Mapping the Distances From Prisons to Hospitals Providing Obstetric and Neonatal Intensive Care

Area of Science:

• Public Health
• Healthcare Access
• Geospatial Analysis

Background:

• Access to timely obstetric and neonatal care is crucial for maternal and infant health.
• Disparities in healthcare access exist, particularly for incarcerated populations.
• Geographic proximity to specialized medical facilities impacts care delivery.

Purpose of the Study:

• To determine the driving distances from U.S. women's prisons to obstetric and neonatal intensive care units (NICUs).
• To identify potential geographic barriers to perinatal care for incarcerated pregnant individuals.
• To assess state and regional variations in access to essential maternal and neonatal healthcare services.

Main Methods:

• Cross-sectional analysis using the Google Distance Matrix API.
• Calculated driving distances from women's prisons to the nearest in-state obstetric hospitals and Level III/IV NICUs.
• State-level descriptive statistics and Kruskal-Wallis test for regional comparisons.

Main Results:

• Most prisons (98.5%) had in-state access to obstetric care.
• Median obstetric hospital distance was 11.4 miles; median NICU distance was 19.5 miles.
• Significant state and regional disparities were observed, with some prisons facing distances over 100 miles, particularly for NICU access in Alaska, New Mexico, and South Dakota.

Conclusions:

• While most incarcerated women have access to nearby obstetric and neonatal care, significant geographic disparities persist.
• Long driving distances for some facilities can impede timely perinatal care.
• These access barriers may exacerbate existing inequities in maternal and neonatal health outcomes.