of an association between attending RL and rates of ED presentations (ARR = 0.88; 95% CI = 0.65–1.21), or ambulance attendance (ARR = 0.82; 95% CI = 0.57–1.18). There was no evidence of an association between attending RL and time to first reincarceration, charge, ED presentation or ambulance attendance. Greater detail about reasons for emergency health service contact and other self-report outcome measures may better inform how supported accommodation is meeting its intended aims.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s11524-023-00824-w.

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          The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement

          Eric Benchimol, Liam Smeeth, Astrid Guttmann … (2015)
          Routinely collected health data, obtained for administrative and clinical purposes without specific a priori research goals, are increasingly used for research. The rapid evolution and availability of these data have revealed issues not addressed by existing reporting guidelines, such as Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The REporting of studies Conducted using Observational Routinely collected health Data (RECORD) statement was created to fill these gaps. RECORD was created as an extension to the STROBE statement to address reporting items specific to observational studies using routinely collected health data. RECORD consists of a checklist of 13 items related to the title, abstract, introduction, methods, results, and discussion section of articles, and other information required for inclusion in such research reports. This document contains the checklist and explanatory and elaboration information to enhance the use of the checklist. Examples of good reporting for each RECORD checklist item are also included herein. This document, as well as the accompanying website and message board (http://www.record-statement.org), will enhance the implementation and understanding of RECORD. Through implementation of RECORD, authors, journals editors, and peer reviewers can encourage transparency of research reporting.
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            Evidence based medicine: what it is and what it isn't

            D L Sackett, W. Rosenberg, J A M. Gray … (1996)
            Article 0 comments Cited 741 times – based on 0 reviews     Review now
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              Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis

              Robert W Aldridge, Alistair Story, Stephen Hwang … (2018)
              Summary Background Inclusion health focuses on people in extremely poor health due to poverty, marginalisation, and multimorbidity. We aimed to review morbidity and mortality data on four overlapping populations who experience considerable social exclusion: homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals. Methods For this systematic review and meta-analysis, we searched MEDLINE, Embase, and the Cochrane Library for studies published between Jan 1, 2005, and Oct 1, 2015. We included only systematic reviews, meta-analyses, interventional studies, and observational studies that had morbidity and mortality outcomes, were published in English, from high-income countries, and were done in populations with a history of homelessness, imprisonment, sex work, or substance use disorder (excluding cannabis and alcohol use). Studies with only perinatal outcomes and studies of individuals with a specific health condition or those recruited from intensive care or high dependency hospital units were excluded. We screened studies using systematic review software and extracted data from published reports. Primary outcomes were measures of morbidity (prevalence or incidence) and mortality (standardised mortality ratios [SMRs] and mortality rates). Summary estimates were calculated using a random effects model. Findings Our search identified 7946 articles, of which 337 studies were included for analysis. All-cause standardised mortality ratios were significantly increased in 91 (99%) of 92 extracted datapoints and were 11·86 (95% CI 10·42–13·30; I 2=94·1%) in female individuals and 7·88 (7·03–8·74; I 2=99·1%) in men. Summary SMR estimates for the International Classification of Diseases disease categories with two or more included datapoints were highest for deaths due to injury, poisoning, and other external causes, in both men (7·89; 95% CI 6·40–9·37; I 2=98·1%) and women (18·72; 13·73–23·71; I 2=91·5%). Disease prevalence was consistently raised across the following categories: infections (eg, highest reported was 90% for hepatitis C, 67 [65%] of 103 individuals for hepatitis B, and 133 [51%] of 263 individuals for latent tuberculosis infection), mental health (eg, highest reported was 9 [4%] of 227 individuals for schizophrenia), cardiovascular conditions (eg, highest reported was 32 [13%] of 247 individuals for coronary heart disease), and respiratory conditions (eg, highest reported was 9 [26%] of 35 individuals for asthma). Interpretation Our study shows that homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals experience extreme health inequities across a wide range of health conditions, with the relative effect of exclusion being greater in female individuals than male individuals. The high heterogeneity between studies should be explored further using improved data collection in population subgroups. The extreme health inequity identified demands intensive cross-sectoral policy and service action to prevent exclusion and improve health outcomes in individuals who are already marginalised. Funding Wellcome Trust, National Institute for Health Research, NHS England, NHS Research Scotland Scottish Senior Clinical Fellowship, Medical Research Council, Chief Scientist Office, and the Central and North West London NHS Trust.
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                Author and article information

                Contributors
                Daisy Gibbs:
                ORCID: http://orcid.org/0000-0002-2116-8190
                daisy.gibbs@unsw.edu.au
                Journal
                Journal ID (nlm-ta): J Urban Health
                Journal ID (iso-abbrev): J Urban Health
                Title: Journal of Urban Health : Bulletin of the New York Academy of Medicine
                Publisher: Springer US (New York )
                ISSN (Print): 1099-3460
                ISSN (Electronic): 1468-2869
                Publication date (Electronic): 13 February 2024
                Publication date PMC-release: 13 February 2024
                Publication date (Print): February 2024
                Volume: 101
                Issue: 1
                Pages: 80-91
                Affiliations
                [1 ]GRID grid.1005.4, ISNI 0000 0004 4902 0432, National Drug and Alcohol Research Centre, ; UNSW Sydney, 22-32 King Street, Randwick, NSW 2031 Australia
                [2 ]National Drug Research Institute, Curtin University, ( https://ror.org/02n415q13) Perth, Australia
                [3 ]Central Clinical School, University of Sydney, ( https://ror.org/0384j8v12) Sydney, Australia
                [4 ]Poche Centre for Urban Indigenous Health, University of Queensland, ( https://ror.org/00rqy9422) Brisbane, Queensland Australia
                [5 ]GRID grid.410559.c, ISNI 0000 0001 0743 2111, Department of Family Medicine and Emergency Medicine, , Universite de Montreal and Centre de Recherche du CHUM, ; Montreal, Canada
                Author information
                http://orcid.org/0000-0002-2116-8190
                Article
                Publisher ID: 824
                DOI: 10.1007/s11524-023-00824-w
                PMC ID: 10897077
                PubMed ID: 38349583
                SO-VID: 9452a37f-ca27-42a6-9235-dc6c63a4573c
                Copyright © © The Author(s) 2024
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date accepted : 19 December 2023
                Funding
                Funded by: Rainbow Lodge PhD Scholarship
                Funded by: FundRef http://dx.doi.org/10.13039/501100000156, Fonds de Recherche du Québec - Santé;
                Funded by: University of New South Wales
                Open Access :

                Open Access funding enabled and organized by CAUL and its Member Institutions

                Categories
                Subject: Original Article
                Custom metadata
                issue-copyright-statement © The New York Academy of Medicine 2024

                ScienceOpen disciplines: Public health
                Keywords: supported accommodation,prison,reincarceration,post-release accommodation
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: supported accommodation, prison, reincarceration, post-release accommodation

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