AbstractsWomens Studies

Medical records for 129 women incarcerated in a state prison are reviewed to assess the extent and nature of health needs and service use, both at the time of entrance to prison and during 4 months of incarceration. In addition, age, race/ethnicity, prior physical and sexual abuse, prior drug and alcohol abuse, criminal activity, and health need at the time of entrance to prison are examined for association with extent of medical service use. Individual interviews are then conducted with 15 of the women from the larger sample, stratified by race and extent of health service use. Interview questions explore how medical care and the manner in which treatment is provided are perceived by the women, and the nature of the relationship between these perceptions and service use. Descriptive analyses reveal that health needs and service use are extensive with a mean number of 12.7 service encounters in 4 months time. Sixty percent of the sample indicate they have at least one significant medical problem at intake. Statistical analyses reveal that race/ethnicity and an interaction between race and whether one is on medication at the time of admission to prison significantly predict extent of service use. Nonwhites on medication receive the most services on average, followed closely by whites on medication. The gap in number of services between whites and nonwhites not on medication is much greater, with whites receiving almost 5 more services on average than nonwhites. Qualitative analysis of the interview data reveals that nonwhites view the quality of medical care and the manner in which treatment is provided less positively than white inmates. Implications of the findings for health services and program planning for incarcerated women are explored, with an emphasis on targeting limited resources to areas of most need.