People with past or current criminal legal involvement pay significantly more visits to emergency departments
· Medical Xpressedited by Stephanie Baum, reviewed by Andrew Zinin
Stephanie Baum
Scientific Editor
Meet our editorial team
Behind our editorial process
Andrew Zinin
Chief Editor
Meet our editorial team
Behind our editorial process Editors' notes
This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:
fact-checked
peer-reviewed publication
trusted source
proofread
The GIST Add as preferred source
People with a history of criminal legal involvement have higher odds of visiting an emergency department (ED), particularly for substance use and mental health reasons, according to a study published in PLOS One by Vidya Eswaran of Washington University in St. Louis, U.S., and colleagues.
Criminal legal involvement (CLI), defined as ever having been arrested and booked for breaking the law, is a known predictor of adverse health outcomes, with incarcerated individuals suffering a high burden of chronic medical conditions and comorbidities. Previous studies on ED use among people with CLI have focused on cohorts with known and recent incarcerations rather than those with a lifetime history of CLI.
National survey broadens the picture
In the new work, researchers used data from 139,524 adults who participated in the 2021–2023 National Survey on Drug Use and Health, a nationally representative, cross-sectional survey of civilian, noninstitutionalized U.S. residents. Participants self-reported any lifetime and past-year CLI as well as ED visits in the prior 12 months for any reason, for substance use and for mental health.
Of those who reported an ED visit for any reason, 19% reported lifetime CLI and 3% reported past-year CLI. These proportions were higher for substance-use-related ED visits (44% lifetime CLI; 15% past-year CLI) and mental-health-related ED visits (29% lifetime CLI; 8% past-year CLI). After adjusting for sociodemographic and behavioral health factors, those with lifetime CLI had higher odds of an ED visit for any reason (aOR 1.20, 95% CI 1.12–1.29), for substance use (aOR 1.82, 95% CI 1.36–2.43) and for mental health (aOR 1.54, 95% CI 1.19–1.99).
Likely an undercount of need
Because the survey excludes currently incarcerated and housing-insecure individuals, two populations more likely to have CLI and to use EDs, the true prevalence of CLI among ED patients may be higher than these findings suggest. The authors conclude that CLI history should be recognized as a social determinant of health that shapes patterns of ED use, particularly for substance use and mental health care.
The authors add, "In a nationally representative survey, 1 in 5 individuals who have visited an emergency department (ED) report a history of lifetime criminal legal involvement (CLI), which is associated with adverse health outcomes. EDs are uniquely positioned to help address health disparities and should be considered as sites of screening and intervention in collaboration with community partners focused on improving outcomes in this population."
Publication details
Prevalence of criminal legal involvement among emergency department patients: Insights from the National Survey on Drug Use and Health 2021-2023, PLOS One (2026). DOI: 10.1371/journal.pone.0351233
Journal information: PLoS ONE
Key medical concepts
Emergency Service, HospitalMental HealthSubstance Uses
Clinical categories
Emergency medicinePsychology & Mental healthPsychiatryCommon illnesses & Prevention Provided by Public Library of Science Who's behind this story?
Stephanie Baum
Master's in TESOL from The New School. Passionate about language learning and editing science news on biology and space exploration. Full profile →
Andrew Zinin
Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →
Citation: People with past or current criminal legal involvement pay significantly more visits to emergency departments (2026, July 8) retrieved 9 July 2026 from https://medicalxpress.com/news/2026-07-people-current-criminal-legal-involvement.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.