Health Services Use Among Jailed Women with Alcohol Use Disorders

  • Christine TimkoEmail author
  • Jennifer E. Johnson
  • Megan Kurth
  • Yael Chatav Schonbrun
  • Bradley J. Anderson
  • Michael D. Stein


Correctional facilities now house unprecedented numbers of women with complex treatment needs. This investigation applied the Behavioral Model for Vulnerable Populations to study 168 jailed women with alcohol use disorders. It described the sample’s predisposing (age, race, victimization), enabling (health insurance), and need (self-reported medical, substance use, and mental health problems) factors and examined associations of these factors with pre-incarceration services utilization. Most participants had clinically significant levels of depression and PTSD symptoms, most took psychiatric medications, and most had been victimized. Participants reported considerable health services utilization. Younger, Black, and uninsured women utilized fewer medical and mental health services. Drug use was associated with less use of medical services, but more use of alcohol and drug services. High rates of health services use support the need for integrated, ongoing care for substance-using women before, during, and after incarceration.



This research was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA; R01 AA021732; PIs Stein and Johnson) and the Department of Veterans Affairs (VA), Health Services Research and Development Service (RCS 00-001 to Dr. Timko). The trial is registered at (Clinical Trials #NCT0197093). NIAAA and VA did not participate in the design, collection, analysis, or interpretation of the data, the writing of the manuscript, or the decision to submit the manuscript for publication.

Compliance with Ethical Standards

Ethical Approval

All procedures were reviewed and approved by the Institutional Review Board of Butler Hospital.

Conflict of Interest

The authors declare that they have no conflicts of interest.


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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection  2018

Authors and Affiliations

  1. 1.Center for Innovation to ImplementationVA Palo Alto Health Care System and Stanford University School of MedicineMenlo ParkUSA
  2. 2.Division of Public Health, College of Human MedicineMichigan State UniversityFlintUSA
  3. 3.Behavioral Medicine and Addictions ResearchButler HospitalProvidenceUSA
  4. 4.Department of Psychiatry and Human Behavior, Alpert Medical SchoolBrown UniversityProvidenceUSA
  5. 5.Department of Health Law, Policy, & ManagementBoston University School of Public HealthBostonUSA

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