Forty per cent of people did not visit a family doctor after being released from prison, finds study analyzing 2010 Ontario data

By Jennifer Stranges

About 60 per cent of people who were in Ontario’s prison system were seen by a family doctor in the two years after being released from prison compared to 85 per cent of people in the general population, according to a new study published today in Canadian Family Physician.

The researchers analyzed the experiences of people released from provincial prison in Ontario in 2010, and measured their health care visits two years prior to admission into prison and two years after release. Rates of being seen by a family doctor were only slightly higher after prison release than before admission to prison.

The study, co-authored by St. Michael’s Hospital and ICES researchers and led by McMaster University’s Dr. Fiona Kouyoumdjian, also found that those released from provincial prison were more likely to come from low income neighbourhoods and have a significantly higher prevalence of almost all health conditions examined, including asthma, diabetes, and mental health conditions.

“We found that people in prison were more likely to have chronic health conditions, yet they were less likely to be seen by a family doctor who could help them manage their health,” said Dr. Tara Kiran, one of the authors of the study, who is also a family physician and an associate scientist with the Li Ka Shing Knowledge Institute of St. Michael’s.

“Half of the people in our study were readmitted to prison within two years of release. It begs the question — how many of those readmissions could have been prevented if people had been connected with a family doctor who could support them to manage their depression or substance use?” said Dr. Kiran, who is also an adjunct scientist with the not-for-profit research institute ICES, where the Ontario data were analyzed.

The study also found that 20 per cent of people released from prison accessed primary care through team-based care models, including community health centres and family health teams. The researchers noted that given the high prevalence of physical and mental health conditions in the prison release group, access to team-based care – including social workers – is especially important for that cohort.

Dr. Kiran said more research is needed to understand why people who are released from prison are so much less likely to access primary care. She said the study confirms that people who are in the prison system typically come from a background of poverty, and unfortunately that is likely a determinant of their trajectory in life.

“Society needs to do more to address the root causes of crime and imprisonment, and more structured programs are needed to link people discharged from prison with primary care.”

This paper is an example of how St. Michael’s Hospital is making Ontario Healthier, Wealthier, Smarter.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.