Justice-Involved Status and In-Hospital Mortality Among Nonelderly Adults During the COVID-19 Pandemic, 2021

Area of Science:

• Public Health
• Health Services Research
• Epidemiology

Background:

• The COVID-19 pandemic significantly impacted healthcare access and outcomes.
• Understanding disparities in mortality risk among vulnerable populations is crucial.

Purpose of the Study:

• To investigate the association between justice-involved status and in-hospital mortality in nonelderly adults.
• To analyze this relationship during the second year of the COVID-19 pandemic.

Main Methods:

• Retrospective cohort study using 2021 State Inpatient Databases from 20 US states.
• Included nonelderly adults (18-64 years) hospitalized for COVID-19.
• Logistic regression analyzed all-cause in-hospital mortality, adjusting for multiple covariates.

Main Results:

• The study included over 4.7 million discharges, with 1.1% justice-involved.
• In-hospital mortality was approximately 40% lower among justice-involved patients (OR 0.6; 95% CI 0.5-0.7).
• The predictive model demonstrated excellent discrimination and good calibration.

Conclusions:

• Justice-involved status was independently associated with decreased in-hospital mortality.
• Further research is recommended to explore pre- and post-discharge outcomes for this population.